Can I still have an SMAS facelift with well controlled HBP that unfortunately spikes greatly due to GAD?

Question

My BP spikes to around 138/98 or sometimes even higher . I have generalized anxiety disorder and [white coat synd.] In the plastic surgeons office it was 159/106, but after I left I went to have it taken and it was 117/ 72. My surgery is to be done under general anesthesia. It will be a smas facelift/neck lift so around 3 to 4 hours. I am worried about increased risk of hematoma due to my anxiety . What is the best way to combat anxiety ridden BP so that I can still have surgery?

Paul Lanfranchi, DO, FAOCOO · Answer

Thank you for sharing your thoughts and concerns.  Certainly having controlled BP both during and after the procedure is important in helping prevent hematomas and unnecessary swelling.  It is usual to have one's BP increase slightly after a lift simply from the mild/moderate discomfort that occurs normally.  Thus good pain control afterwards would be part of the solution.  Assuming there were no factors that contraindicated their use, for my patients I would prescribe 2-3 days of a mild sedative (ie xanax) to keep them relaxed and not anxious.  However, we perform our procedures under local anesthesia, and thus is it reasonable to prescribe these sedatives afterwards (since we don't need to worry about the after-effects of General Anesthesia).  Having the procedure under general anesthesia may require you to have a discussion with both your PS and anesthesiologist to see if this is indeed an option.

Alejandro J. Quiroz, MD · Answer

Thank you for your question.  The most valuable peace  of information I can give you is to have a complete physical by your internist and also normally prescribe a tranquilizer the day before surgery and give medication as soon  as the patient arrived to the office of course a Board Certified anesthesiologist in keep you overnight for observation

Zoran Potparic, MD · Answer

We routinely give our patients 1 mg of Ativane night before surgery for good sleep and anxiety. Sometimes Xanax is given few days, possibly a week before surgery to help with anxiety. For HBP female patients are given 0.1 mg of Clonidine to take 2 h before surgery it their BP is over 130. When in preoperative area patients are reevaluated and additional BP and anxiety meds are given as needed. Twilight anesthesia may be a better option than general for face/neck lift in patient with elevated BP. Good luck.

William Portuese, MD · Answer

It is probably a good idea to check in with your primary care physician  to make sure your high blood pressure is under control, especially leading up to the surgery. Management of your medications would be a priority, to prevent a hematoma.  If you have significant anxiety, might be best to seek out professional help by a psychiatrist before the surgery. In addition, make sure you tell your operative surgeon about your all your issues to minimize complications and risks

Gaby D. Doumit, MD · Answer

Thank you for sharing your concerns
It is best to have your blood pressure controlled prior to surgery with anti hypertensive medication. 
your anesthesiologist will make sure that it is well controlled during surgery,
It is also essential to control it after surgery
Sincerely
Gaby Doumit MD

Can I still have an SMAS facelift with well controlled HBP that unfortunately spikes greatly due to GAD?

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Answer: Can I still have a facelift with well-controlled high blood pressure?

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Can I still have an SMAS facelift with well controlled HBP that unfortunately spikes greatly due to GAD?

Answers (7)

Answer: Can I still have a facelift with well-controlled high blood pressure?

Answer: Can I still have a facelift with well-controlled high blood pressure?

Answer: Facelift

Answer: Facelift

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Recommended reading

Everything you need to know about SMAS Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.