Mini Facelift on Warfarin?

Question

Hi. I'm 40 and look younger, but I'm starting to get fat loss but also jowls… i hate it. And double chin. Its just a little bit but its starting, of course. I'm on warfarin for life. I know more and more doctors are trying and considering continuing warfarin (dentists etc). There has been cases of facelifts continuing warfarin on medical literature. My surgeon will do it and he is established and very known. What is the real risk? Only bleeding? stroke is much worse & happened to those bridging..

Jeffrey M. Darrow, MD · Answer

A mini facelift could possibly be performed while on Warfarin, with the understanding of the increased possibility of post operative hematomas and need for reoperation. Minimizing the amount of skin elevation, meticulous hemostasis at the time of surgery, use of hemostatic agents ( intravenous and topical) and a gentle compression dressing all may be helpful to reduce your risk.  Discuss these with your plastic surgeon. Best wishes.

Ronald J. Edelson, MD · Answer

I would never perform a facelift on a patient while they are on warfarin or any other  blood thinner. It’s an absolute dealbreaker. You would need to be off of it for at least one week. If you can’t stop the warfarin you can’t have the surgery

Connie Hiers, MD, FACS · Answer

Since you are on warfarin at age 40, there will always be a risk of stroke. I would suggest trying something less invasive first like radiofrequency with micro-needling or even Renuvion with tiny incisions. You will have to be off warfarin and on Lovenox for surgery.

Manuel Diaz, MD · Answer

Hello dear! Thank you very much for the question! It is not indicated to operate on patients while they are under the use of anticoagulants, if applicable, walfarin.  Please consult your specialist. If you cannot stop its use at least for a while, then you will not be able to undergo plastic surgery. Good luck

Mats Hagstrom, MD (license on probation) · Answer

The face is highly vascular, and I personally would never attempt a facelift with a patient on Coumadin.
The published rate of postoperative bleeding after facelift surgery is 2%.
Postoperative bleeding after facelift surgery can become a surgical emergency, including compressing The airway.
Talk to your surgeon about this.
Best,
Mats Hagstrom MD

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