Facelift Complications Related to Median and Peak Blood Pressure Evaluation

Maricevich, Marco; Adair, Marcus J.; Maricevich, Renata L.; Kashyap, Rahul; Jacobson, Steven R.

doi:10.1007/s00266-014-0353-z

Cited by 21 publications

(18 citation statements)

References 21 publications

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“…15 Studies have demonstrated that post-operative hematomas in surgery can occur frequently in the first 48 hours after surgery, but factors influencing these events are still not fully elucidated. 16, 17 One proposed theory is that inadequate post-operative pain control could lead to postoperative hypertension and possibly increase risk for bleeding. Better pain control, therefore, may reduce bleeding incidence, thus overruling the anti-platelet effects from NSAIDs.…”

Section: Discussionmentioning

confidence: 99%

Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis

Kelley

Bennett

Chung

et al. 2016

Plastic &Amp; Reconstructive Surgery

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Background Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are common medications with multiple useful effects including pain relief and reduction of inflammation. However, surgeons commonly hold all NSAIDs peri-operatively because of bleeding concerns. However, not all NSAIDs irreversibly block platelet function. We hypothesized that the use of ibuprofen would have no effect on postoperative bleeding in plastic surgery patients. Methods A literature review was performed using Medline (PubMed), EMBASE, and the Cochrane Collaboration Library for primary research articles on ibuprofen and bleeding. Inclusion criteria were primary journal articles examining treatment of acute postoperative based on any modality. Data related to pain assessment, postoperative recovery, and complications were extracted. Bias assessment and meta-analysis were performed. Results A total of 881 publications were reviewed. Four primary randomized controlled trials were selected for full analysis. Articles were of high quality by bias assessment. No significant difference was noted regarding bleeding events (p = 0.32) and pain control was noted to be equivalent. Conclusion Ibuprofen is a useful medication in the setting of surgery with multiple beneficial effects. This meta-analysis represents a small set of high quality studies that suggests ibuprofen provides equivalent pain control to narcotics. Importantly, ibuprofen was not associated with an increased risk of bleeding. Further large studies will be necessary to elucidate this issue further, but ibuprofen is a safe postoperative analgesic in patients undergoing common plastic surgery soft tissue procedures.

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Section: Discussionmentioning

confidence: 99%

Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis

Kelley

Bennett

Chung

et al. 2016

Plastic &Amp; Reconstructive Surgery

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“…The association of elevated blood pressure with increased incidence of hematoma in facelifts has been well documented. [6][7][8][9][10][11] Baker et al demonstrated over a 30-year period a decreased hematoma rate from 8.7% to 3.97% in male facelifts with the implementation of perioperative blood pressure control. 3 Ramanadham et al reported a hematoma rate of 0.9% in a study of 1089 facelift patients treated with a perioperative medical regimen aimed to mitigate factors that precipitate elevated blood pressure, such as pain, anxiety, nausea, and exposure to anesthesia.…”

Section: Blood Pressurementioning

confidence: 99%

Methods for Minimizing Bleeding in Facelift Surgery: An Evidence-based Review

Tiourin

Barton

Janis

2021

Plastic and Reconstructive Surgery - Global Open

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INTRODUCTIONFacelifts are in the top five aesthetic procedures performed in plastic surgery. In 2019, almost 124,000 facelifts were performed in the United States per the American Society of Plastic Surgery. 1 Bleeding and hematomas arise in facelift surgery secondary to disrupted vascular and lymphatic networks as skin flaps are elevated, which may lead to postoperative complications and unsatisfactory patient outcomes. 2 Hematoma is the most common postoperative complication in facelifts with a reported incidence from 0.2% to 8%. 3 The pressure of an expanding hematoma on the overlying skin flaps may decrease arterial perfusion, cause venous congestion, and increase inflammation that may lead to skin irregularities. While expanding hematomas require immediate re-exploration, minor hematomas of smaller volume may be aspirated. Predisposing risk factors to hematoma in facelift surgery include male gender, history of hypertension, and coagulopathy. 4 Multiple methods have been developed, and new evidence continues to be generated about how to best manage bleeding in facelifts. This literature review aims to summarize evidence-based methods in minimizing bleeding and postoperative hematoma in facelift surgery. METHODSAn evidence-based review of methods used to minimize bleeding in facelift surgery was conducted using the PubMed database adhering to PRISMA guidelines (Fig. 1). Inclusion criteria entailed randomized controlled trials, prospective/ retrospective cohort and case-control studies, and case series. Exclusion criteria included (1) lack of availability Disclosure: Dr. Jeffrey Janis receives royalties from Thieme and Springer Publishing.

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“…A 2014 retrospective review identified a history of hypertension, a preoperative SBP greater than 160 mm Hg, and an operating room peak SBP greater than 165 mm Hg as predictive risk factors for hematoma. 10 Strict perioperative blood pressure control, including preoperative clonidine administration, has been shown to reduce hematoma incidence in male patients. 4 , 6 Additionally, postoperative blood pressure control with intravenous labetalol and hydralazine significantly decreases the incidence of hematoma in both female and male patients.…”

Section: Common Complicationsmentioning

confidence: 99%

How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications

Sinclair

Coombs

Kwiecień

2021

Aesthetic Surgery Journal Open Forum

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Facelift Complications Related to Median and Peak Blood Pressure Evaluation

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 21 publications

References 21 publications

Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis

Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis

Methods for Minimizing Bleeding in Facelift Surgery: An Evidence-based Review

How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications

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