Management of Antiplatelet and Anticoagulant Therapy in Aesthetic Plastic Surgery: A Literature Review.

BACKGROUND

The perioperative management of anticoagulant and antiplatelet therapy in aesthetic plastic surgery is a critical challenge, especially with the increasing demand for cosmetic procedures among elderly patients. Currently, there is a notable lack of consensus in the available literature regarding the optimal perioperative management of these medications in elective aesthetic procedures.

METHODS

A systematic review of PubMed, Embase, and Cochrane Library databases was conducted up to September 2024 to identify studies addressing anticoagulant and antiplatelet therapy management in aesthetic plastic surgery. Inclusion criteria focused on studies related to perioperative management and bleeding risks in elective cosmetic procedures. Articles unrelated to aesthetic surgery or written in non-English languages were excluded.

RESULTS

From 192 identified studies, 10 were included. Recommendations varied by procedure and patient risk. For high-risk surgeries like facelifts, anticoagulant cessation 48-72 h before surgery was advised. For low-risk procedures like blepharoplasty, continuation of antithrombotics was deemed safe in some cases, but consensus was lacking.

DISCUSSION: The review highlights a lack of standardization in managing anticoagulant and antiplatelet therapies in aesthetic surgery. There is an urgent need for risk-based guidelines to ensure patient safety and minimize bleeding and thromboembolic risks.

CONCLUSION

The management of anticoagulant and antiplatelet therapy in aesthetic plastic surgery remains uncertain. Given the elective and aesthetic nature of these procedures, patient safety should always take precedence.

LEVEL OF EVIDENCE IV REVIEW: 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 .