Facelift VTE complication risks revealed
MedWire News: Longer operations and concurrent procedures are significant risks for venous thromboembolism (VTE) in patients undergoing facelifts, research shows.
"In light of our findings and the previously published literature, we can say that the risk of VTE in facelift patients is real and should inspire us to concentrate on preventive efforts," write Nour Abboushi (Paces Plastic Surgery, Atlanta, Georgia, USA) and colleagues in Aesthetic Surgery Journal.
In addition, patient age (>55 years), a history of aspirin use, and higher body mass index (BMI) were independent risks for developing complications, the most common complication being hematoma.
In the USA, more than 1.6 million cosmetic surgical procedures were performed in 2010, an increase of 9% compared with the previous year. In 2010, more than 127,000 facelifts were performed, a number that has increased almost 30% since 1997.
In the current analysis, Abboushi and colleagues examined the operative results in patients undergoing facelifts at a private facility to determine the overall complication rate and the specific risks for VTE.
Between 2004 and 2010, 630 patients underwent a facelift procedure. The mean age of the patients was 58.4 years and 8.1% were men. Of those treated, 23.6% of the patients underwent concurrent procedures. The mean operating time was 4.2 hours.
Complications occurred in 38 (6%) patients and the most common postoperative complication was hematoma (4.6%). Two (0.3%) patients developed postoperative deep vein thrombosis (DVT) and no pulmonary embolisms were reported. Both patients had undergone facelift in combination with another procedure, with surgery lasting more than 5 hours.
Patients older than 55 years had a significantly higher risk for complications than younger patients (7.3 vs 2.8%), as did those who took preoperative aspirin (27.2 vs 5.2%), and those with a BMI above 25 kg/m2 (9.5 vs 4.7% for those with a BMI <25 kg/m2).
Overall, the risk for hematoma was significantly higher in men than women (11.7 vs 3.9%), as well as in patients taking aspirin and those with a history of hypertension. Patients with a BMI greater than 25 kg/m2 were also at a higher risk for developing a hematoma.
For patients at risk for VTE, the "administration of pharmacologic prophylaxis must be weighed against the postoperative risk of hematoma," write Abboushi and colleagues. They advise applying risk-stratification models developed in other surgical disciplines to help guide therapy.
By MedWire Reporters