Cosmetic Surgery and High Blood Pressure

Patients who are in overall good health are the best candidates for cosmetic surgical procedures. There is much less risk of complications during the surgery, healing time is significantly less, and patients get much better results from the procedures. However, not all prospective cosmetic surgery patients are the picture of perfect health. They may have chronic medical conditions, such as high blood pressure, which puts them at greater risk. Does this mean that such patients should not undergo cosmetic surgery because of the increased risk of complications?

What Is High Blood Pressure?

High blood pressure means that the blood is being pumped through the body at an abnormally high rate. Blood pressure is measured with two numbers. The greater of the two numbers is the systolic pressure, which is the pressure of the blood against the arteries during heartbeats. The lower number is the diastolic pressure, which is the pressure of the blood against the arteries between heartbeats.

Normal blood pressure has a systolic below 120 and a diastolic below 80, such as 117/70. High blood pressure starts with a systolic at 120 to 139 and a diastolic at 80 to 89 (mild pre-hypertension) and can go all the way up to greater than 180 and 110 (hypertension crisis requiring immediate medical care). The American Heart Association has a good summary of high blood pressure.

What Are the Risks of Cosmetic Surgery for Patients with High Blood Pressure?

Because high blood pressure involves the heart, the biggest risk comes from changes to the heartbeat that may occur during surgery due to the anesthetic. The anesthesiologist is responsible for monitoring both respiratory and cardiac function during the procedure. If at all possible, the cosmetic surgeon will avoid general anesthesia, which will increase the risk of a cardiac event during surgery. Many cosmetic procedures can now be done with what is known as twilight anesthesia, where the patient is awake, but completely relaxed and immobile. This is less risky for patients with high blood pressure.

Although high blood pressure by itself may not be a big risk if it is under proper control with medications, there may be an increased risk if the patient is also taking a blood-thinner, such as Coumadin (warfarin). Blood thinners inhibit the blood from clotting, and are usually prescribed to reduce the risk of stroke. However, they will increase the risk for bleeding during a surgical procedure.

Is Cosmetic Surgery Safe for Patients with High Blood Pressure?

Patients with high blood pressure are not at much of an increased risk for complications from cosmetic surgery. However, the key is that such patients must be under the care of a physician for control of their high blood pressure. It is important to discuss any risks from surgery both with the cosmetic surgeon and the primary care doctor. Patients who are not under current medical care for their high blood pressure are strongly encouraged to start treatment for the condition before considering any cosmetic surgical procedure.

Contact Crawford Plastic Surgery to schedule a consultation.