The Role of Blood Pressure Control in Prevention of Hematoma After Blepharoplasty

Makenna Ash; Orr Shauly; Courtney Swan; Ambika Menon; Charles Schafer; Foad Nahai

doi:10.1007/s00266-024-04072-4

The Role of Blood Pressure Control in Prevention of Hematoma After Blepharoplasty

Aesthetic Plast Surg. 2024 May 7. doi: 10.1007/s00266-024-04072-4. Online ahead of print.

Authors

Makenna Ash¹, Orr Shauly², Courtney Swan³, Ambika Menon¹, Charles Schafer³, Foad Nahai³

Affiliations

¹ Emory University School of Medicine, Atlanta, USA.
² Department of Plastic and Reconstructive Surgery, Emory University, 2015 Uppergate Drive, Atlanta, GA, 30322, USA. Orr.damien.shauly@emory.edu.
³ Department of Plastic and Reconstructive Surgery, Emory University, 2015 Uppergate Drive, Atlanta, GA, 30322, USA.

PMID: 38714536
DOI: 10.1007/s00266-024-04072-4

Abstract

Introduction: Hematoma formation after blepharoplasty is serious and potentially vision-threatening, with hypertension being the primary risk factor. The aim of this paper is to assess perioperative blood pressure trends and rates of complication in patients undergoing a strict blood pressure protocol designed to keep perioperative systolic blood pressure below 120 mmHg.

Methods: A retrospective chart review was performed of 32 patients undergoing face lift with conomitant blepharoplasty from January 2015 to July 2018. For each patient blood pressure readings obtained before, during, and after surgery were reviewed. Two-sample one-tail T-tests were performed, and p values less than 0.05 were considered statistically significant.

Results: The mean systolic blood pressure (SBP) for all patients was highest intraoperatively. Patients with known hypertension had higher mean SBPs than patients without hypertension across all phases of care, with a statistically significant difference in immediate preoperative SBP (p=0.05). Males had a higher average blood pressure immediately postoperatively (p=0.05). A previous diagnosis of hypertension in females was associated with a higher immediate preoperative SBP (p=0.07) as well as age over 65 (p=0.07). The overall rate of complications was 37.5%. No patients experienced hematoma.

Conclusion: This study demonstrated that keeping blood pressure below 120 mmHg after surgery was an effective method of preventing hematoma after blepharoplasty, even in patients concurrently on anti-coagulative medications. Special attention to blood pressure control should be shown to patients with known risk factors such as a previous diagnosis of hypertension, male sex, or age greater than 65.

Level of evidence iii: 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 .

Keywords: Blepharoplasty; Cosmetic surgery; Hematoma; Hypertension.