From the Guidelines
A facial lift under general anesthesia is not considered low-risk for cardiovascular complications due to the potential stress it places on the cardiovascular system and the underlying health conditions of the patients undergoing this procedure. The 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM guideline for perioperative cardiovascular management for noncardiac surgery 1 emphasizes the importance of considering the hemodynamic effects of anesthesia, even in procedures that might otherwise be considered low-risk. General anesthesia can cause vasodilation, blood pressure fluctuations, and changes in heart rate, all of which can increase the risk of cardiovascular complications. Furthermore, facial lift surgery often involves the use of epinephrine for hemostasis, which can temporarily increase heart rate and blood pressure, adding to the cardiovascular risk.
Key factors to consider in assessing the risk of cardiovascular complications in patients undergoing facial lift surgery under general anesthesia include:
- The duration of the procedure, which can extend anesthesia exposure time and increase the risk of complications
- The age and underlying health conditions of the patients, as older adults with pre-existing cardiovascular conditions are at higher risk
- The need for thorough preoperative cardiovascular assessment, including evaluation of cardiac risk factors and possibly an ECG or consultation with a cardiologist
- The potential need for medication adjustments before surgery and more intensive monitoring during the procedure for patients with existing heart conditions
The anesthesiologist plays a critical role in minimizing cardiovascular complications during the procedure through the use of continuous cardiac monitoring, blood pressure management, and careful fluid administration. While guidelines such as the 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery 1 provide valuable insights into risk assessment and management, the most recent and highest quality evidence, such as the 2024 guideline 1, should guide clinical decision-making to prioritize patient safety and outcomes.
From the Research
Facial Lift Under General Anesthesia and Cardiovascular Complications
- The provided studies do not directly address the risk of cardiovascular complications associated with facial lift under general anesthesia 2, 3, 4, 5.
- However, a study on the management of anesthesia and facility in facelift surgery highlights the importance of patient safety and comfort during anesthesia for facial plastic surgery, which may indirectly relate to cardiovascular complications 4.
- Another study discusses the anesthesia management of face-lift patients and describes a protocol that reduces the risk of hematoma, but does not specifically address cardiovascular complications 3.
- A study on the minimal access deep plane extended vertical facelift mentions that the procedure can be performed under local anesthesia, which may be beneficial for patients with cardiovascular concerns 5.
- A separate study on the association of beta-blockers and cardiovascular outcomes after myocardial infarction may be relevant to understanding cardiovascular risk management, but does not directly address facial lift surgery under general anesthesia 6.
Key Findings
- There is limited direct evidence on the risk of cardiovascular complications associated with facial lift under general anesthesia.
- Studies suggest that local anesthesia may be a safer alternative for patients with cardiovascular concerns 2, 5.
- Proper anesthesia management is crucial for reducing complications, including hematoma, during facelift procedures 3, 4.