From the Guidelines
Patients undergoing liposuction should not necessarily stop taking aspirin, as the risk of bleeding complications is increased by 1.5, but the severity of bleeding complications is not significantly affected, according to the most recent and highest quality study 1. The decision to discontinue aspirin before liposuction should be based on an individualized assessment of the risk of bleeding versus the potential cardiac benefit of continuing aspirin therapy. Aspirin inhibits platelet aggregation, which can lead to excessive bleeding during liposuction, but the risk of severe bleeding complications is not significantly increased. Some studies suggest that aspirin can be safely continued in patients undergoing elective noncardiac surgery, including liposuction, without a significant increase in bleeding complications 1. However, other studies recommend discontinuing aspirin at least 3-5 days before the procedure to minimize the risk of bleeding 1. It is essential to consult with both the surgeon and the prescribing physician before discontinuing aspirin, as they may recommend alternative anticoagulation strategies during this period. Alternative pain relievers like acetaminophen (Tylenol) can be used before and immediately after surgery. Key considerations for the management of aspirin therapy in patients undergoing liposuction include:
- The risk of bleeding complications is increased by 1.5, but the severity of bleeding complications is not significantly affected
- Aspirin should only be discontinued if the bleeding risk outweighs the potential cardiac benefit
- Individualized assessment of the risk of bleeding versus the potential cardiac benefit of continuing aspirin therapy is necessary
- Alternative anticoagulation strategies may be recommended during the perioperative period
- Patients should disclose all medications, including over-the-counter drugs and supplements, to their surgeon during pre-operative consultations.
From the Research
Liposuction and Aspirin
- The use of aspirin in patients undergoing liposuction is a concern due to its effect on hemostasis, and it is often recommended that patients discontinue aspirin therapy before elective surgery 2, 3.
- Studies have shown that aspirin's antihemostatic effect lasts for a certain period after its cessation, with bleeding times normalizing within 96 hours and platelet function tests within 144 hours after stopping aspirin 2.
- The optimal timing for aspirin cessation before liposuction is not well established, but one study suggests that reducing the time of aspirin cessation from 7-10 days to 4-5 days may be possible without increased perioperative complications 3.
- Tranexamic acid (TXA) has been shown to be effective in reducing blood loss during liposuction, with studies demonstrating a decrease in blood loss and bruising tendency in patients receiving TXA 4, 5, 6.
- The use of TXA in liposuction may allow for the aspiration of larger volumes of fat with comparable variation in hematocrit levels, and may also reduce the need for blood transfusions 4, 5, 6.