From the Guidelines
Prior to a blepharoplasty, minimal preoperative testing is typically required for healthy patients, with the decision to perform preoperative testing based on the history and physical examination findings, perioperative risk assessment, and clinical judgment 1. When considering preoperative labs and imaging for a blepharoplasty, it's essential to prioritize the patient's safety and optimize surgical outcomes.
- Basic preoperative labs may include a complete blood count (CBC) to assess for anemia, especially in patients with a history of anemia or significant perioperative blood loss anticipated 1.
- Coagulation studies (PT/INR, PTT) may be reserved for patients who are taking anticoagulants, have a history of bleeding, or have medical conditions that predispose them to coagulopathy (e.g., liver disease) 1.
- An electrocardiogram (ECG) may be ordered for patients over 50 or those with cardiac history, as patients with signs and symptoms of cardiovascular disease should undergo preoperative electrocardiography 1.
- Specific imaging is generally not required for routine blepharoplasty; however, if there are concerns about orbital anatomy or in cases of trauma, a CT scan or MRI of the orbits might be ordered.
- A comprehensive eye examination including visual acuity, tear production testing, and evaluation for dry eye is crucial since blepharoplasty can temporarily worsen dry eye symptoms.
- Patients on blood thinners should have appropriate medication management, typically discontinuing aspirin and NSAIDs 1-2 weeks before surgery.
- The most recent guidelines suggest that routine preoperative laboratory testing is not indicated, and directed testing may be recommended as appropriate for a particular surgical candidate with medical problems 1. The key to preoperative assessment for blepharoplasty is a thorough history and physical examination, with targeted testing based on individual patient risk factors and medical history 1.
From the Research
Preoperative Evaluation for Blepharoplasty
The preoperative evaluation for blepharoplasty plays a crucial role in optimizing outcomes and minimizing morbidity for patients undergoing this procedure 2.
Required Preop Labs and Imaging
While there is no specific study that outlines the exact preoperative labs and imaging required for blepharoplasty, the following can be inferred:
- A complete blood count, peripheral blood smear, prothrombin time (PT), and partial thromboplastin time (PTT) may be necessary to evaluate the patient's bleeding risk 3, 4.
- However, studies have shown that PT and aPTT tests are often unnecessary for preoperative patients without a history of abnormal bleeding or other risk factors 3.
- A thorough medical history and physical examination are essential to identify any potential risks or complications 2, 5, 6.
- Imaging studies may not be routinely required for blepharoplasty, but may be necessary in certain cases to evaluate the patient's anatomy and plan the procedure 5, 6.
Key Considerations
- The patient's medical history, including any history of bleeding disorders or medication use, should be carefully evaluated 4.
- A physical examination should be performed to identify any potential risks or complications, such as mucocutaneous bleeding or hemarthroses 4.
- The patient's anatomy should be carefully evaluated to plan the procedure and minimize the risk of complications 5, 6.