How Daily Aspirin Users can Undergo Eye Bag Surgery and Other Cosmetic Procedures

How Daily Aspirin Users can Undergo Eye Bag Surgery and Other Cosmetic Procedures


Thank you for your question. You submitted your question with several photos
and you state in your question that you’re 34-years-old and that you had a stroke 6 years
prior and that you’re fully recovered and that you’ve developed these under eye bags.
And you’re asking can you still have surgery or fillers given that you take aspirin every
day. Well, I can certainly help you with this question
by explaining what I do in my practice. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have
been in practice in Manhattan and Long Island for over 20 years. Helping people with under
eye aesthetics has been a significant part of my practice and I’m very busy with both
the surgical solutions as well as the use of injectable fillers in my practice to help
people with situations similar to yourself. So to begin with, it’s important for there
to be an understanding as to the situation that you had where you had a stroke and you
were on aspirin whether or not your doctor is comfortable with you being off aspirin
for how long. Basically the concern is about bleeding. And it is not unusual for someone
who has to take aspirin daily to still have procedures whether it’s aesthetic or otherwise
by staying off the aspirin for several days. It is sometimes important for people to do
this before dental procedures as well as medical procedures for routine health maintenance
such as colonoscopy. So it would be a discussion with your doctor as to how comfortable the
doctor is with you being off aspirin. Given that you had a stroke, it is important
to also understand whether or not that holding off of aspirin will put you in any significant
relative risk. I would say that in general speaking, because of the effect of aspirin
on blood clotting that in my experience, that person who is off aspirin for a few days,
generally, we ask 5-7 days is that they still have an effect on the clotting because there
is also the effect that is also 30 days on the platelets. So that being said, there is
still a certain amount of blood thinning that is still present even when you are off aspirin
for a few days. Again, every situation is handled on a case by case basis but we have
a lot of patients who have had similar stories and they were on aspirin for a variety of
reasons whether it’s for cardiac stents or whether they have had issues with the carotid
artery. There are a lot of indications for being on daily aspirin. So, as far as options whether it is injectables
or surgery, this requires an understanding of what your outcome can be. A lot of times
when someone has a mild amount of puffiness under their eyes, injectable fillers can be
very effective. Understanding that when you have injectable fillers, you can still be
at risk of bruising that is, because you are entering the skin, what I would say is that
there are different ways to do the injectable fillers so that you can actually minimize
the bruising. I routinely use something called blunt cannulas when I do fillers under the
eyes and I find that it just works out so well and is so precise and I do so much of
it that it’s become fairly routine and usually bruising is not much of an issue at all. Even with surgery, the techniques employed
during surgery and the way we do lower eyelid surgery under local anesthesia with LITE™
IV sedation, we actually minimize the risks of bleeding just in the process of surgery
itself as well as in the recovery from the sedation. A lot of times, my colleagues want
to put patients under general anesthesia and people who have been on blood thinners, when
they’re waking from general anesthesia, unfortunately there’s a risk of coughing
that can be significant that can be potentially lead to bleeding. When we do our procedures
under local anesthesia with sedation, coughing is not really much of an issue. Of course,
people can still cough but not the way that they would after a tube is removed from their
throat after general anesthesia. Of course, anesthesiologists would of course counter
that you can put people under a deeper state and take the tube etc. But these are things
that we’ve learned to just not need to depend on. The point is that in the right scenario, you
can do either. But I think it’s generally what I counsel my patients is to do whatever
is the least invasive first and then accomplish an outcome that you will be comfortable with
and happy with, then you can start with something like injectable fillers first. It can be very
effective as long as the puffiness is not too prominent. Once it’s too prominent,
then it’s not really that useful to do fillers. You have to do a cosmetic surgical procedure So I would say meet with qualified, experienced
cosmetic surgeons who perform a lot of eyelid rejuvenation both the injectable fillers and
with surgery and see what kind of impression you get and take it from there. Again, the
answer to the aspirin question is a question that really is between your doctor’s level
of comfort of having you off aspirin. But invariably, especially for someone as young
as yourself, as you get older, there are going to be necessary times where holding aspirin
will be appropriate for medically indicated procedures. So just to understand that context
and you’ll probably get an answer as to how comfortable your doctor is as far as the
relative risk of having another cerebral event. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

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