QUESTION: I am in my late 60s and I am considering having a facelift done and my eyebags removed. However, I am hypertensive with blood pressures shooting up to 170mm Hg and was also diagnosed to have diabetes. Can I still have surgery? What complications should I be wary about?
ANSWER: Hypertensive disease and diabetes are not absolute contraindications for surgery, even for cosmetic surgery, like a facelift. In diabetic patients, the main concern among other possible complications is that the wounds may undergo delayed healing or may not heal at all. Medical studies have shown that as long as the blood sugar levels are controlled, wound healing in diabetic patients is comparable to non-diabetic patients.
In patients who are hypertensive, the main concern is the increase in blood pressure during the surgery or immediately after the surgery when the patient would experience post-op pain. If the blood pressure increases, then unwanted bleeding could occur. The other dreaded consequence is a cerebro-vascular accident or a stroke during the surgery or while the patient is recovering. This means the blood pressure increases too high as to cause some blood vessels in the brain to burst and cause deficits or even death. It is because of these complications that we require a medical clearance from the cardiologist and the endocrinologist to determine the risks we are taking if we do surgery in patients with these problems. In practice, with the proper clearance form the internists and proper monitoring with the appropriate equipment, cosmetic surgery can be perform safely with most of the patients following a normal recovery.