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Deep Venous Thrombosis and Pulmonary Embolus after Face Lift: A Study of Incidence and Prophylaxis

Reinisch, John F. M.D.; Bresnick, Stephen D. M.D., D.D.S.; Walker, John W. T. M.D.; Rosso, Ronald F. M.D.
Plastic and Reconstructive Surgery: May 2001
Cosmetic: PDF Only

Deep venous thrombosis and pulmonary embolus are known risks of surgery. However, the incidence of these conditions in face lift is unknown. In this study, the incidence of deep venous thrombosis/pulmonary embolus after face lift is studied and factors associated with thromboembolic complications are evaluated. One-third of the active members of the American Society for Aesthetic Plastic Surgery were randomly selected. Participating surgeons completed a one-page survey providing information on face-lift procedures during a 12-month study period. A response rate of 80 percent was achieved, with 273 of the 342 surgeons responding to the survey. A total of 9937 face-lift procedures were reported in the 1-year study period. There were 35 patients with deep venous thrombosis (0.35 percent), 14 patients with pulmonary embolus (0.14 percent), and 1 patient death in the series. Although 43.5 percent of patients underwent face lift under general anesthesia, 83.7 percent of deep venous thrombosis/pulmonary embolus events occurred with general anesthesia. For prophylaxis for deep venous thrombosis/pulmonary embolus, 19.7 percent of the surgeons used intermittent compression devices, 19.6 percent used thromboembolic disease hose or Ace wraps, and 60.7 percent used no prophylaxis. Of patients developing deep venous thrombosis/pulmonary embolus, 4.1 percent were treated prophylactically with intermittent compression devices, 36.7 percent with thromboembolic disease hose/Ace wraps, and 59.2 percent with no prophylaxis. It was found that deep venous thrombosis/pulmonary embolus after face lift is a measurable complication experienced by one of nine surgeons surveyed. Deep venous thrombosis/pulmonary embolus is more likely to occur when the procedure is performed under general anesthesia. The majority of plastic surgeons surveyed used no prophylaxis for deep venous thrombosis when performing face-lift procedures. Intermittent compression devices were associated with significantly fewer thromboembolic complications, whereas Ace wrap/thromboembolic disease hose afforded no protection against deep venous thrombosis/pulmonary embolus when used alone. In conclusion, aesthetic surgeons should consider adopting intermittent compression devices when performing face lift under general anesthesia. (Plast. Reconstr. Surg. 107: 1570, 2001.)

From the Division of Plastic Surgery, University of Southern California Keck School of Medicine, and Children's Hospital Los Angeles. Received for publication August 10, 2000; revised September 28, 2000.

Presented at the Annual Meeting of the American Association of Plastic Surgeons, in Montreal, Quebec, Canada, in 1998.

John F. Reinisch, M.D.

Division of Plastic Surgery

Children's Hospital Los Angeles

Mailstop #96

4650 Sunset Boulevard

Los Angeles, Calif. 90027

©2001American Society of Plastic Surgeons