Taraschi Federico, Botti Chiara, Botti Giovanni
Plastic Surgery Resident, UOSD Chirurgia Plastica, Dipartimento per la Salute della Donna del Bambino e di Sanità Pubblica - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del "Sacro Cuore", Largo A. Gemelli 8, 00168, Rome, Italy.
Plastic Surgeon in Private Practice at VillaBella Clinic, Via Europa, 55, 25087, Salò, BS, Italy.
Aesthetic Plast Surg. 2025 Jun 3. doi: 10.1007/s00266-025-04943-4.
The perioperative management of anticoagulant and antiplatelet therapy in aesthetic plastic surgery is a critical challenge, especially with the increasing demand for cosmetic procedures among elderly patients. Currently, there is a notable lack of consensus in the available literature regarding the optimal perioperative management of these medications in elective aesthetic procedures.
A systematic review of PubMed, Embase, and Cochrane Library databases was conducted up to September 2024 to identify studies addressing anticoagulant and antiplatelet therapy management in aesthetic plastic surgery. Inclusion criteria focused on studies related to perioperative management and bleeding risks in elective cosmetic procedures. Articles unrelated to aesthetic surgery or written in non-English languages were excluded.
From 192 identified studies, 10 were included. Recommendations varied by procedure and patient risk. For high-risk surgeries like facelifts, anticoagulant cessation 48-72 h before surgery was advised. For low-risk procedures like blepharoplasty, continuation of antithrombotics was deemed safe in some cases, but consensus was lacking.
The review highlights a lack of standardization in managing anticoagulant and antiplatelet therapies in aesthetic surgery. There is an urgent need for risk-based guidelines to ensure patient safety and minimize bleeding and thromboembolic risks.
The management of anticoagulant and antiplatelet therapy in aesthetic plastic surgery remains uncertain. Given the elective and aesthetic nature of these procedures, patient safety should always take precedence.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
美容整形手术中抗凝和抗血小板治疗的围手术期管理是一项严峻挑战，尤其是随着老年患者对美容手术的需求不断增加。目前，现有文献中对于这些药物在择期美容手术中的最佳围手术期管理缺乏显著共识。
截至2024年9月，对PubMed、Embase和Cochrane图书馆数据库进行了系统综述，以识别涉及美容整形手术中抗凝和抗血小板治疗管理的研究。纳入标准侧重于与择期美容手术围手术期管理和出血风险相关的研究。排除与美容手术无关或用非英语撰写的文章。
从192项已识别的研究中，纳入了10项。建议因手术和患者风险而异。对于像面部提升等高风险手术，建议在手术前48 - 72小时停用抗凝剂。对于像眼睑成形术等低风险手术，在某些情况下继续使用抗血栓药物被认为是安全的，但缺乏共识。
该综述强调了美容手术中抗凝和抗血小板治疗管理缺乏标准化。迫切需要基于风险的指南，以确保患者安全并将出血和血栓栓塞风险降至最低。
美容整形手术中抗凝和抗血小板治疗的管理仍不确定。鉴于这些手术的择期性和美容性质，患者安全应始终优先考虑。
证据水平IV综述：本杂志要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
