High blood pressure (hypertension) is one of the most common conditions and is routinely included in the medical history for almost every surgical procedure. With an eyelid surgery this is no different, and it is even more relevant, because the blood vessels around the eye are small and sensitive.
In this blog, you can read why blood pressure plays such an important role in eyelid surgery and how we deal with it at Kliniek het Bolwerk.
Why is blood pressure relevant with an eyelid correction?
Hypertension is seen as the most important risk factor for the arising of a bruise (haematoma) after an eyelid correction. A haematoma behind the eye (retrobulbar haematoma) is rare, but can in serious cases threaten eyesight [1,3].
Research shows that an elevated blood pressure during and directly after the operation is related to a greater chance of secondary bleeding. In a study in which the blood pressure after the operation was kept strictly below 120 mmHg (systolic), no haematoma occurred in any of the patients, not even in patients who used blood thinners [1]. Fluctuations in the blood pressure during the procedure itself also turn out to be a predictive factor for secondary bleeding [2].
Points of attention
- A well-regulated blood pressure before the procedure reduces the risk of bleeding complications [1,2,4]
- Sudden blood pressure fluctuations during the procedure increase the risk of a haematoma, even more than a slightly elevated starting value [2]
- Hypertension also increases the risk of swelling after eyelid corrections [4]
- Stress and tension around the procedure can temporarily increase the blood pressure; a calm, relaxed preparation helps
Discuss it in a personal consultation with plastic surgeon David Jairath, at our clinic for eyelid surgery in Haarlem. A first consultation can usually take place within a week.
Our protocol at Kliniek het Bolwerk
1. Extensive medical history and blood pressure measurement
We ask about your blood pressure history, medication use and how well your blood pressure is currently regulated. Let us know whether you have high blood pressure and how you are treated for it. If you are in doubt about whether you have high blood pressure, then let us know. It is a small effort to measure this for you.
2. Medication continues
Blood pressure medication is, as a rule, simply continued on the day of the procedure, in consultation with your plastic surgeon, GP or cardiologist; stopping can actually have a counterproductive effect [2].
3. Blood pressure monitoring during the procedure
If you have a strongly elevated blood pressure, we monitor your blood pressure during the procedure and try to prevent fluctuations, in line with the insights from recent research into haematoma formation [1,2]. This is also sometimes difficult because the measuring can actually have a blood-pressure-raising effect due to extra stress.
4. Rest after the procedure
We give you clear instructions about resting, not bending over or straining, and how to act in the case of a sudden rise in blood pressure after the procedure, because precisely the first few hours after the operation are important [1,2].
Important: well-regulated hypertension is not a contraindication for an eyelid correction, but an untreated or poorly regulated high blood pressure increases the risk of secondary bleeding considerably and requires postponement.
When do we advise against the procedure (for the time being)?
- In the case of a strongly elevated blood pressure that is not yet under treatment
- In the case of an unstable or difficult-to-regulate blood pressure [2]
- In combination with blood thinners without prior consultation with the prescribing doctor [3]
- If your GP or cardiologist advises against the procedure at this time
Our advice
Do you have high blood pressure and are you considering an eyelid correction? Have your blood pressure properly checked beforehand by your GP and bring this information to the intake consultation. During a consultation at Kliniek het Bolwerk we discuss together how we can make the procedure proceed as safely as possible.
Literature references
The publications below form the medical-scientific basis of this article:
- The Role of Blood Pressure Control in Prevention of Hematoma After Blepharoplasty. Aesthetic Plastic Surgery. 2024. https://link.springer.com/article/10.1007/s00266-024-04072-4
- Intraoperative Systolic Blood Pressure as a Significant Predictor of Postoperative Hematoma Following Facelift. Aesthetic Surgery Journal. 2024. https://academic.oup.com/asj/article/45/1/11/7737433
- Complications of Blepharoplasty: Prevention and Management. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC3357590/
- Risk factors for early eyelid swelling following blepharoptosis surgery: A retrospective study. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828529/
