Newly Published Cosmetic Safety Study by Dr. Rod J. Rohrich Supports Protocol for Hypertension Management During Facelift Surgery

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A retrospective review of 1,089 of Dr. Rohrich’s Dallas facelift patients confirms the importance of blood pressure management before, during, and after facial surgery to avoid incidences of postoperative hematomas and suggests an effective algorithm to follow.

Rod J. Rohrich, MD

Rod J. Rohrich, MD

Every surgery is unique, and plastic surgeons should continually study reliable and reproducible methods such as this to determine individual treatment plans and gain the best results for our patients.

More than 1,000 Dallas facelift patients of Dr. Rod J. Rohrich were the subject of a retrospective study of hypertension and post-facelift hematomas reported last month in the Plastic and Reconstructive Surgery journal. Dr. Rohrich is a Dallas plastic surgeon and distinguished professor of plastic surgery in the Department of Plastic Surgery at UT Southwestern Medical Center. The report is based on a multifaceted anti-hypertension regimen Dr. Rohrich used over a number of years to significantly reduce hematomas, a common complication of facelifts. In the report, Dr. Rohrich and his coauthors share an algorithm plastic surgeons can apply as a protocol to reduce postoperative facelift hematomas.

A hematoma is the pooling of blood in the body outside of blood vessels commonly called a blood clot, a common complication of facelifts. Hematomas can lead to a number of postoperative problems, including skin sloughing and edema. According to medical literature cited in the report, incidences of hematomas during and after facelifts range from two to eight percent for women. For men, it is almost 13 percent. The protocol used by Dr. Rohrich before, during, and after the facelift surgeries of his 1,089 patients resulted in hematomas in only .9% of the patients, the lowest rate ever formally recorded.

"This safety outcomes study supports the idea that strict blood pressure control significantly reduces the likelihood a patient will develop a hematoma," Dr. Rohrich said. "Our positive results also suggest the regimen we used could be used by others to help control the occurrence of hematomas after facial surgery." He said the regimen is designed to address each patient’s unique preoperative health condition, as well as the way each person's body reacts during and after surgery. The regimen includes the use of general anesthesia with both preventive and responsive hypertension medicines to keep patients' blood pressure under 140mmHg during and after facelift surgery.

According to Dr. Rohrich, high blood pressure is a well-known risk factor for hematomas. He said medical literature includes other reports by plastic surgeons demonstrating the importance of hypertension control in conjunction with facelifts, but the literature does not include much about specific protocols for reducing the risk of hematomas. This study provides the guidelines for other plastic surgeon to enhance their results and safety with this cosmetic procedure.

"Every surgery is unique, and plastic surgeons should continually study reliable and reproducible methods such as this to determine individual treatment plans and gain the best results for our patients," said Dr. Rohrich. He hopes this will help others performing this procedure enhance their results and reduce their complication rate

About Rod J. Rohrich, M.D., F.A.C.S.

Dr. Rod J. Rohrich is a Distinguished Teaching Professor and Founding Chairman of the Department of Plastic Surgery at UT Southwestern Medical Center in Dallas, Texas. Dr. Rohrich graduated from Baylor College of Medicine with high honors, and completed residencies at the University of Michigan Medical Center and fellowships at Massachusetts General Hospital/Harvard (hand/microsurgery) and Oxford University (pediatric plastic surgery). He has served as president of the American Society of Plastic Surgeons, the largest organization of board certified plastic surgeons in the world. He repeatedly has been selected by his peers as one of America's best doctors, and twice has received one of his profession's highest honors, the Plastic Surgery Educational Foundation Distinguished Service Award, which recognizes his contributions to education in plastic surgery. Dr. Rohrich participates in and has led numerous associations and councils for the advancement of plastic and reconstructive surgery.

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Department of Plastic Surgery