Proper facelift preparation is key to a safe and successful procedure—and that includes managing your current medications. Whether you’re taking prescription drugs, over-the-counter remedies, or herbal supplements, some substances can increase your risk of bleeding, interfere with anesthesia, or delay healing.
Here’s a comprehensive list of the most common medications to stop before surgery, and guidance on when and how to do so safely before your SMAS facelift.
Why Medications Matter Before a Facelift
Certain drugs and supplements can:
- Thin the blood, increasing the risk of hematoma (a blood collection under the skin)
- Affect anesthesia metabolism, leading to complications during or after surgery
- Delay wound healing or increase infection risk
That’s why your surgeon will ask for a full list of all substances you take—including prescription drugs, over-the-counter medications, herbal remedies, and vitamins—during your initial consultation.
Common Medications to Stop Before Surgery
1. Blood Thinners (Anticoagulants and Antiplatelets)
These are among the most important to pause before surgery, as they significantly raise bleeding risks.
Examples include:
- Aspirin (Bayer, Bufferin, Excedrin)
- Clopidogrel (Plavix)
- Warfarin (Coumadin)
- Apixaban (Eliquis)
- Rivaroxaban (Xarelto)
- Dabigatran (Pradaxa)
- Heparin or Lovenox (enoxaparin)
When to stop: Usually 7–10 days prior to surgery, but timing may vary based on your health status and your prescribing physician’s guidance. Never stop these without approval from your doctor.
2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
These pain relievers can increase bleeding and bruising.
Examples include:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
- Diclofenac (Voltaren)
- Indomethacin
When to stop: At least 7 days before your facelift, unless your surgeon instructs otherwise.
3. Herbal Supplements
Many herbal and natural products can thin the blood, raise blood pressure, or interact with anesthesia—even though they seem “harmless.”
Supplements to avoid include:
- Ginkgo biloba
- Garlic (high doses)
- Ginseng
- St. John’s Wort
- Echinacea
- Kava
- Feverfew
- Fish oil or omega-3s
- Turmeric
- Vitamin E (in high doses)
When to stop: Ideally 2 weeks before surgery.
4. Certain Prescription Medications
Some prescription drugs may need to be paused or adjusted before your facelift, depending on your health history.
Examples include:
- Diuretics (may affect fluid balance)
- MAO inhibitors (antidepressants that interact with anesthesia)
- Some anti-diabetic medications (especially if you’re fasting before surgery)
What to do: Your surgeon will coordinate with your prescribing doctor to determine if these should be stopped or adjusted temporarily.
5. Over-the-Counter Products and Combination Meds
Many cold, flu, and pain medications contain ingredients that increase bleeding or interfere with anesthesia.
Examples include:
- Cold and flu medications with aspirin or NSAIDs
- Alka-Seltzer (contains aspirin)
- Excedrin (contains aspirin and caffeine)
- Some sleep aids and decongestants (may elevate blood pressure or cause interactions)
Medications You Should NOT Stop Unless Instructed
- Blood pressure medications: Often continued to maintain stability during and after surgery
- Thyroid medications
- Anti-anxiety medications: May be continued the night before or morning of surgery if prescribed
- Insulin or diabetes medications: Will be adjusted but not necessarily stopped—this must be carefully managed
Always follow your surgeon’s and prescribing physician’s instructions for which medications to pause or continue.
Tips for Safe Facelift Preparation
- Bring a full medication list to your consultation (including dosages and frequency).
- Disclose everything, even if it seems minor (like vitamins or protein powders).
- Use a medication pause chart provided by your surgical team to track what to stop and when.
- Plan ahead—many medications need to be stopped at least 7–14 days in advance.
Final Thoughts
Understanding and managing medications to stop before surgery is an essential part of your facelift preparation. By working closely with your plastic surgeon and your primary care provider, you can minimize risks and ensure a smoother, safer SMAS facelift experience.
