Aspirin Therapy, Multimorbidity, andMicrovascular Instability as Predictors ofHematoma after Facial and Body PlasticSurgery

Abstract

Introduction: The rising demand for cosmetic and plastic surgery in urban Kyrgyzstan has increased concerns about post-operative complications, including venous thromboembolism, which is increasingly understood as an inflammation– coagulation “immunothrombotic” process involving endothelial dysfunction and platelet–leukocyte interactions. Objective: This retrospective study assessed the frequency and predictors of complications after facial and body plastic, esthetic, and reconstructive procedures in Bishkek, Kyrgyz Republic. Materials and methods: Pre-operative assessment included history, examination, complete blood count, coagulation profile, biochemistry, and electrocardiogram; smokers were advised to abstain for 3 weeks, and patients on antiplatelet therapy stopped aspirin 7–10 days pre-operatively. Results: Among 370 patients (mean age 55.9 ± 6.81 years; 85.1% women; mean body mass index (BMI) 23.1 ± 3.72; 19.7% smokers; 11.1% aspirin users; 29.7% with multiple comorbidities), 69.7% underwent body procedures and 30.3% facial procedures, with a mean operative duration of 3.7 ± 1.8–4.2 ± 1.3 h. The overall complication rate was 17.0% (63/370), with hematoma (52.4%), anemia (20.6%), chemosis (17.5%), and minor eye infections (7.9%) being the most common; no sepsis or pulmonary embolism occurred, although a fatal case was reported nationally. Univariate analysis revealed that age ≥55 years, BMI >25, aspirin use, and >2 comorbidities were associated with complications. Multivariable modeling identified prior aspirin use (adjusted odds ratio [OR] 4.8; P = 0.01) and multimorbidity (adjusted OR 5.2; P = 0.01) as independent predictors. Hematoma risk was higher with aspirin exposure (adjusted OR 5.3; P = 0.001) and multimorbidity (adjusted OR 2.49; P = 0.001), supporting 1-month pre-operative aspirin cessation and risk stratification. Post- operative complications were noted in 17% of patients undergoing plastic, esthetic, and reconstructive surgery, with hematoma being the most common issue. Conclusion: Post-operative complications were noted in 17% of patients undergoing plastic, esthetic, and reconstructive surgery, with hematoma being the most common issue.