Aesthetic Reconstructive Jaw Surgery and Dental Implants Blog

Do I need blood transfusion after cosmetic jaw surgery?


bigstock-Asian-doctor-giving-patient-me-61689992Cosmetic jaw surgery is a routinely done throughout the world on a daily basis. The various surgical technqiues have been refined over the years and what use to be complex and unpredictable has evolved into safe and efficient through a better understanding of the anatomy of the face and jaw bones. 

However, the jaw bones are richly supplied by blood vessels and any surgery that involve cutting the bone will entail loss of blood. In particular, upper jaw surgery tend to be more bloody. Unlike many surgeries in other parts of the body where arteries can be identified and tied up before cutting, the arteries supplying the jaws cannot be tied up. The result is that more blood is lost, often necessitating blood transfusion. 

Cosmetic jaw surgery is never an emergency procedure. Being elective in nature, we can plan the surgery way ahead of time. In anticipation of the need for blood transfusion, we usually advise the patient to use autologous blood, i.e. to "deposit" some blood with the blood bank ahead of time for his own use. This is usually done about 3-4 weeks prior to the scheduled date of surgery. The patient will go to the blood bank where they will run the routine tests to determined if he is a suitable blood donor. The patient then "donates" one unit of blood which is about usually about 400-500ml. The body will regenerate the lost blood and a week later, the patient goes to the blood bank to "donate" another unit. The surgery is usually scheduled about 1-2 weeks after the second unit is donated. 

When the patient comes for the surgery, the body would have regenerated the blood to a certain extent though not fully. The blood that is lost during surgery is the diluted blood. Towards the end of the surgery, the patient's own blood is transfused back to him. Using your own blood eliminates the risk of potential cross infection and non-compatibility reactions that may be possible using other people's blood. It also reduces the drain on the blood bank's blood supply, leaving the banked blood for use in emergency situations.  

In most single jaw surgery, blood loss is usually more limited and blood transfusion is usually not needed. For such cases, we usually do not go through the whole process of collecting blood. Instead, blood will be grouped and saved for the patient to be used only when necessary. This can be done a few days before the surgery. For medical tourists who fly in to get their surgery done, autologous blood donation is also not practical as it will require them to fly in several times just for that. As such, most medical tourists usually opt for using blood from the blood bank.

In double jaw surgery or complext upper jaw surgery, blood loss is usually significant and blood transfusion is usually needed. However, with hypotensive anesthesia, whereby the anesthetist lowers the patient's blood pressure during the surgery, blood loss can be kept to a minimum. In some cases, even double jaw surgery may not cause enough blood loss that necesitates transfusion. 

CONCLUSION:

Although jaw surgery procedures have been refined tremendously over the years into predictable and safe operations, it is nonetheless a major operation that entail significant blood loss amongst other impacts on the body. The team of maxillofacial surgeon and anesthetist is the key factor that will determine the outcome of surgery. 

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