Study Examines Postoperative Risks Associated with Antidepressants in Aesthetic Facial Surgery

A large retrospective cohort study published online ahead of print in the Journal of Craniofacial Surgery evaluated whether preoperative antidepressant therapy is associated with postoperative complications after aesthetic facial plastic surgery procedures.

Investigators used the TriNetX Research Network to identify patients undergoing rhinoplasty, blepharoplasty, or rhytidectomy. Antidepressant exposure was defined as documented use within 6 months before surgery and included selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, and atypical antidepressants. Propensity score matching was performed in a 1:1 ratio to balance demographic and clinical variables between cohorts.

After matching, 18,064 patients were included in each group. At 1 year, patients with antidepressant exposure experienced higher rates of any surgical site complication compared with controls (3.40% vs 2.30%; risk ratio [RR], 1.48; 95% CI, 1.30-1.69; P < .0001). Infection rates were also elevated in the antidepressant cohort (3.19% vs 2.21%; RR, 1.44; 95% CI, 1.26-1.65; P < .0001).

Additional postoperative complications included wound-related complications (1.22% vs 0.91%; RR, 1.34; P = .0047), seroma or hematoma formation (0.28% vs 0.16%; RR, 1.73; P = .0175), and unplanned readmission (3.85% vs 3.27%; RR, 1.18; P = .0114). According to the authors, infection remained the most consistent complication signal across all postoperative follow-up intervals evaluated, including 30 days, 90 days, 6 months, and 1 year.

The authors concluded that “preoperative antidepressant exposure was associated with increased postoperative morbidity following aesthetic facial plastic surgery.” They added that the findings underscore the importance of incorporating antidepressant use into perioperative risk assessment and patient counseling.

Source

Psychiatric comorbidities requiring antidepressant therapy and their impact on wound healing and postoperative complications in facial plastic surgery: a propensity-score matched analysis. J Craniofac Surg. Published online May 11, 2026. doi:10.1097/SCS.0000000000012791