Lash extensions are synthetic fibers attached to natural lashes with adhesive. For any procedure requiring general anesthesia or deep sedation, most medical professionals strongly recommend or require their removal beforehand. This policy is based entirely on maintaining patient safety and ensuring the integrity of intraoperative monitoring and surgical conditions.
Why Lash Extensions Interfere with Safety Monitoring
A primary concern is that lash extensions obstruct the medical team’s ability to monitor the patient’s physical status during the procedure. Medical staff must maintain a clear view of the eye and surrounding tissues throughout the surgery. Extensions can hamper the visual assessment of the patient’s pupils, a standard check for neurological status and the depth of anesthesia.
The physical presence of extensions can also interfere with the precise placement of monitoring equipment. In some procedures, specific leads are placed near the face to monitor facial nerve activity. Extensions or their adhesive bases could obstruct the exact placement needed for accurate readings. Furthermore, synthetic materials or metallic components in the extensions can create artifacts or interference with optical monitoring tools.
Anesthesiologists often tape the patient’s eyes shut to prevent drying and corneal injury while the blink reflex is suppressed. The bulk of lash extensions can complicate this process, potentially preventing complete eye closure (lagophthalmos). Incomplete closure increases the risk of corneal abrasion or irritation. If the eyes are taped shut, the adhesive may pull the extensions off upon removal, causing irritation or injury to the natural lashes and eyelid.
Fire and Infection Concerns During Procedures
The materials used in lash extensions and their adhesives pose a significant fire hazard in the operating room. Surgical teams frequently use electrocautery devices, which generate intense heat and electrical sparks. Synthetic fibers are flammable, and the adhesive can act as a fuel source. This risk is amplified when supplemental oxygen is administered near the patient’s face, creating an oxygen-rich atmosphere where a small spark can ignite a flash fire.
Lash extensions also introduce a heightened risk of infection, as they create additional surfaces where bacteria can accumulate. Maintaining a sterile field is paramount, and extensions are difficult to clean adequately with strong surgical prep agents. This bacterial reservoir increases the chance of post-operative eye infections, such as conjunctivitis.
Strong cleaning solutions and skin prep agents used on the face can chemically degrade the lash adhesive. If the adhesive breaks down, extensions may loosen or fall off during the procedure. These small, stiff pieces could fall into the eye, causing corneal abrasions, or migrate into a sterile surgical field.
Pre-operative Instructions and Final Authority
Patient safety protocols at most hospitals include standardized pre-operative checklists requiring the removal of all foreign objects and cosmetics, including jewelry, nail polish, and lash extensions. These instructions eliminate foreseeable risks. Failure to follow these guidelines can lead to delays or the cancellation of a scheduled procedure.
The anesthesiologist is the physician responsible for the patient’s safety and well-being throughout the surgery. This physician holds the final authority regarding the patient’s readiness for anesthesia. If the anesthesiologist determines that extensions present an unacceptable safety risk, they have the authority to insist on their removal or postpone the surgery.
Patients scheduled for surgery should confirm specific preparation instructions with their surgeon’s office or the pre-admission testing nurse in advance. Removing the extensions professionally a week or two before the surgery is the safest course of action. Proactively addressing this detail ensures a smoother experience and avoids last-minute safety conflicts.