It sounds like you have both. Probably the white coat syndrome is the result of your fear of needles and doctors. Depending upon the doctor you can often take your own blood pressure at home over time and keep a record yourself. That way they see a history of normal blood pressure and they can see that you don’t have hypertension.

The good news is your blood pressure is normally good. Since it spikes when you are in the plastic surgeon’s office that means you are vulnerable to elevations of blood pressure due to stress. There are a couple of ways to deal with this. One is to learn a technique such as slow deep abdominal respiration that has been shown to lower your blood pressure, it is very effective for stress induced blood pressure changes. Once you learn how to breathe abdominally you can then desensitize yourself to the doctors office by first imagining that you are in the doctor’s office while taking your blood pressure and then apply the breathing technique to lower it. You can even go so far as to take your blood pressure yourself in your doctors office waiting room to practice lowering it in that location. This is called ‘situational desensitization’ and can be very effective.

It is entirely possible that this elevated blood pressure was due both to stress and the white coat syndrome. The 140 part is not really a problem, particularly if it occurred just once and the top number goes up with stress quite easily. The part that is concerning here is the 110. The bottom number doesn’t usually go up with stress so I would recommend starting to monitor your blood pressure regularly on your own to see how it is running. That way you can tell if this is an anomaly or if you are moving toward a higher blood pressure.