Risks of Plastic Surgery on Patient with Lupus and Fibromyalgia

Lupus and fibromyalgia are associated with significant
complications in patients undergoing facelift surgery. Lupus has the potential
to cause constriction of small blood vessels in skin flaps that are elevated
during facelift procedures. This can lead to skin necrosis and skin loss. In
addition both of these diseases have systemic manifestations that effect the
overall health of patients. These diseases may increase the risks of surgery
and general anesthesia.Furthermore
drugs that are frequently utilized to treat these problems may have significant
side effects in patients undergoing cosmetic surgery. Examples include
prednisone which can increase the potential for wound healing problems and
infection and non steroidal anti-inflammatory agents which can increase the
potential for bleeding.For
these reasons patients with systemic Lupus and fibromyalgia aren’t always ideal
candidates for cosmetic surgery. Any patient with lupus who’s considering this
type of surgery should undergo a comprehensive medical evaluation before
proceeding. It’s
important to emphasize that patients need to be honest about their medical
history so they can have the best possible care available. Safety should be
everyone’s’ first priority, especially the patients.

There are always some risks with healing related to lupus and other autoimmune disease of skin, but as long as these disease processes are in remission it is acceptable to proceed with the facial cosmetic surgery. Hiding your medical condition from your surgeon only will harm you

First of all a facelift, all Plastic Surgery for that matter, involves risk. Informed consent for surgical  procedures means that a through medical history and physical exam takes place so that the plastic surgeon can inform the patients on the relative risks of what can go wrong and whether is is worth taking this risk. The rheumatologist, internist,  primary care doctor in general usually gives a surgical clearance and makes sure that the disease process is well under control and may want to adjust medicines before hand or during the peri-operative time period and also be available to help manage complications.

Once that is done - and in my experience plastic surgery of the face can be done by minimizing these risks. Seek the help of a board certified plastic surgeon.

Patients should always work with their surgeons so that they can work together for the best result.  Many times, it may require coordination between the surgeon and the physician taking care of the autoimmune disorder to help optimize a patient for surgery.  This may include cessation of any medication which impairs wound healing.

Cutaneous lupus should be under control and stabilized with clearance by the dermatologist or rheumatologist  before considering a facelift. I would modify the operation by performing a deep plane or composite elevation of the skin and platysma for better vascularization of the flaps with limited underminingMichael  Eisemann M.D.Plastic SurgeonHouston, Texas

Thank you for your question. Especially with
adverse conditions like lupus and fibromyalgia, it would be wise to discuss
specific instructions and concerns with your surgeon. The disease should be
maintained and under control before the surgery is performed.

What you describe is every plastic surgeon's nightmare: that a patient who desires a procedure and has been rejected after disclosing a medical condition will go to another plastic surgeon and intentionally fail to reveal medical conditions that would not be picked up on routine prep testing. I require that my patients complete an extensive medical history form and obtain medical clearance from their personal physicians. I am aware that other surgeons in the area, particularly those who are not board certified in plastic surgery, do not have similar requirements and underplay risks of surgery for patients who have chronic conditions but, as doctors, we must take risks seriously and, in the words of the Hippocratic oath, first do no harm.

It is of utmost importance for potential surgery patients to inform their surgeon of any and all medical conditions.  Otherwise, they placing themselves at risk.  Qualified, Board Certified Plastic Surgeons insist on a complete physical examination including laboratory tests, electrocardiogram, and medical clearance from the patient's personal physician prior to any surgery requiring general anesthesia.   

There are always small risks with healing related to lupus and fibromyalgia, but as long as both of the disease processes are in remission it is acceptable to proceed with the facial cosmetic surgery.

These conditions may affect adversly the safety of a facelift and the healing and the final potential result. Some of this depends on the medications you are on that may decrease your ability to heal (ie Prednisone), and can affect your body's ability to react to stress. You MUST tell your doctor about all of your conditions and you must listen to them if they tell you it isn't safe to do.