Can you have a breast augmentation with Rheumatoid Arthritis? PS called & said he & my Rheumy agree that it is not a good idea.

Question

I went to see a Surgeon in regards to a BA. I was honest w/ him in regards to my health. I'm 24 yrs old diagnosed w/ Rheumatoid Arthritis 8 yrs ago. I take Enbrel & Mxt. The PS wanted a letter from my Rheumy (rheumy told me just to w/hold meds 4 wks before surgery) he never told me not to do the surgery. PS said they don't know how my body will react to a foreign object, so obviously he refused to do it. Can I safely have this surgery? I'm very upset this disease is holding me back AGAIN!

Jose M. Soler-Baillo, MD, MS · Answer

Please follow up with your rheumatologist regarding this question. I cannot give you adequate advice about this manner through an internet service. All the best,Dr. ResultsMiami, FL

Kevin G. Rose, MD · Answer

Thanks for the question. RA is so troublesome for patients! However, the good news is that most recently, RA has been linked to leaky gut syndrome, NOT silicone breast implants. Look up Dr. Steven Gundry. He wrote a book which is on the NY Times best seller list called “The Plant Paradox”. I highly recommend it! It will change your life! Silicone is an inert substance and as such can not contribute to disease. Saline implants have a silicone shell as well, so either way you would be getting silicone implanted. If you are dead set against implanted silicone then the best thing to do is to use your own fat and do an autologous fat transfer assuming you have enough fat stores to do so. The limitation being the total fat that can be transferred at one time. Most patients would benefit from two stages if they don’t have access to the BRAVA device which expands the space for fat transfer. Good luck!

Jose Perez-Gurri, MD, FACS · Answer

Hi. Studies done way back failed to prove any causal relationship between siliocne gel implnats and any of the Collagen Vascular diseases such as RA. IMHO you can have your breast augmentation done without any problem whatsoever. As a matter of gact, I have done afew patients through the years. If you have concerns about using siliocne gels then use saline.I am certified by the American Board of Plastic Surgery and have practiced in the"land of breast implants", Miami, for the past 29 years. I encourage you to look up the surgeon you eventually select and make sure they have years of experience in performing cosmetic breast surgery. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits?How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.I wish you the best on your journey. I hope that the info provided has been helpful. Should you require any further clarification, do not hesitate to contact our institute. I answer all questions personally, not through patient coordinators or other marketing individuals.In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up. Good luck Dr PG

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Generally speaking, breast augmentation surgery can be performed for most patients with rheumatoid arthritis; careful management of medications will be important (communication between rheumatologist and plastic surgeon is helpful).  In your case, you may wish to ask  your physicians for clarification of their rationale and seek second  opinion consultations if necessary.  Best wishes.

Melinda Haws, MD, FACS · Answer

Yes! Patients with RA can have Breast augmentation, you just have to stop those medications that prevent inflammation enough time before surgery so that the good inflammation of wound healing can occur.  You then need to wait a little while after surgery to restart.  You and your rheumatologist  need to discuss whether withholding those meds is worth it too you and what the downside would be.  And I have to agree with the other docs that there has been no study showing exacerbation of RA with the Breast implants themselves.  All that being said,  it doesn't sound like your first plastic surgeon is comfortable with performing this procedure on you.  I would seek another opinion or double check with your rheumatologist.  I hope this helps.

Robert Brueck, MD · Answer

If you are otherwise healthy and you get medical clearance I think you can proceed.There will be a slight increased risk for problems with wound healing but I think you would be safe if you are willing to accept a slight increase in risk.

Darryl J. Blinski, MD · Answer

If your Rheumatologist has given written medical clearance and instructions on meds than I see no reason not to offer you this operation. But YERS you have a higher risk of issues postoperatively. So if you are willing & understand ythese risks than I see NO reason not to operate. Seek other boarded "private practice' PS opinions in person.

Joseph Franklin, MD · Answer

If two experienced and board certified physicians are telling you NOT to undergo a procedure, then you should take their advice.   The problem with holding your medication is that you may experience a flare of your disease.   The problem with taking MTX and Enbrel is that they can cause would healing problems.

Can you have a breast augmentation with Rheumatoid Arthritis? PS called & said he & my Rheumy agree that it is not a good idea.

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