Have had 2 breast surgeries, resulting in C-diff post-op. I would like to get a facelift - are antibiotics required?

Question

I am 61 years old, and had Ancef perioperatively and Keflex post op. Otherwise healthy.

Dallas Buchanan, MD · Answer

Thank you for your questions. In general, most surgeons recommend a minimum of a dose of IV antibiotics at the time of surgery as this has been shown to decrease the risk of infections postop. However, every decision comes with risks and benefits and if those doses of medication have resulted in C-diff, maybe it is the lesser of two evils to skip the antibiotic or choose a different one, or pre-treat with another one to prevent the C-diff. This would obviously require a conversation with your plastic surgeon to discuss the risk/benefit ratio.
Good luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Semih Yildiz, MD, FEBOPRAS · Answer

Antibiotic use for a facelift depends on the surgeon's protocol, your specific risk factors, and the details of the operation. Many surgeons use a single perioperative antibiotic dose for clean elective surgery, but a routine multi-day oral antibiotic course is not always necessary. A prior C. difficile infection is important because unnecessary or prolonged antibiotics can increase the chance of recurrence.

Before scheduling surgery, make sure your facelift surgeon knows the exact C. diff history and which antibiotics were used. It would be reasonable for your surgeon to coordinate with your primary doctor or an infectious disease specialist to choose the narrowest effective plan, avoid unnecessary postoperative antibiotics if possible, and give you clear instructions on what symptoms should prompt a call. Do not stop or decline antibiotics on your own; the plan should be individualized before surgery.

Thomas A. Mustoe, MD, FACS · Answer

The answer will vary by surgeon , but the risk of an infection after facelift is extremely low, and I personally do not use antibiotics . Theinfection rate has only been 1 in a thousand in my experience. I do routinely use one dose during surgery which should not put a person at risk for C. difficile..

John Michael Thomassen, MD · Answer

Facelift procedures have very low risk of infection.  Nonetheless, antibiotics are typically given in the perioperative period.  This can be tailored to your particular situation and limited to maybe limited to preop or just a few days postop.

Zoran Potparic, MD · Answer

Antibiotics are given preoperatively for every major surgery, including face lift. Although it may not be necessary to have antibiotics for 3-5 days after surgery (if your surgeon insists on that), I do not think that few days of antibiotics will cause C. diff. related problems. Discuss that issue with your surgeon ahead of surgery. Good luck.

Stephen Prendiville, MD · Answer

Antibiotics during facelift surgery are more based on Surgeon's preference than science, and are most frequently given when implants are p[laced.  The answer is "No", you do not need antibiotics, especially given your history.  It is my preference to administer antibiotics in general during a Facelift, but yo have a very obvious reason for their omission.

Ronald J. Edelson, MD · Answer

C. difficile is usually caused by oral antibiotics. With a facelift you should not need oral antibiotics so the risk of C diff is far less

Ahmad H. Ahmadi, MD · Answer

As you have experienced, C-diff is a GI infection most commonly due to the overuse of antibiotics. Having said that, sometimes antibiotics must be prescribed for a prolonged time, and the consequences must be dealt with. Typically, one dose of Ancef before surgery is enough for a facelift procedure and should not cause another episode of C-diff.

Leo McCafferty, MD · Answer

I believe if you have your facial surgery in a licensed, accredited surgical center using proper sterile techniques an anti-biotic would not be required.  Please consult with a board certified plastic surgeon and confirm that your procedure would be done in a licensed facility and good luck.

Karan Chopra, MD · Answer

I am sorry you had C Diff before. I usually recommend the kit from PostRecoveryMD to my patients it seems to have everything they need for a smooth recovery. Check it out using the link below.

Have had 2 breast surgeries, resulting in C-diff post-op. I would like to get a facelift - are antibiotics required?

Answers (12)

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