I have SLE (lupus), but it has been under control for the past year and I'm no longer under medication. Is it safe for me to undergo Tummy Tuck?
Can Someone with Lupus Undergo Tummy Tuck?
Doctor Answers 18
Seek medical advice with your treating physicians and a plastic surgeon before to make your decsion.
Even though your lupus (SLE) is under control, I would strongly advise you to first seek opinion(s) with your treating physician(s). Most likely on your medical team are an internist (internal medicine specialist) and a rheumatologist. See them in consultation to see if you are, indeed, a reasonable medical candidate for surgery procedure of this magnitude. It imperative to know what medications your have been on in the past; lupus is usually treatable with steroids and immune-suppressants. This may need to be resumed.
You must remember that lupus is an auto-immune disorder that is multi-systemic, life-long disease without a cure. Because it is an auto-immune disorder, it attacks the body’s cells and tissue, resulting in inflammation and tissue damage. SLE can affect any part of the body, but most often affects the heart, blood vessels, joints, lungs, liver, kidneys, skin, and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remissions.
Currently, you are blessed with your disease process being in remission; however, it could potentially flare in the post-operative period following a tummy tuck. Therefore, it is prudent to have your entire medical team assembled and prepared for any problems that may potentially occur.
Assuming that you are a reasonable medical candidate, there are definite steps and modifications that an experienced plastic surgeon can take to give you the cosmetic outcomes you seek. I would advise that you seek a consultation with a plastic surgeon that is board certified and has vast experience with body contouring procedures, especially tummy tuck and liposuction. Ask to see before and after photographs and get a handle on how many procedures he has performed. Is he prepared to take on your medical problems? This needs to be ascertained.
The likely handling of your case would be similar to that of a chronic smoker. There are numerous options available to make your outcomes suitable and safe. This may include logical things such as staging one major operation into several smaller procedures, and emphasizing more liposuction and simplifying the tummy tuck procedure. Personally over the past three years, I have been performing a new modification of the tummy tuck, called a 'lipoabdominoplasty': which essentially means less cutting away of key tissue and more liposuction, which I perform with the VASER®.
Many thanks for your question. I hope you find this information useful!
Lupus and Cosmetic Surgery
If Lupus is well controlled, a tummy tuck can be done.
Have concurrence by your rheumatologist as part of your preop clearance.
There is a risk of skin loss-Laser Liposuction might be an alternative
I agree with all of Dr. Steven Williams excellent points. Lupus does effect the blood vessels and thus the blood supply to the abdominal skin.
During an abdominoplasty the skin is undermined and removed from many of the blod vessels from the underlying abdominal muscles. Becaue of this the abdominal skin is kept alive by accessory blood vessels coming in from above (the chest), and the sdies (your waist and flanks), where the skin is still attached.
When the tummy tuck is closed, the skin is pulled tight, which also stresses the blood vessels and decreases the blood flow to the skin, especially at the botoom of the abdomen where the incision has been made and the wound is closed with sutures.
In people with compromised blood vessels, smokers, svere diabetics and people with a vasculitis such as Lupus, the above scenario can cause loss of skin at the incision site and occaisionally around the umbilicus.
The one abdominoplasty case in the past 26 yeaqrs that I can remember who lost skin and developed scarring as a result turned out to have undiagnosed Lupus.
This is anecdotal, may be a rarity, but I do not do abdominoplasty on Lupus patients.
If you do not have major loose skin and fat, the newer 924nm and 924/975nm laser liposuction might give you an acceptible result. This is a very specific laser technique and MUST be done by an experienced board certified surgeon. Other laser liposuction techniques do not, in my opinion offer the same results. This patient was 70 years old, could not have an abdominoplasty, but was very happy with the 924nm laser.
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A qualified yes.
Great question Lilliupy -
A general guideline for any elective surgery is that general health be intact and that the risk of the operation be worth the possible benefit.
Lupus - as you well know - is a chronic, multifaceted inflammatory disease that can affect every organ system of the body. Obviously lupus that is not in remission would likely cause me to advise my patients to wait until they have better control of the disease. In addition steroids can be a mainstay of management for patients with lupus - a candidate for abdominoplasty at my practice would need to be in remission and off of steroid based treatments.
In addition careful consideration must be taken in consideration for the risks that lupus poses even to patients that are in remission, specifically -
Are there renal issues?
Are there pulmonary or cardiac issues?
and are there hematologic issues that might pre-dispose a patient to bleeding, anemia or infectious issues.
Also patients with lupus are prone to panniculitis (lupus profundus) - making many seek abdominoplasty or panniculectomy to manage this problem.
The bottom line it is possible but a very careful review of a patient's individual health status is important and you should seek the advice of a board certified plastic surgeon to guide you who should work in combination with the doctor managing your lupus.
Hope this helps.
Steven Williams, MD
Tummy Tuck and Lupus
Can a patient with lupus have a tummy tuck
Provided your lupus is under control, you can have a tummy tuck procedure. You will need to discuss this and have clearance from your rheumatologist prior to surgery. Since you are off your steroid medication you should not have wound healing issues.
Lupus and Tummy tuck
Any autoimmune disease is a concern with major surgery. Performing an extensive procedure will require your body to focus on the healing and any concurrent flare of the lupus may require steroid therapy which can compromise the healing process. Please be prepared for this event and discuss with your rheumatologist.
Lupus and tummy tucks
I have performed tummy tucks on patients with lupus and have had no troubles. You have to have clearance from your private MD first.
Lupus and abdominoplasty
It is advisable to speak to your rheumatologist before undergoing surgery. I have performed an abdominoplasty on patients with lupus and have had no problems. Chronic prednisone use, however, may impair wound healing.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.