Planning on having facelift/neck lift/blepharoplasty. Does this pin need to come out first? (Photo)

Question

I am planning on having Facelift/neck lift, upper and lower blepharoplasty with fat transposition, endoscopic eyebrow lift and fat injections to face. I had minor foot surgery 3 weeks ago to remove screw from previous bunionectomy and a pin placed in a previous hammertoe repair to straighten the toe. The pin is still in place otherwise everything else is healed over well. Is it necessary to have that pin removed prior to face surgeries? Ideally the foot doctor wants it to remain another week.

Lucian Ion, FRCS · Answer

Thank you for your question.

The main aspect is related to your mobility and the risk of deep vein thrombosis, in particular if you have a general anaesthetic. If your planned surgical intervention is under twilight anaesthesia the combination of risk factors would be diminished.

For a lengthier general anaesthetic, it is preferable to have normal mobility as it would be associated with an increased risk of deep vein thrombosis if your mobility is poor.

When the risk of deep vein thrombosis is increased blood thinner medication can be used but it does increase the risk of bleeding from the surgery.

All in all, because facial and neck surgery are elective interventions, it is preferable to work towards the minimum level of risk that you can achieve.

Erman Ak, MD · Answer

Since monopolar cautery will be used during the surgery, the pin must be removed before the surgery.BestErman Ak MD

Stephen Prendiville, MD · Answer

Modern electrocautery surgical devices are very safe.  You do not have to have the pin removed. Inform your Surgeon and most likely the toe will be wrapped in tape at the time of surgery.  We encounter this situation from time to time when piercings can't be removed at the time of surgery.

Amer Nassar, MD · Answer

While having a pin the toes is not a direct contraindication to proceeding with facial surgery, it is advisable that patients recover from one surgery prior to pursuing another. The recovery after a facelift surgery, especially with adjuncts like brow lifts, fat transfer and blepharoplasties, is quite challenging and requires a certain amount of mobility.
Kind Regards,
Amer Nassar, MDPlastic and Reconstructive Surgeon

William Portuese, MD · Answer

If you're undergoing general anesthesia for any other procedures, you should probably wait at least one month between the two general anesthetic's. It's probably best to have that pin removed from your foot so it does not get dislodged while you're asleep under anesthesia and being moved around in the recovery room

Thomas Spalla, MD · Answer

During surgery, surgeons often use electrocautery to stop bleeding. Monopolar cautery utilizes a grounding pad, typically placed on the leg, to allow for the same passage of electricity through the body. However, there is a potential risk of the electricity arcing through other metal through the body. Sometimes, metal cannot be removed such as certain piercings and other body modifications. In these situations, surgeons will often tape over these areas to decrease the chance of the electricity arcing. There is often a separate area of consent or documentation performed to inform the patient of this possibility and the increased risk of burn, fire, or injury.

Mats Hagstrom, MD (license on probation) · Answer

I see no inhered reason why you can’t have a facelift with a pin in your toe.
It may be more convenient to have the pin remove it first.
I suggest you discuss this with your providers.
Best,
Mats Hagstrom, MD

Planning on having facelift/neck lift/blepharoplasty. Does this pin need to come out first? (Photo)

Answers (7)

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