Risks of Plastic Surgery on Patient with Lupus and Fibromyalgia

What are the risks of having plastic surgery of the face while also having Lupus and Fibromyalgia? Also, the patient did not tell her doctor that she has Lupus because he might not do the surgery.

Doctor Answers 12

Failure to discos medical conditions

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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.

Be honest regarding medical history.

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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.

Lupus and facelift

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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 undermining

Michael  Eisemann M.D.

Plastic Surgeon

Houston, Texas

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Lupus and Fibromyalgia: Impact?

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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.

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 180 reviews

Plastic Surgery Risks and Connective Tissue Disease

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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.

Autoimmune disorders and facelifts

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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.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Medical conditions must be disclosed

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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.   

Malcolm A. Lesavoy, MD
Beverly Hills Plastic Surgeon

Facelifts with lupus and fibromyalgia

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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.

Facelift With lupus and Fibromyalgia

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There are different forms of Lupus, but I would be very concerned doing a facelift on a patient with both diseases. The patient should discuss this with her rheumatologist  and surgeon. Complications could be severe and deforming.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Disease processes must be in remission

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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.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

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.