Can I get surgery with possible connective tissue disease? (photos)

Question

I've had three children all via c-section and am done having children. In the last year multiple doctors have suspected I have Ehlers Danlos due to dislocations and Brighton score as well as velvety skin and other signs. Is it safe to have a tummy tuck and breast lift if I'm otherwise healthy (no chronic health issues)? I think the laxity caused by it is making my skin super gross and my neck is even showing signs of aging now (lose skin). Pros and cons?

Gary M. Horndeski, MD · Answer

Ehlers-Danlos Syndrome (EDS) is a connective tissue disease that is inherited in approximately one in 5000 births.  Skin, ligaments, joints, blood vessels and other connective tissues can be affected.  EDS has been classified into six varieties based on distinct clinical presentation: classical, hypermobile, vascular, kypho-scoliotic, arthrochalasis and dermatosparis.  Your case sounds like the hypermobile type, which has moderate skin involvement and hypermobile joints.  This is an autosomal dominant mutation of the TNXB gene creates a tenascin X deficiency which adversely effects the assembly of the collagen fibers.  There are no effective medical treatments for EDS.  In the past, I have operated on EDS patients doing breast lifts.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  After this, you can consider doing an abdominoplasty.  If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement.  The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.  As others have stated, you should get medical clearance for surgery.Best Wishes,Gary Horndeski, M.D.

Luis A. Mejia, MD · Answer

Hello dear,Thanks for your question and provided information as well. You could get the surgery with a written clearance from your primary MD. I don't think there's a problem for getting into the procedure. Best of lucks and Merry Christmas :)Dr. Luis Mejia.

Pejman Aflaki, MD · Answer

Hello and thank you for your question and sharing your photos. You can potentially have the surgery. More specific and detailed information is needed regarding your medical condition and how is affects your wound healing potential and recovery. I would seek consultation with a board-certified plastic surgeon
for a full evaluation and advice. Best,
Pejman Aflaki, M.D.                                             
Johns
Hopkins-trained double board-certified plastic surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Because of the myriad subtypes of ED, I would speak with your managing physician to understand the relative risks of pursuing any surgery. You are otherwise an excellent candidate for a mommy makeover, but your safety is paramount and needs to be investigated further.

Ajaya Kashyap, MD · Answer

Thank you for your question.There are different types of connective tissue disorder and different extent to which one is afflicted by the disease. It is best to have your Plastic Surgeon talk to your treating Physician regarding the suitability of Plastic Surgical procedures. All The Best !

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. As long as you are otherwise healthy and can obtain medical clearance from the physician who treats your Ehlers Danlos, then you can safely proceed forward with surgery.  Based on your photographs, skin laxity, and history of c-sections, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short incision, all completely below the bikini line.  The belly button can be designed to look natural and have no scars on the exterior.   Your muscles can also be plicated resulting in a flat abdomen.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  
 
 Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Robert M. Tornambe, MD · Answer

Swayze2I appreciate your concern, however your particular condition should not be a contraindication to mommy makeover surgery. However I would first check in with your medical doctor and describe your desires with regard to the surgery. It appears from your photographs that tummy tuck combined with breast lift, with or without implants, would be a nice option for you. Consult with a board-certified plastic surgeon in your area for a full evaluation and be certain to describe your medical condition. Good luck.

Daniel Barrett, MD · Answer

Dear Swayze2,
you will need to get a clearance from your doctor in order to be a candidate for a surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Whether you can have a MM with Ehlers-Danlos Syndrome depends on the severity of your diagnosis.  You will need clearance from the health care professional treating you for the EDS as fragile skin can develop prominent scarring.

Camille Cash, MD · Answer

I recommend beginning by speaking with the physician who treats your EDS.  Discuss your desire for elective plastic surgery and potential risks related to your EDS.  If given medical clearance by your physician you can then schedule a consultation with a board certified plastic surgeon near you.  Your connective tissue disorder aside, you appear to be a good candidate for the procedures based on your photos alone.

Can I get surgery with possible connective tissue disease? (photos)

Answers (15)

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