What if you can take out a Dermal piercing before the general anesthesia?

Question

I am getting just a breast lift this Friday and I have piercings I can take out with no problem, But I have 3 dermal piercing ( not around my breast at all ) I cannot take them out. What will happen since I cannot take out the piercings?

Sam Speron, MD, FACS · Answer

Piercings can present a problem, of course, because the metal in them can lead to negative outcomes with the equipment that is used in surgery.  Specifically, cautery devices use electrical current and the metal can be a serious issue. You should speak with your surgeon in regards to your piercings and a strategy for surgery that takes them into account. I usually schedule pre-op appointments with my patients to speak to them about what will happen during surgery,   Your safety needs to be the top priority and that can only be achieve through good communication.  Thank you for your question and best wishes for your upcoming surgery and recovery.

Anita Patel, MD, FACS · Answer

The reason it is recommended to remove all metal piercings is that they can cause an arc when the surgeon uses electrocautery, resulting in a burn where the metal is. If the piercings are far from the surgical site, the risk is small, but still present. If you absolutely cannot remove them, typically the metal is covered with paper tape or other material to try to protect the area or minimize this risk.

Dallas Buchanan, MD · Answer

Thank you for the question. The concern with body jewelry is that the metal can sometimes cause an arcing of the electrocautery current through the body and cause a burn around the metal. This is unlikely if the area is far from the surgical site, but it is still possible. If you cannot remove the jewelry, then you can cover it or protect it, and hope for the best. Just accept the small possibility of a burn. Or have the metal removed.Best of luck!

Daniel Barrett, MD · Answer

Dear JasaraeMarie,every plastic surgeon has his own pretoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Kenneth Hughes, MD · Answer

With surgery only a couple of days away, I would get in touch with my plastic surgeon and anesthesiologist immediately to determine if the dermal piercings have to be removed.  Because they are not near the surgery site, you will probably be o.k. but always best to ask.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Douglas J. Mackenzie, MD · Answer

This is one of those things where folklore trumps common sense.  Yes, an electrical current will take the path of least resistance to complete the circuit.  So yes, theoretically a piercing could complete the circuit and cause a burn, and I'm sure some MD on this forum may have seen it in his/her career.  I have NEVER seen it, and no I don't recommend their removal unless they're within or close to the surgical site (ie nose ring during rhinoplasty, earring during otoplasty!)  I HAVE seen hospital nurses (under strict OR protocols, often devoid of common sense) aggressively trying to remove a difficult belly button piercing, causing trauma, for a surgery on the face.  Ridiculous.  If the patient is properly grounded (basic OR protocol), covering the piercing with a piece of Tegaderm (plastic sticky layer) or tape should prevent the problem.

Michael C. Edwards, MD, FACS · Answer

As has been mentioned there will be differences between plastic surgeons. My practice is to place an antibiotic ointment over the posts and cover it with a tegaderm dressing. This is no guarantee that you won't get a burn there from the use of electrocautery but ro date I have not seen this occur. Discuss your concerns with your board-certified plastic surgeon.Dr. Edwards

Jon A. Perlman, MD (retired) · Answer

If your piercings are away from your breast area then our routine is to tape the piercings but warn the patient of the small but present risk of an electrocautery burn. The other issue is cleanliness and sterility and the area of course needs to be cleansed and prepped while you are under anesthesia. Keeping your piercings especially clean for at least a week before surgery is a good idea. Discuss this with your surgeon.

Regards,
Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

Regards, 
Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

Robert E. Zaworski, MD (retired) · Answer

Best to ask your surgeon and anesthesiologist.  In general, many times they are taped during surgery.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Metal piercings can prove troublesome during an operative procedure, as electrocautery is usually employed to control bleeding. If the metal piercing comes into contact with the OR table, it can generate a spark leading to a burn of the skin. If possible, we recommend replacing metal piercings with plastic. If not possible, we tape the piercing sites to prevent contact with other metal objects.
Be sure to make the OR team aware of your piercings.
Best wishes!

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