Sickle cell SC - am I a candidate for cosmetic surgery? (Photo)

Question

I really want to get bbl or lipo however I have sickle cell disease SC my blood level is 11 and never had a crisis besides that I have spoken o my haematology doctor and h said I'm good. Is there any surgeons ThAts perform bbl with a patient with sickle cell

Semih Yildiz, MD, FEPOBRAS · Answer

The visible photo mainly shows body-contouring goals around the waist and hips, but it cannot determine whether BBL or liposuction is medically safe with Sickle Cell SC. This condition is not always an automatic "no," but elective liposuction/BBL can involve long anesthesia time, fluid shifts, blood loss, hypoxia, dehydration, cooling, pain, and clot risk, all of which can trigger sickling even in someone who has not had a prior crisis.

A hematologist saying you are "good" should become a written perioperative plan, not just a verbal clearance. You would need a board-certified plastic surgeon, anesthesiologist, and hematologist all comfortable with the plan, with recent labs, a transfusion plan if indicated, aggressive hydration/oxygenation/warming, pain control, and VTE prevention in an accredited setting prepared for complications. Many surgeons may decline BBL or large-volume lipo because the risk-benefit balance is unfavorable, so avoid high-volume, overseas, or long combined procedures and only proceed if all teams agree the risk is acceptable.

Alan Gonzalez, MD, FACS · Answer

Hello @ghanagirl1, thank you for your question. Every practice has different requirements for performing a BBL I suggest you speak with the specialist that will perform surgery. It is because the requirements for each surgery vary from specialist to specialist. To reduce the risk, I require my patients to have hemoglobin levels of 12 or higher. Best wishes! Alan Gonzalez MD FACS Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Daniel Barrett, MD · Answer

Dear ghanagirl1,
it is hard to tell for sure without an examination. You will need to get clearance from your doctor prior to surgery. If you are considering surgery, I would suggest you 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

Darryl J. Blinski, MD · Answer

Nice posted photos. Yes I am one of few boarded Plastic Surgeons doing BBLs on sickle cell patients. If you HB is at 11 and you obtain written clearance from primary MD and Hematologist you can be done!

Douglas Taranow, DO, FACOS · Answer

I have performed elective surgeries on several SSD patients. With your history and hematologist clearance, you should be alright to have the procedure.  Close postop observation is required. 
Best wishes 
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

In your you say you have sickle cell disease but I believe you in fact have sickle cell trait. there’s a major difference between the two and individuals with sickle cell disease should not have elective cosmetic surgery.
Those who have the trait or the single gene typically or at low risk for having a Sicle crisis during routine elective surgical procedures and should be fine with clearance from your hematologist. Your pictures are a bit limited but based on those I am not sold that you need a BBL. You can have Liposuction or alternatively you can also work on losing weight.
I think most plastic surgeons would be happy to do liposuction for you. With quality reduction of your love handles waste back, upper and lower abdomen your bottom will proportionately already become larger.
Delivering consistent quality results for these procedures is more difficult than most people believe. The number of plastic surgeons who can deliver consistent quality results as A minority of providers.
A substantial number of plastic surgeons think they are far better at both Liposuction and fat chance for that they actually are.
Liposuction with or without fat transfer has more variability based purely on which provider the patient juices and any other surgical procedure I’ve ever seen.
Finding the right provider is paramount and the single most important variable.
To do that I recommend patients have multiple in person consultations with local board-certified plastic surgeons in their community.
I do not recommend patients have virtual consultations and I do not recommend patients travel long distances for elective surgical procedures.
During each consultation you need to get an accurate assessment as to your own candidacy for the procedure. this means differentiating all the other tissue variables that are not related to or are not treated by Liposuction. these include skin laxity for the loss of skin elasticity, potential pregnancy related changes like muscle separation and the presence or absence or absence of visceral fat.
You will also need to accurately vent the providers to be able to pick the most talented and experienced one for your procedure.
Like I said earlier choosing the right provider is the most important variable and getting this decision right is the difference between quality outcomes you can be proud of you for the rest of your life or regret and you’ll be reminded of every day for the rest of your life.
During each in person consultation ask each provider to open up your portfolio and show you their entire collection of before and after pictures for Liposuction and if you’re interested in the BBL and then then BBL as well.
You should also ask providers what the revision rate is and what the revision policy is should you need one. Recognize that a BBL is two procedures done at the same time. It is Liposuction and fat transfer.
It’s possible that someone can be a good candidate for Liposuction but not a good candidate for fat transfer. The opposite is also possible or someone could be a good candidate for fat transfer but not a good candidate for Liposuction. someone could be a good candidate for both or not a good candidate for either.There are a lot of variables to take in the consideration and they should all be discussed thoroughly during a proper in person consultation.
Being shown a handful of preselected pictures which most likely represent the best results of a provider‘s career is totally insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures the surgeon has actually performed.
This is why patients need to push providers to open up your entire portfolio and start showing you lots of pictures.
Ask specifically to only see pictures of previous patients who had similar body characteristics to your own.
Ask the provider to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped for it. We all have a variety of outcomes and it’s fair game for patients to ask to see them.
For reference and experience surgeon should have no difficulty showing you at least 50 sets of before and after pictures of a commonly performed procedures of which abdominal liposuction and gluteal fat transfer definitely are.
Become familiarized with quality results by reviewing lots of pictures of both liposuction and BBL results before hand.
Choose only images having people who have very similar body characteristics to your own in the before pictures.
To do that you need to start by having a set of proper pictures of your own body take them the same way plastic surgeons take before and after pictures.
Have someone else take the pictures or use the timer on your camera. Picture should be taken from about 8 feet away standing in a neutral position with your arms down showing your front, side and back side. wear revealing undergarments and crop the pictures from your neck to your knees. 
Look for other patients who have the same degree of skin laxity and approximately the same amount of obesity and overall proportions.
Create a reading system for quality results.
Bring your printed copies of pictures of yourself to use for reference when reviewing before and after pictures during the consultation.
That way you can compare to make sure the provider is showing people that look like you and the before pictures to get an accurate understanding of what the procedure can and cannot accomplish.
When looking at after pictures look very carefully at every area treated to make sure there are no skin contour irregularities anywhere.
Ask the provider exactly what areas were treated and what areas were not.
It’s also important to have a very clear understanding of exactly what areas are going to be treated and what areas will not be treated. You need to see quality before and after pictures depicting impressive results for every area you’re paying for.
Personally I view the entire torso as a single anatomic unit and try to treat the entire torso when doing abdominal liposuction.
Technically a full tour so when it comes to subdividing Liposuction anatomic units would include upper abdomen, lower abdomen, love handles, waste, entire back and under arms all the way to the side of the breast. sometimes the front bra roll, mons pubis and lower back are included as well.
For the BBL different plastic surgeons have very different views on what an attractive female tour so it should look like. There Are plastic surgeons who purposefully do liposuction of the outer thigh to help make the buttocks look larger. This completely destroys the natural S-curve a perfect female figure should have that goes from the armpit to the knee. Some of the extreme caricature results some providers are creating are highly undesirable and extremely difficult to correct ones performed.
Results should look natural and they should be viewed seeing the entire torso including lower extremities down to the knees.
There’s no set number of consultations someone has to have to find the right provider but I am quite convinced the only way to do it is to interview and have in person consultations with quite a few of them.
A talent provider can make an accurate assessment tell you exactly what kind of candidate you are and then show you representative before and after pictures accurately depicting exactly what they can and cannot deliver.
I suggest patient start with at least five consultations and continue scheduling many more if needed.
If done poorly these procedures can leave people disfigured and correcting poor Liposuction results is more or less impossible.
When in doubt slow down and schedule more consultations.
In the meantime consider losing weight which will get you looking better without having to have surgery.
Best,
Mats Hagstrom MD

Sickle cell SC - am I a candidate for cosmetic surgery? (Photo)

Answers (6)

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