I Have Macrocytic Anemia Due to a Round Chemo. Is Lower Facelift Safe?

I was on 6mp for auto immune issues (crohns) for 1 1/2 yrs and d/c last oct. I now have macrocytic anemia. I bleed easily and have some trouble healing. Now I've been told I have cascading AI probs( sjogrens). My dr "thinks" surgery shld be fine but as I have 6 diff docs I'm trying to coordinate my care with-I wonder if any of them get the big picture. I also have high bp taking losartan & intuniv as well as vyvanse for exacerbated ADD w/Autoimmune brain fog. Thoughts?

Doctor Answers 4

Many Medical Problems and Facelift

     I would be extremely cautious about pursuing elective surgery at this time.  Your mind and body should be primed prior to facelift.

Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Anemia and cosmetic surgery

Your first question was regarding anemia. Anemia by itself, if it is stable and miner in nature is not a contraindication to surgery. However yo have many other issues. Bleeding can be a major problem during and after facelift.You should have a thorough medical exam with complete work up of all medical issues prior to considering any form of elective surgery. Face lift surgery should be an exciting change for you, you don't want to proceed unless your risks have been minimized.

Shahriar Mabourakh, MD, FACS
Sacramento Plastic Surgeon
4.9 out of 5 stars 210 reviews

I Have Macrocytic Anemia Due to a Round Chemo. Is Lower Facelift Safe?

It is very important that your medical issues be controlled before any cosmetic surgery is considered, including coordination of your care by your surgeon to insure that you are in a safe position to have the procedure you desire. Usually physicians will get medical clearances or check labs to make sure you are in a good situation to have surgery. For example your physician may look into your platelet counts or get a bleeding time to further assess your risk status.


That being said, there are several technologies that can help optimize your recovery chances having a facelift. In terms of bleeding risk, combining a facelift with the use of 1064 laser lipolysis systems (SMART LIPO/Cynosure) can significantly reduce intraoperaive bleeding and reduce hematoma risk. One of my colleagues in Seattle presented on this subject at a recent meeting and the results were very compelling. Intraoperatively, the use of Protein Rich Plasma, I believe, can reduce bleeding and also help accelrate healing. Often physicians combine this PRP with thrombin to help increase tissue coagulation. There are many different PRP systems out there for physicians to have easy access to them. Next, we often use phototherapuetic lights to help our patients with healing issues. The brand we use is called Omnilux, and the Plus and Revive lights I have found useful. We usually do a 5-7 day regimen with these lights around the surgery time. Next, I have found ultrasound technology helpful to reduce swelling in people who may have delayed healing issues. We usually will do 3-5 treatments with a system made by a company called Mettler. The regimen is similar to what physician therapists provide.  Finally, as a back stop, we always have wound care products available should a patient experience delayed healing. The products i like here are EpiFIx and a new product AmnioMend made my Mimedx. Other brands are available but I feel physicians who do higher risk facelifts should have ready access to these products, as they can be a great support for tissue that is not healing well. Hope this helps. Good luck!!

Farhan Taghizadeh, MD
Phoenix Facial Plastic Surgeon
4.1 out of 5 stars 25 reviews


With all the problems you have, first control all your diseases and blood pressure. Once all diseases are completely controlled then consult a Board Certified Plastic Surgeon (American Board of Plastic Surgery). Plastic surgeon should coordinate and communicate with all your doctors befre surgery is contemplated.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 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.