Will external hanging hemorrhoids cause an issue during my surgery or recovery?

Question

I am having a TT, existing implants removed, fat injections and lift in breasts, and lipo. My issue is that i have external hanging hemorroids. Not only is this embarrassing, but i dont know if this can complicate the surgery or recovery.

Daniel Barrett, MD · Answer

Dear mystikaldream,

it is hard to tell for sure without an examination. 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

Yasemin Aydinli, MD · Answer

First, please do not feel embarrassed &mdash; external hemorrhoids are extremely common, your surgical team has seen them countless times, and they are simply a medical detail to plan around, nothing more. The reassuring news is that they should not complicate the surgeries you are planning. A tummy tuck, implant removal, breast lift with fat grafting, and liposuction are all performed in completely different areas of the body from the anal region, so your hemorrhoids will not be in the surgical field and do not raise your risk for the operations themselves.
Where they are relevant is your recovery, and this is worth preparing for. After a tummy tuck in particular, constipation is very common &mdash; it is caused by the anesthesia, the opioid pain medication, and reduced movement in the early days &mdash; and the straining that comes with constipation can flare up hemorrhoids and make them more swollen and uncomfortable. On top of that, a tummy tuck tightens your abdominal wall, so you will want to avoid straining anyway. None of this is dangerous; it is just a comfort issue that is very manageable with a little planning.
The practical steps make a real difference: stay well hydrated, start a stool softener and fiber as your surgeon approves, keep opioid pain medication to the minimum you need, and begin gentle walking early. It is also a good idea to mention the hemorrhoids to your surgeon and anesthesiologist before the day of surgery, so they can account for positioning and include bowel management in your aftercare plan.
Finally, if your hemorrhoids are frequently symptomatic &mdash; bleeding, painful, or bothersome day to day &mdash; it is reasonable to see a colorectal specialist to have them evaluated and treated separately, ideally either well before your cosmetic surgery or after you have fully recovered, rather than at the same time. But if they are only an occasional nuisance, they are not a reason to delay your plans; you simply manage your bowels carefully through the recovery period.

Warren Schutte, MD · Answer

These will not complicate your surgeries in any way, or your recovery. Congratulations and good luck on your upcoming surgeries.

Francesco Campanile, MD · Answer

Please don’t let embarrassment keep you from bringing this up with your surgical team. External hemorrhoids are extremely common and something we’re very accustomed to addressing as part of surgical planning. They are not a reason to cancel or delay procedures like a tummy tuck, breast surgery or liposuction.

The surgeries you’re describing are performed in a completely different area of the body, so your hemorrhoids are not in the surgical field and don’t increase your procedural risk. Where they become relevant is recovery.

After a tummy tuck in particular, constipation is common. Anesthesia slows the GI tract, narcotic pain medication compounds that effect and reduced mobility in the early days doesn’t help. Straining is uncomfortable after any abdominal surgery, and if you already have external hemorrhoids, that discomfort can be more pronounced. The good news is that this is very manageable with advance planning: stay well hydrated, begin a stool softener before or immediately after surgery as your surgeon advises, keep narcotic pain medication to the minimum needed and start gentle walking as early as possible.

Most importantly, mention the hemorrhoids to your surgeon and anesthesiologist before your surgery date so they can account for positioning and include bowel management in your aftercare plan. For most patients with occasional hemorrhoids, they are not a barrier to moving forward with your plans.

Camille Cash, MD · Answer

Having hemorrhoids is common and won't directly impact your surgery.  However narcotics are often used during and after surgery for pain management and they can slow down your digestive system and lead to issues such as constipation.  This can exacerbate your hemorrhoids.  I encourage you to speak with your surgeon for tips on minimizing this for you.

Will external hanging hemorrhoids cause an issue during my surgery or recovery?

Answers (5)

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