How long do I need to be off methotrexate in order to have tummy tuck?

I always work in conjunction with your rheumatologist. Generally 1-2 weeks for most cosmetic surgeons. There is some research that says you can stay on it without causing any complications with surgery. However it is new research and many surgeons would be hesitant to do that when we are doing a big surgery like liposuction and a tummy tuck.

Ask your board certified PS or rheumatologist for their advice, but methotrexate treatment is usually not stopped in patients whose disease is controlled by the drug. Several studies have reported that methotrexate does not increase the risk of either infections or of surgical complications occurring in patients taking the medication.

Thank you for your question. I would defer this decision to your rheumatologist or the doctor who is prescribing the medication. You should also be getting a medical clearance from this doctor. Generally speaking, this type of medication is generally stopped 1-2 weeks prior to surgery and started back 1-2 weeks after surgery. There have been some studies showing that patients can stay on the medication throughout surgery and do fine, but I think if you are OK without it for a period, it would be best not to risk it. Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Dear dayagi4,
Every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The answer is variable based on who you ask. The best person to consult for this is your rheumatologist (prescribing physician) and have a frank discussion regarding surgical risks with your surgeon. In my practice, patients are typically off Methotrexate for 2 weeks prior to surgery, and resume it 1 week post-operatively. This varies on a case by case basis. Best, Dr. Satey.

Assuming you are otherwise in good health and have the clearance from your Rheumatologist then there are several options. On is to continue with the Methotrexate based upon limited evidence that suggests it does not increase the risk of postoperative complications. However many surgeons would probably prefer it was discontinued for a short period both before and after the surgery, especially if the patient can tolerate being of the medicine for that amount of time.  Best of Luck  Dr Harrell

I would defer to your medical care giver RXing you the drug for a written clearance. Most likely depending upon the dose you could be still taking the drug during the recovery phase. 

Discuss your medical history with your plastic surgeon.   As long as you are given medical clearance from you rheumatologist, you should be fine for surgery. Generally speaking, this type of medication is generally stopped 1-2 weeks prior to surgery and started back 1-2 weeks after surgery. Best of luck for a nice recovery.

There is no scientific answer to your question as it is Rheumatoid arthritis and not Methotrexate that is the issue here. Autoimmune diseases are what we call "small vessel diseases", meaning that your capillary circulation reacts to any surgery by forming clots and micro-emboli. This risks making healing more probematic especially for surgeries that have increased tension as an operating mechanism (tummy tuck, breast lift). I have operated on RA patients who were actively on Methotrexate but only after they were cleared for surgery by their treating physician. Best of luck.