Risks of having explanation surgery and lift with moderate Myasthenia Gravis?

Question

I have had Myasthenia Gravis for 2 and a half years. My symptoms have been mild to moderate. Is it riskier to have explantation surgery or leave implants in that are ruptured with ruptured capsule and extra capsular extension of silicone? 66 years old; good health other than MG.

Tom J. Pousti, MD · Answer

I am sorry to hear about the situation you are in but in my opinion the best course of action for you would be to have the breast implants removed. Given that you are generally in good health, best for you to seek your neurologist's opinion about proceeding. He/she may be able to communicate with your plastic surgeon and/or anesthesiologist. Then select your plastic surgeon carefully.  Make sure that he/she is board certified and works with board-certified anesthesiologists in a fully accredited surgery facility. Best wishes.

Lori H. Saltz, MD (retired) · Answer

You have left a lot of information out, but from what you have told us you are between a rock and a hard place.  The surgery itself is not the problem; it's the anesthesia.  MG can attack any of your muscles including respiratory ones.  Conventional wisdom says that muscle relaxants need to be used sparingly by the anesthesiologist and that they should be reversed at the end of the case.  There is a still the small possibility that your breathing muscles will be affected and you could have to be ventilated by a machine in the hospital until your muscles are working again.  This is rare, but still a concern.  You have to weigh that against the risks associated with your ruptured implants.  You didn't say whether the extracapsular silicone is itself  encapsulated which is sometimes is.  If so it's no worse than the silicone the remains in the capsule which may have been there for years without causing you problems.  If the extracapsular silicone is embedded into the tissues chances are that not all of it will be removed with surgery anyway.  There is no evidence to show this will cause you a problem.  At some point your capsules will become calcified and hard.  That may be another reason added to the others to want them removed.  I would find a center (most likely a University) that deals with lots of MG patients and approach them with the question of anesthetic risks.  There are surgeries done to help people with MG that I am sure your diagnosing physician will know about.  I am certain that a surgeon that does them (thymectomies) would work closely with his anesthesiologist on these cases and know the risks. They would be a good resource for information.  These are not common procedures at all, but I know there is a surgeon in Orange County California that does them because he did my cousin's (and he had no problems).  Good Luck

Risks of having explanation surgery and lift with moderate Myasthenia Gravis?

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Risks of having explanation surgery and lift with moderate Myasthenia Gravis?

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Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.