Could I consider a facelift considering that I have Psoriatic Arthritis and take Methotrexate?

Doctor Answers 14

Facelift & Methotrexate

I would probably recommend that you begin with some non-surgical procedures since taking methotrexate suppresses your immune system which can adversely affect your body's ability to heal post surgery. Schedule a consultation with a board certified plastic surgeon in your area to discuss your options. Surgery isn't off the table, but it is more risky for you so just be aware. 


Kouros Azar 

Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 35 reviews

Facelift and Methotrexate

Dear melwel14,

There is no reason why you cannot have a facelift on methotrexate as long as all your blood values come back in a normal range. If you are getting the methotrexate weekly I usually suggest skipping the dose the week before surgery and then resuming it five days postop.

I hope this has been helpful.

Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

My reccomendation

Generally, I would not recommend elective cosmetic surgery while taking Methotrexate because it suppresses the immune system.  This may result in delayed healing and or infection.  However,  there are now many less invasive options such as non-surgical face lifts, dermal fillers, and neurotoxins (Botox®).  I would encourage you to inquire about what specific facial aging concerns you have and what options are available to help soften the aging process.

Michael N. Desvigne, MD, FACS
Scottsdale Plastic Surgeon
4.1 out of 5 stars 8 reviews

Good cadidate

You should visit with several board certified plastic surgeons, make sure they are aware of your medical history, and be compliant with medications leading up to surgery to ensure you get the best results and avoid complications. Best Wishes!

Michael R. Whetstone, MD
Irving Plastic Surgeon
4.4 out of 5 stars 22 reviews

Methotrexate and surgery

I have never had a problem with patients on Methotrexate. It would be best if your psoriasis is under good control before you had the surgery. If you do not have any other medical problems I don't think it will cause a problem provided you go to a well trained competent surgeon. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 81 reviews

Could I consider a facelift considering that I have Psoriatic Arthritis and take Methotrexate?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Since Methotrexate is known to thin the blood and promote bleeding, you may not be able to even have one of these minimally invasive type facelifts.  

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Facelift and Methotrexate

Unless you have other medical issues that you didn't mention, you will likely be a good candidate for a facelift.  However, I do recommend that you discuss this with your rheumatologist.  They may be able to hold your methotrexate before and after your cosmetic surgery; which will decrease the chance of a postop infection.

Good luck!

Clyde Mathison, MD
Knoxville Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Methotrexate and surgery

Yes, you can consider having a facelift.  There are several studies in the orthopedic surgery literature that show no increase in surgical site infection in methotrexate users, at least in rheumatoid arthritis.  Best to discuss with your rheumatologist, though.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 80 reviews

Facelift Cosmetic surgery and arthritis

It's probably best to get medical clearance from your rheumatologist prior to elective cosmetic surgery such as a facelift procedure. It's probably best not take methotrexate for a period of time before and after surgery, to help prevent any infection.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Could I consider a facelift considering that I have Psoriatic Arthritis and take Methotrexate?

Hello melwel14,

Anytime someone is on a rheumatological medication, it is important to understand that it affects your healing.  If you have no other risk factors and you are a good candidate for a facelift, you'd probably be ok.  The best person to ask is your rheumatologist, as sometimes patients will come off these medications for a few days before and after the surgery.  I'd recommend you consult with a facial plastic surgeon, learn if you are a good candidate for a face lift, and then follow the recommendations of your surgeon which will likely be to ask your rheumatologist.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 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.