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

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.

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.

Without knowing your age, seeing photos of you, or examining you in person, it is difficult to answer your question with any certainly.  I would say that if your face exhibits the classic signs of aging (excess of your upper eyelids, puffiness of the lower eyelids, deepening of your nasolabial folds, jowl formation, neck laxity), you would need preoperative testing and a letter of medical clearance from you internist before having surgery. If your internist cleared you, then you could move forward with your surgery and could look forward to a beautiful result. 

Hello melwel14 - Thanks for your question. Taking methotrexate is not a contraindication to having a facelift. You need to work with your surgeon and your rheumatologist to be medically optimized and nutritionally optimized prior to your facelift. I've performed over 2000 facelifts in the last 10 years. In that time, I've successfully taken care of many patients with chronic medical conditions such as cardiac problems, need for blood thinners, and various rheumatologic issues requiring immune suppression. It just requires communication between the members of your healthcare team. I hope this helps. Good luck. Dr. Shah

Methotrexate may affect platelets function therefore

increasing the chances of bleeding. Ask your doctor if the

medication may be stop temporarily and discuss your options 

with a board certified plastic surgeon.

Best wishes.

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. Kindly,Kouros Azar 

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

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.

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!

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.