Sickle cell disease - am I able to get cosmetic surgery?

With sickle cell disease, any elective surgery carries higher risks, including problems with anesthesia, wound healing, and blood clotting. Even if your overall health is good and your crises are infrequent, these risks remain important considerations.
The fact that your hematologist cleared you for bariatric surgery is reassuring, but most plastic surgeons would still be cautious about performing a tummy tuck and 360 liposuction at your current weight. The body mass index is high, which already increases the chance of complications such as infection, wound breakdown, or blood clots.
A safer approach is often to pursue bariatric surgery first if that is appropriate for you, and then consider body contouring procedures after significant weight loss. At that point, both the surgical risk and the quality of results are much improved.
I have also shared a detailed video where I explain how underlying medical conditions like sickle cell disease influence surgical planning, and why timing and safety are so critical.
— Güray Yesiladali, MD

Dear Brireign25,

it is hard to tell for sure without an examination. You will need to get a clearance from your doctor prior to any elective procedure. 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

Your BMI is 41. There is an increasing complication rate when operating on patients with a BMI greater than 30 and the rate of complications increases as the BMI increases. In addition, the results of the surgeries that you’re requesting are subpar due to the excess weight. Your results would be better and your surgery would be safer if you underwent your bariatric surgery first and brought your BMI down below 30 prior to considering any cosmetic surgery. Have a detailed discussion with a plastic surgeon to help you best understand all your options.

Hello, in sickle cell anemia, surgical stress and especially hypovolemia and vascular damage after liposuction can trigger sickle cell crisis. This situation increases the risk of patchy skin necrosis in surgical areas and sometimes causes delayed wound healing. I think I have to speak hypothetically since I have not examined your situation: If your abdominal deformity is small, I will not recommend you to have surgery. However, if your deformity is large, your sagging abdominal skin and abdominal muscle defect cause you difficulty in daily life, then you can consider surgery. Before the operation, you can consult your own hematologist and get preoperative recommendations and have surgical treatment under the necessary drug therapy. Performing minimal liposuction as much as possible will keep the risks to a minimum.

Yes, cosmetic surgery may be possible for you even with sickle cell disease but it requires extra planning and precautions due to the unique risks involved.
Let’s break it down
Your Strengths
• You're overall in good health
• You’re under regular hematologist care
• You’ve had few crises and they’re well-managed
• Your hemoglobin (10–11) is relatively stable for someone with sickle cell
• Your iron levels are good, which helps with healing
• You were already cleared for bariatric surgery, which is more invasive than a tummy tuck or lipo in many cases. That’s a very good sign
What Makes Cosmetic Surgery Riskier with Sickle Cell?
Surgery, especially longer or more invasive procedures like a tummy tuck or lipo 360, increases your risk of a sickle cell crisis because of:
• Dehydration
• Low oxygen levels (hypoxia)
• Cold operating room temps
• Stress from anesthesia and healing
These factors can trigger vaso-occlusive episodes (pain crises) or other complications.
Many plastic surgeons will operate on patients with sickle cell only if these steps are taken
1. Full surgical clearance by your hematologist
• You’ve already got this for bariatric surgery—so ask if they'd also provide a written clearance specifically for cosmetic surgery.
2. Pre-op optimization
• IV hydration
• Oxygen monitoring
• Warm blankets during and after surgery
• Sometimes pre-op blood transfusions to reduce sickled cells
3. Choosing the right surgeon & setting
• Look for a board-certified plastic surgeon experienced with high-risk patients
• They should perform your procedure in a hospital or accredited surgery center, not an office-based setting
What You Can Do Now
1. Talk to your hematologist again and ask specifically about cosmetic surgery.
2. Start consultations with board-certified plastic surgeons who are familiar with medical conditions like yours.
3. Be open to doing your transformation in phases, if needed.
You’re doing everything right: researching, staying on top of your health, and asking the right questions. With the right team and planning, your goal may very well be achievable. And even if it takes a little longer or requires a modified plan, your safety is what makes those results truly worth it.