Hi, I was diagnosed with discoid lupus almost 5 years ago. I am not on medication and have not had a flare since i was diagnosed. I am scheduled for chip lipo woth morpheus skin tightening at the same time. Had anyone done this on a patient with DL before? My doctor is concerned with the energy internally and externally possibly triggering a flare. I am thinking of canceling the procedure. Maybe kybella is a safer option?
Answer: Discoid Lupus Good Morning! Great question. I would agree with your doctor that any energy-based device may trigger a flare. The excess inflammation could lead to a less than ideal outcome such as scarring or pigmentation issues. The liposuction may be "safer" so-to-speak, though any intervention may trigger a recurrence. Natural, topical treatments such as natural skin care products and light peels may be a better route to go. Sorry there isn't a clear answer, but I hope this helps!
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Answer: Discoid Lupus Good Morning! Great question. I would agree with your doctor that any energy-based device may trigger a flare. The excess inflammation could lead to a less than ideal outcome such as scarring or pigmentation issues. The liposuction may be "safer" so-to-speak, though any intervention may trigger a recurrence. Natural, topical treatments such as natural skin care products and light peels may be a better route to go. Sorry there isn't a clear answer, but I hope this helps!
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Answer: Lupus and cosmetic surgery Lupus can potentially be a very serious condition that for some people is a contraindication to having cosmetic surgery. Both you and your plastic surgeon will need to rely on your rheumatologist expertise to stratify risk and see if you are a candidate and what the risks for adverse outcomes would be. The one thing all patients should do but is in many ways even more important for individuals who have underlying medical disorders is to make sure you’re a good candidate for the procedure in the first place and if the surgeon has the skill and experience to deliver consistent quality results. Taking any risks when the reward is smaller or potentially negative is sort of the worst of both. Delivering consistent quality liposuction results is more difficult than most people believe. Simply being a board-certified plastic surgeon with overall good reputation does not necessarily mean that someone has mastered this procedure. My recommendations are the following. Discuss this with your rheumatologist first and foremost. Before choosing a provider make sure you have had a sufficient number of consultations and properly vetted each provider. Make sure any provider you’re considering is board certified by either the American Board of plastic surgery or the American Board of facial plastic surgery. In my opinion no other board certification is sufficient. During the consultation process rely exclusively on in person consultations. During each consultation bring pictures of your own face and neck taken the same way plastic surgeons take before and after pictures. Basically mugshots. Ask each provider to open up your portfolio and show you their entire collection and before and after pictures for chin and neck liposuction. As the provider to pull as many pictures as possible of the patients who have very similar facial characteristics to your own. This may be difficult because with that training you may not know how to do facial assessments. 95% of people who seek chin and neck liposuction have is the primary underlying ideology and issue with their mandible. The mandible is either small or lacking in a forward projection. This typically presents with a dental overbite occlusion and I’m profile pictures the upper lip will have more forward projection than the lower lip. When the mandible is small compared to the Maxilla the origin of the platysma muscle starts closer to the neck and it drips the neck in a more oblique fashion. This illuminates job definition and can be part of what creates the double chin. Older individuals do not do well with liposuction in this area and it’s important to differentiate who is going to get good results and who is not. Simply being shown a handful of sample pictures representing the best results of the providers career is totally insufficient to get a clear understanding of what your results will look like or what average results look like in the hands of each provider. Descriptions need to be tailored to you based on your age, amount of fat that can be removed, mandible shape and size etc. etc. An experience provider should have no difficulty showing you at least 50 sets before and after pictures of commonly performed procedures. Become familiar with before and after pictures especially looking for people who have similar facial characteristics to your own as is described above. Know what good results look like. During each consultation rate or grade the results of each provider and keep track of how many pictures they show you. Especially how many pictures they show you of patients who look similar to yourself. The goal here is to not find out what the best results look like in their career but to get a good understanding of what the average results look like and what your individual candidacy for the procedure is. You also wanna take this opportunity to get confirmation of how often and how many of these procedures each surgeon has performed. Adding radio frequency treatments to the procedure makes absolutely no sense to me at all. First radio frequency typically does very little. My doing radio frequency treatment at the same time is the procedure you’ll have no way of knowing if it worked or not. Most plastic surgeons do not add radio frequency to Liposuction treatments. I am wondering if your provider is just ringing up a bigger bill for you or trying to utilize an expensive piece of equipment they recently purchased. I don’t know how many plastic surgeons patients should consult with to find the right provider but I suggest starting with at least five and I have a more if you have any questions or doubts. Liposuction is permanent and irreversible. If done poorly people can be left disfigured. If your lupus is mild, well-controlled and your rheumatologist is very comfortable with you having cosmetic surgery and it’s been confirmed that you are indeed a very good candidate for the procedure and you found a surgeon who has a proven track record with a stack of before and after pictures that reads like a telephone book then this may be a good procedure for you. If however you’re not necessarily a good candidate and the risk of having surgery is significant and you haven’t done a good job of picking a provider with a proven track record then it may not be a wise decision. I generally tell people to simply slow down the train and schedule more consultations if they have doubts or concerns. You should feel very comfortable about your decision and who’s going to be doing your procedure. If you’re not then slow down and schedule a few more consultations. There is a significant difference in outcomes based on who does the procedure. Best, Mats Hagstrom MD
Helpful
Answer: Lupus and cosmetic surgery Lupus can potentially be a very serious condition that for some people is a contraindication to having cosmetic surgery. Both you and your plastic surgeon will need to rely on your rheumatologist expertise to stratify risk and see if you are a candidate and what the risks for adverse outcomes would be. The one thing all patients should do but is in many ways even more important for individuals who have underlying medical disorders is to make sure you’re a good candidate for the procedure in the first place and if the surgeon has the skill and experience to deliver consistent quality results. Taking any risks when the reward is smaller or potentially negative is sort of the worst of both. Delivering consistent quality liposuction results is more difficult than most people believe. Simply being a board-certified plastic surgeon with overall good reputation does not necessarily mean that someone has mastered this procedure. My recommendations are the following. Discuss this with your rheumatologist first and foremost. Before choosing a provider make sure you have had a sufficient number of consultations and properly vetted each provider. Make sure any provider you’re considering is board certified by either the American Board of plastic surgery or the American Board of facial plastic surgery. In my opinion no other board certification is sufficient. During the consultation process rely exclusively on in person consultations. During each consultation bring pictures of your own face and neck taken the same way plastic surgeons take before and after pictures. Basically mugshots. Ask each provider to open up your portfolio and show you their entire collection and before and after pictures for chin and neck liposuction. As the provider to pull as many pictures as possible of the patients who have very similar facial characteristics to your own. This may be difficult because with that training you may not know how to do facial assessments. 95% of people who seek chin and neck liposuction have is the primary underlying ideology and issue with their mandible. The mandible is either small or lacking in a forward projection. This typically presents with a dental overbite occlusion and I’m profile pictures the upper lip will have more forward projection than the lower lip. When the mandible is small compared to the Maxilla the origin of the platysma muscle starts closer to the neck and it drips the neck in a more oblique fashion. This illuminates job definition and can be part of what creates the double chin. Older individuals do not do well with liposuction in this area and it’s important to differentiate who is going to get good results and who is not. Simply being shown a handful of sample pictures representing the best results of the providers career is totally insufficient to get a clear understanding of what your results will look like or what average results look like in the hands of each provider. Descriptions need to be tailored to you based on your age, amount of fat that can be removed, mandible shape and size etc. etc. An experience provider should have no difficulty showing you at least 50 sets before and after pictures of commonly performed procedures. Become familiar with before and after pictures especially looking for people who have similar facial characteristics to your own as is described above. Know what good results look like. During each consultation rate or grade the results of each provider and keep track of how many pictures they show you. Especially how many pictures they show you of patients who look similar to yourself. The goal here is to not find out what the best results look like in their career but to get a good understanding of what the average results look like and what your individual candidacy for the procedure is. You also wanna take this opportunity to get confirmation of how often and how many of these procedures each surgeon has performed. Adding radio frequency treatments to the procedure makes absolutely no sense to me at all. First radio frequency typically does very little. My doing radio frequency treatment at the same time is the procedure you’ll have no way of knowing if it worked or not. Most plastic surgeons do not add radio frequency to Liposuction treatments. I am wondering if your provider is just ringing up a bigger bill for you or trying to utilize an expensive piece of equipment they recently purchased. I don’t know how many plastic surgeons patients should consult with to find the right provider but I suggest starting with at least five and I have a more if you have any questions or doubts. Liposuction is permanent and irreversible. If done poorly people can be left disfigured. If your lupus is mild, well-controlled and your rheumatologist is very comfortable with you having cosmetic surgery and it’s been confirmed that you are indeed a very good candidate for the procedure and you found a surgeon who has a proven track record with a stack of before and after pictures that reads like a telephone book then this may be a good procedure for you. If however you’re not necessarily a good candidate and the risk of having surgery is significant and you haven’t done a good job of picking a provider with a proven track record then it may not be a wise decision. I generally tell people to simply slow down the train and schedule more consultations if they have doubts or concerns. You should feel very comfortable about your decision and who’s going to be doing your procedure. If you’re not then slow down and schedule a few more consultations. There is a significant difference in outcomes based on who does the procedure. Best, Mats Hagstrom MD
Helpful