Can Lupus Patients Safely Undergo Cosmetic Surgery?

Can patients with lupus erythematosus undergo cosmetic surgery?

Dear Dr.
Lu,
I am a patient with systemic lupus erythematosus and have been experiencing low white blood cell counts (around 2500 to 3500) for some time.
Currently, due to severe winter-related blood inflammation, I am taking anticoagulants.
I would like to ask if, in this situation, it is advisable to undergo cosmetic surgery.
What if my white blood cell count returns to normal and I am not taking anticoagulants?
I have two concerns that I hope to address through cosmetic surgery: one is a flat nasal bridge, and the other is noticeable facial asymmetry.

1.
Regarding my flat nasal bridge, aside from invasive surgical implants, given my current health condition, would it be possible to inject polymethyl methacrylate (PMMA) or is that also considered an invasive procedure? Are there any other non-surgical options with minimal side effects that I could consider?
2.
My facial asymmetry is quite pronounced; the right side of my face appears to have a higher cheekbone and looks more droopy, making it appear larger.
Even friends and family have noticed the asymmetry, especially in photographs.
I first became aware of this issue during high school.
Could you please explain what might be causing this and if there are methods to correct it?
I am particularly troubled by the appearance above my nose, such as having uneven eyes, and when wearing glasses, the flatter right side of my nose causes the glasses to sit closer to my cheekbone.
The left side does not touch the frame, but the right side is noticeably closer, sometimes causing my cheekbone to push against the frame, making it look like my glasses are crooked.
Below the nose, the droopiness on the right side causes the right nostril and mouth corner to sag as well.
When I smile, the right cheek appears to have nasolabial folds, and sometimes I feel like I have facial paralysis, as I need to exert extra effort on the right side to avoid a crooked smile.
I appreciate your response.
Thank you!

Ni, 20~29 year old female. Ask Date: 2016/04/06

Dr. Lu Daokuan reply Plastic Surgery

1.
Surgery is not recommended when there is leukopenia, including cosmetic procedures.
2.
Facial asymmetry is often related to dental issues; the side of the face that is favored for chewing tends to have better blood flow, resulting in a larger and higher appearance.

Reply Date: 2016/04/06

More Info

When considering cosmetic surgery for patients with lupus, particularly those with concurrent issues such as low white blood cell counts and anticoagulant therapy, several important factors must be taken into account. Lupus, or systemic lupus erythematosus (SLE), is an autoimmune disease that can affect multiple systems in the body, leading to complications that may influence surgical outcomes.

First and foremost, the current state of your health is crucial. A white blood cell count between 2500 and 3500 is considered low (leukopenia), which can increase the risk of infections post-surgery. Infections can be particularly concerning for lupus patients, as their immune systems may already be compromised. Additionally, the use of anticoagulants raises the risk of excessive bleeding during and after surgery, which can complicate recovery and lead to further health issues.

Given these factors, it is generally advisable to postpone any elective cosmetic procedures until your white blood cell count returns to normal and you are no longer on anticoagulant therapy. This precaution helps minimize the risk of complications and ensures a safer surgical experience.

Regarding your specific concerns about the cosmetic procedures you are considering, such as correcting a flat nasal bridge and addressing facial asymmetry, there are non-invasive options available. For instance, dermal fillers, such as hyaluronic acid or microcrystalline hydroxyapatite, can be used to enhance the nasal bridge without the need for surgical implants. These fillers can provide a temporary solution with minimal downtime, making them a safer alternative while you manage your lupus symptoms.

As for the facial asymmetry, it is essential to understand that asymmetry is common and can be influenced by various factors, including genetics, dental alignment, and muscle tone. Non-invasive treatments, such as fillers or Botox, may help improve the appearance of asymmetry without the need for invasive surgery. However, it is crucial to consult with a qualified cosmetic surgeon or dermatologist who understands your medical history and can tailor treatments to your specific needs.

In summary, while cosmetic surgery can be a viable option for many, lupus patients must approach it with caution. Ensuring that your health is stable, particularly regarding white blood cell counts and anticoagulant use, is paramount. Non-invasive alternatives may provide a suitable interim solution while you manage your condition. Always consult with your healthcare provider and a qualified cosmetic specialist to discuss the best options tailored to your health status and aesthetic goals.

Similar Q&A

Can SLE Patients Safely Undergo Laser Treatments for Skin Issues?

Hello, doctor! I am a patient with over twenty years of history of Systemic Lupus Erythematosus (SLE), and my condition is currently stable. Recently, I received hyaluronic acid injections to fill in my tear troughs. Will this have any impact on my condition? I am also considerin...

Dr. Yang Zhiya reply Dermatology
Hello, if there are erythema on the face or if there are wounds that are difficult to heal due to long-term medication, laser treatment is generally not recommended. If the skin condition is stable, it is important to have thorough communication with the physician before undergoi...

Can HIV Patients Safely Undergo Cosmetic Surgery for Eye Bags?

Dr. Lu: Hello, I would like to ask about my long-standing concerns with tear troughs and under-eye bags. I have been considering cosmetic surgery but am worried about being denied treatment. I am an HIV-positive individual who has regular follow-up appointments and is on medicati...

Dr. Lü Mingchuan reply Plastic Surgery
You can visit the orthopedic outpatient clinic for a detailed assessment. The Ministry of Health and Welfare Changhua Hospital cares about you.

Understanding Cataracts in SLE Patients: Surgical Insights and Recommendations

Hello, I heard that patients with SLE (Systemic Lupus Erythematosus) may develop cataracts, but isn't surgery necessary? Why did my doctor not recommend surgery initially? What should I do to improve my situation? I also have amblyopia; is that related? It's quite chall...

Dr. Huang Bozhen reply Ophthalmology
As long as the SLE condition is stable, cataract surgery can certainly be performed. It is recommended to consult a medical center; since you are quite young and have SLE along with amblyopia, a thorough evaluation is necessary before surgery to determine whether vision will impr...

Can Lupus Patients Safely Use Weight Loss Medications?

Can patients with lupus erythematosus take weight loss medications?

Dr. Li Yufen reply Dermatology
Hello: Please consult your rheumatologist to determine if it is appropriate for you to lose weight given your current health condition. Thank you. Wishing you peace and happiness.