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Does a history of lupus exclude from outpatient gynecomastia surgery?

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Hi,

Does a history of class 4 lupus nephritis with superimposed ANCA vasculitis 2 years ago exclude someone from outpatient gynecomastia surgery? 
Long story long, previously in shape healthy guy mid-30s - I mean fit: I did spartan races, previously ran marathons - but randomly went into lupus nephritis (like 2/3 lupus nephritis and 1/3 ANCA vasculitis of the kidneys based on biopsy) out of no where - no other organs affected. Received chemo, a LONG course of prednisone, and post-induction immune suppression with imuran.  The prednisone caused weight gain and it seems like my pecs became breasts that never went away. Have not had a consultation yet - not even sure if I would be a candidate. 
After all that, I'm CKD stage 1 - a normalized creatinine but proteinuria remains. Still keeping active and in cardiovascular shape. Have no spoken to my Rheum yet about this, as I realize this would be a surgery for my personal insecurities rather than a necessity. 

Linkback: https://www.gynecomastia.org/smf/index.php?topic=34132.0

Re: Does a history of lupus exclude from outpatient gynecomastia surgery?
« Reply #1 on: January 08, 2019, 07:47:30 PM »
I don't know enough about your diagnosis to answer for sure. If you are in clinical remission and your labs have normalized, than I think you could probably go through surgery uneventfully. The biggest concern I would have is how the vasculitis might effect your skin's healing capacity, which will rely on good blood flow. I would suggest going forward with a consultation and thn have your surgeon speak directly to your Rheumatologist.
Dr. Schuster
Chief, Division of Plastic Surgery Northwest Hospital
Private practice in Baltimore, Maryland
10807 Falls Road
Lutherville, Maryland 21093
410-902-9800
email: [email protected]
website: www.CosmeticSurgeryBaltimore.com

Re: Does a history of lupus exclude from outpatient gynecomastia surgery?
« Reply #2 on: January 09, 2019, 11:43:41 AM »
I have operated on numerous patients with Lupus .The clearance for surgery is obtained in consultation with the  nephrologist and myself in all cases. Each case is unique and we try to optimize the medications in a manner to give the patient the best chance at a successful outcome.
Jay M. Pensler,M.D.
680 North Lake Shore Drive
suite 1125
Chicago,Illinois 60611
(312) 642-7777
http://www.gynecomastiachicago.com

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Re: Does a history of lupus exclude from outpatient gynecomastia surgery?
« Reply #3 on: January 15, 2019, 11:22:50 PM »
I've only seen this in one patient, who was otherwise in good health at the time of his surgery.  We cleared him medically, and his course was uneventful. 
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458
617-965-9500
800-785-7860
www.ricksilverman.com
www.gynecomastia-boston.com
[email protected]

Certified by the American Board of Plastic Surgery


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