Breast Augmentation and Immunosuppression Drugs
Q: Dr. Eppley, I am curious to know if being on immunosuppression is a reason that I can not have breast augmentation. I am on 5mg of prednisone, Imuran and Plavix daily. I am unhappy with my breasts and is interested in breast implants. Is this something that can be done, or not while on those medications? Thank you for your time.
A: Being on immunosuppression is not necessarily a contraindication to breast augmentation surgery. The risk of doing surgery on these medications is not really one of implant infection but a medical one (adrenal suppression) to avoid a postop hypoadrenal crisis with an inadequate stress response to the effects of surgery and hypotension issues. Int such patients that risk is mitigated with supplement doses of steroids during and after surgery.
That behind said the dose of 5mg of Prednisone daily would not be considered significant enough to warrant the need for additional steroid coverage. The focus then becomes one of making sure that tissue healing would be normal and supplementation with Vitamin A and Zinc are well known to help lessen any adverse effects of immunosuppression therapy on collagen production which is paramount for adequate wound healing.
When it comes to the drug Imuran, the risk of complications by being on the drug must be weighed against the risk of a flareup being off of it. Since Imuran is a purine antimetabolite immunosuppressive medication the medical literature does indicate a proven higher risk for wound healing problems. Is this is one she can continue with before during and after surgery.
Plavix, however is a different story. I don’t know why she is on it as your medical history is not detailed enough to make that determination. But I would speak to the doctor who prescribed it to determine its absolute medical necessity. I would be very hesitant to do surgery in her unless she was off of it as that is a hematoma just waiting to happen.
Dr. Barry Eppley