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Connective Tissue Disease and Its Impact on Outcomes Following Cosmetic Surgery

Jose Reyes, BS; Ying Ku, BS; Jacob Lammers, DO; Diane Jo, MA; Ryan Khalaf, BS; R'ay Fodor, BS; Lianne Mulvihill, BA; Mazen Al-Malak, MD; Brian A. Figueroa, MD; Antonio Rampazzo, MD PhD; Bahar Bassiri Gharb, MD, PhD
Case Western Reserve University School of Medicine/ CCF
2023-02-08

Presenter: Jose Reyes

Affidavit:
Bahar Bassiri Gharb

Director Name: Bahar Bassiri Gharb

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics

Purpose: Connective tissue disease (CTDs) and medications used for treatment can impair wound healing and increase risk of infection. This study sought to elucidate whether CTDs are associated with higher post-operative complications in cosmetic surgery.
Methods: Patients with Rheumatoid Arthritis (RA), Lupus, or Scleroderma that underwent aesthetic surgery at a single institution were reviewed and matched to controls without CTD. Demographics, comorbidities, medications, and post-operative outcomes were recorded. Post-operative complications were divided in minor and major (requiring re-operation). To reach 80% power, a sample size of at least 96 patients was estimated.
Results: Hundred-twenty-eight CTD patients 131 and non-CTD patients were included. Eighty patients had RA, 40 lupus, and 8 scleroderma. The average age in CTD and control groups was 59±13, and 57±12 years. Mean follow-up time in the CTD group and non-CTD group was 7+13 months and 5+8 months. CTD cohort underwent 65 facial procedures, 49 body contouring, and 14 breast procedures. Non-CTD cohort had 84 facial procedures, 35 body contouring, and 13 breast procedures. Seventy CTD patients were on DMARDs/steroids: 16 discontinued medications prior to surgery (as indicated), and 8 continued medications (against indications). Seventeen (6 major/11 minor) complications occurred in the CTD group compared to 9 (3 major/ 6 minor) complications in the control group (p=0.913). Patients that did not interrupt DMARDs/steroids did not experience a post-operative complication.
Conclusion: Patients with CTD diagnosis and who are on anti-rheumatologic medications may not be at greater risk for post-operative complications compared to the general population seeking cosmetic surgical interventions.

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