For this reason, lupus patients considering breast reconstruction or other cosmetic surgery must prioritize consultations with experienced specialists who understand the complexities of autoimmune conditions. The collaboration between rheumatologists, oncologists, and plastic surgeons ensures personalized care that balances aesthetic goals with individual health needs.

Understanding Autoimmune Disease and Breast Surgery

Lupus is an autoimmune disease where the immune system attacks healthy tissues, causing inflammation and making surgery more challenging. It can slow healing, increase infection risks, and lead to complications like scarring. Medications used to control lupus, such as immunosuppressants, may also impact recovery.

Surgery is best performed when lupus is stable and involves careful planning and close monitoring by a team of specialists who understand how lupus impacts the immune system. This approach ensures the safest outcome.

What Does It Mean for Lupus to Be Stable?

Surgery is safest for lupus patients when the condition is stable, meaning there are no active flares or significant inflammation. Stability reduces the risk of complications like poor healing, infections, and organ issues. Achieving stability may involve managing symptoms with medications and monitoring organ function.

Ultimately, your doctor will assess whether your lupus is under control before surgery and may recommend delaying the procedure if flares are present. Ensuring stability allows your body to handle the stress of surgery and recover more effectively, making it a critical factor in planning a successful procedure.

When to Consult with a Lupus Specialist

Lupus patients should consult with a specialist as soon as they consider breast reconstruction surgery, ideally several months in advance. This allows enough time to assess the stability of their lupus, make any necessary medication adjustments, and coordinate care with other doctors, like rheumatologists or oncologists.

Early consultations also give the surgeon time to evaluate health risks, discuss realistic outcomes, and create a personalized surgical and recovery plan. Starting the process early on ensures that lupus is well-managed and the body is prepared for the procedure, reducing the likelihood of complications.

Breast Reconstruction Options for Lupus Patients

Lupus patients have several breast reconstruction options, but the choice depends on their overall health, lupus stability, and personal preferences.

These are the most common approaches:

• Implant-Based Reconstruction:
  What It Is: Using saline or silicone implants to rebuild the breast.
  Considerations: This option may involve a shorter surgery and quicker recovery, but lupus patients may be at higher risk of complications like infection or capsular contracture due to immune system issues.
• Autologous Reconstruction:
  What It Is: Using the patient’s own tissue, often taken from the abdomen, back, or thighs, to reconstruct the breast.
  Considerations: While this method can offer more natural results, it involves a more extended surgery and recovery time. It may not be ideal if lupus affects organ systems or compromises healing.
• Combination Techniques
  What It Is: Combining implants with autologous tissue for a more customized result.
  Considerations: This approach offers flexibility but may increase surgical complexity and recovery demands.
• Delayed Reconstruction
  What It Is: Waiting until lupus is stable or cancer treatment is completed before undergoing reconstruction.
  Considerations: This allows the body to recover fully and minimizes risks associated with active lupus or ongoing treatments.
• Fat Grafting
  What It Is: Using fat from other parts of the body to shape or refine reconstructed breasts.
  Considerations: This minimally invasive technique may be a good option for touch-ups or minor adjustments.

Important Considerations Before Surgery

Before any surgery, your doctor will consider several factors to determine your candidacy.

Typically, these considerations include:

• Overall Health Assessment: Surgery is safest when lupus is under control, so your doctor will first check your health and organ function.
• Immune System Status: Lupus and its treatments can slow healing and increase infection risks. Your care team will guide you on how to manage this.
• Medication Adjustments: Some lupus medications may need to be adjusted before surgery to prevent complications or flares.
• Type of Surgery: Less invasive surgeries are often better for lupus patients because they have fewer risks.
• Post-Surgical Recovery: Healing times can be longer for lupus patients, and there may be a higher risk of scarring or complications. Careful monitoring and a tailored recovery plan are critical.
• Communication Between Specialists: Collaboration between the plastic surgeon, rheumatologist, and other relevant specialists (e.g., oncologist for cancer treatment) ensures a comprehensive approach to care.

DIEP Flap Breast Reconstruction for Lupus Patients

DIEP flap surgery uses skin, fat, and blood vessels from the lower abdomen to reconstruct the breast, providing natural-looking results without sacrificing abdominal muscles. This procedure can be a viable option for lupus patients, but it requires extra care due to the complexities of the condition.

Since lupus can affect healing and the immune system, the surgery is best performed when the disease is stable and the patient is under the care of a skilled surgeon and a coordinated medical team. While the recovery process may take longer due to the involvement of two surgical sites, with careful planning and close monitoring, many lupus patients achieve excellent outcomes.

Tram Flap Options for Lupus Patients

TRAM (Transverse Rectus Abdominis Myocutaneous) flap surgery reconstructs the breast using skin, fat, and muscle from the lower abdomen. For lupus patients, this procedure involves additional considerations due to the impact of lupus on healing, immune function, and tissue health.

Patients should consult with a plastic surgeon experienced in lupus care and their rheumatologist to assess their suitability for the TRAM flap. Alternative options like DIEP flap surgery, which preserves the abdominal muscle, might also be discussed to minimize risks while achieving effective reconstruction.

Implant-Based Reconstruction for Lupus Patients

For lupus patients, implant-based reconstruction can be a less invasive alternative to flap surgeries like TRAM or DIEP. This approach uses saline or silicone implants to rebuild the breast, offering a shorter surgery time and reduced recovery demands.

Implant reconstruction is particularly appealing for lupus patients whose condition might make complex surgeries more risky. However, it’s important to note that implants come with their own set of considerations, including a higher risk of capsular contracture (scar tissue around the implant) and infection, especially for those on immunosuppressive medications.

Potential Risks With Breast Reconstruction For Lupus Patients

Breast reconstruction for lupus patients can be successful, but it carries some unique risks due to the nature of the autoimmune condition. These include:

• Slower Healing: Lupus can impair the body’s ability to heal, increasing the time needed for recovery and the risk of wound complications.
• Infection: Medications like immunosuppressants may weaken the immune system, making patients more susceptible to infections.
• Flares: The stress of surgery may trigger a lupus flare, leading to inflammation and other symptoms.
• Tissue Damage: Poor blood flow or vascular issues associated with lupus can increase the likelihood of tissue breakdown or necrosis, particularly in flap surgeries.
• Capsular Contracture: For implant-based reconstruction, lupus patients may have a higher risk of developing excessive scar tissue around the implant.
• Organ Complications: Lupus-related organ involvement, such as kidney or heart issues, can complicate surgery and recovery.

To minimize these risks, lupus patients must undergo reconstruction when their disease is stable and work with a multidisciplinary team experienced in managing autoimmune conditions.

Lupus Patient Testimonial Post Breast Reconstruction

When lupus patient Paula Lindsey discovered she had breast cancer, she was devastated. Not only was she already facing the challenges of lupus, but now she also had to make critical decisions regarding her treatment options for breast cancer.

Since lupus affects the immune system, undergoing surgery can be concerning. Additionally, the choices surrounding breast reconstruction after a mastectomy can feel overwhelming.

In this testimonial, Paula shares her journey through breast cancer and her experiences with breast reconstruction under the care of plastic surgeon Dr. Chrysopoulo.

Expert Breast Reconstruction for Lupus Patients at PRMA

If you’re navigating the complexities of cancer treatment or considering cosmetic surgery as a lupus patient, our San Antonio plastic surgeons are here to guide you with care and expertise. We understand the unique challenges of balancing autoimmune conditions and recovery, and we’re committed to helping you achieve safe, beautiful results.

Contact us today to book a Virtual Consultation. Our expert medical team will walk you through the process, address your concerns, and create a personalized plan prioritizing your health and well-being. Don’t wait—your next step toward recovery is just a consultation away!