Hormone Contraindications in Plastic Surgery

Introduction:

In recent years, plastic reconstructive surgery has attained popularity, with many individuals seeking to improve their physical appearance or correct certain physical features. However, before undergoing any plastic surgery procedure, it is essential to consider any underlying medical conditions or medications that may impact the outcome of the surgery. Hormones are critical when undergoing plastic surgery, as they can significantly impact the procedure's healing process and overall outcome.

What Are Hormones?

Hormones transport signals through the blood and interact with specific cells or tissues. They are essential substances that regulate the development of body tissues and physiological functions. The body has different types of hormones, including estrogen, progesterone, testosterone, and cortisol.

What Is the Role of Hormones in Plastic Surgery?

Hormones can play a role in plastic surgery by affecting the appearance and structure of the body. For example, estrogen and testosterone can impact secondary sexual development, like the growth of breast tissue and muscle mass. In addition, human growth hormone (HGH) can promote tissue growth and repair, which may be desirable in certain plastic surgery procedures.

However, hormones can also increase the risk of complications during and after plastic surgery. For example, estrogen and testosterone use in patients with a history of cancer can increase the risk of cancer recurrence and interfere with cancer treatment. In addition, HGH use may lead to the development of acromegaly, a serious condition characterized by the overgrowth of bone and soft tissue.

Hormones can impact the body's response to surgery, including wound healing, blood clotting, and inflammation. Overall, the role of hormones in plastic surgery must be carefully evaluated to ensure the patient's safety.

What Are the Hormones Contraindicated in Plastic Surgery?

Certain hormone contraindications in plastic surgery should be considered to minimize the risks associated with these procedures.

Estrogen:

Estrogen is contraindicated in certain plastic surgery procedures due to the potential for increased risk of complications.

• One significant contraindication for estrogen use in plastic surgery is in patients with a history of breast cancer or other estrogen-sensitive cancers. Estrogen can promote the growth and spread of cancer cells, and its use in patients with a history of these cancers can increase the risk of recurrence and interfere with cancer treatment. Therefore, plastic surgery procedures such as breast augmentation or reconstruction may not be recommended for these patients.

• Estrogen may also be contraindicated in patients with a history of blood clots or other clotting disorders. Estrogen increases the probability of forming blood clots, and its use in these patients may further increase this risk. Procedures such as facelifts, which can increase the risk of blood clots, may be contraindicated in these patients.

• Estrogen use may also affect the results of procedures such as liposuction, where estrogen can interfere with the breakdown of fatty tissue and reduce the procedure's effectiveness.

Testosterone:

Testosterone is a male sex hormone crucial in developing and maintaining male reproductive organs and secondary sexual characteristics. In addition, testosterone therapy is used to address hypogonadism (reduced quantity of testosterone).

• However, testosterone therapy can increase the risk of blood clots, stroke, or liver damage.

• Testosterone therapy can also affect the healing process after surgery by promoting acne, hirsutism (growth of thick and dark hair on face in women), or masculinization of female features.

• Facial feminization surgery is a surgical procedure that aims to transform male facial features into female ones. Facial feminization surgery can include various procedures, such as brow lifts, rhinoplasty, or facial implants. Testosterone therapy can affect the facial surgery outcome by promoting facial hair growth, the thickening of the skin, or the enlargement of the jawbone.

• Testosterone therapy can also increase the risk of complications, such as hematoma, infection, or scarring.

Growth Hormone:

Human growth hormone (HGH) is a hormone that promotes body growth and physiological development. In addition, HGH plays a role in maintaining muscle mass and bone density in adults. It is commonly used in plastic surgery procedures to enhance the surgery results.

• However, it is contraindicated in certain patients, including those with a history of cancer, diabetes, or heart disease.

• It can increase the risk of complications during and after surgery, and patients with these conditions may be at increased risk of complications.

• It may also lead to acromegaly, a rare but serious condition characterized by bone and soft tissue overgrowth. Acromegaly can lead to various symptoms, including joint pain, swelling, and deformities.

• One of the primary contraindications to using growth hormone (GH) in plastic surgery is the risk of hyperglycemia or high blood sugar levels. GH can cause the liver to produce more glucose, leading to high blood sugar levels. High blood sugar levels lead to delayed or improper wound healing.

Cortisol:

• Adrenal glands synthesize cortisol hormone. This hormone can impact the body's response to surgery. Cortisol is involved in the body's stress response, and elevated cortisol levels can lead to inflammation and delayed healing.

• Patients with high cortisol levels, such as those with Cushing's syndrome, may be at increased risk of complications during and after surgery.

What Are the Other Hormonal Therapies Contraindicated During Plastic Surgery?

Oral Contraceptives:

• One of the most critical hormone contraindications in plastic surgery is oral contraceptives. Oral contraceptives contain a combination of synthetic hormones, including estrogen and progesterone, that prevent ovulation and pregnancy. While oral contraceptives are generally considered safe, they can increase the risk of blood clots, which can be a significant concern during and after surgery.

• Blood clots can lead to complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE), which can be life-threatening.

Therefore, patients are advised to stop taking oral contraceptives at least four weeks before surgery. This allows the body to clear any excess hormones, reducing the risk of blood clots. In some cases, oral contraceptives may be contraindicated altogether, depending on the type of surgery and the patient's medical history.

Hormone Replacement Therapy:

Another hormone contraindication in plastic surgery is hormone replacement therapy (HRT).

• HRT is a treatment used to alleviate symptoms of menopause, such as hot flashes, vaginal dryness, and mood swings.

• HRT can include estrogen, progesterone, or a combination of both.

• Like oral contraceptives, HRT can increase the risk of blood clots and other complications during and after surgery.

Conclusion:

In conclusion, hormones can play a significant role in plastic surgery, but their use can also increase the risk of complications. Proper preoperative evaluation and patient education are essential to minimize risk and achieve the desired results. Hormone contraindications in plastic surgery must be carefully evaluated to ensure the safety and effectiveness of the procedure. Patients should also have regular follow-ups with their plastic surgeons to minimize the risk of complications in the postoperative period.