Ask Dr. Pane! Do you work on patients with heart history AND do all patients need clearance or only the ones with a history of problems?

In a recent Instagram Live session with our founder and Chief Medical Officer, Dr. Thomas A. Pane, patients asked about how existing medical issues may impact cosmetic surgery. These are very common questions, especially among prospective patients who are older or in poor physical health, and so as you can imagine, we at Atlantic Coast Aesthetics see them a lot. Dr. Pane chose to tackle two specific questions head-on, which we’ve grouped together here because of the overlap in content and because we believe this information is valuable to all patients who may be considering cosmetic surgery but maybe aren’t exactly in Olympian physical condition. The questions as received during the IG Live session were: “Do you work on patients who have heart issues? Also, does every patient need to have medical clearance or only the ones who have issues?” Let’s see what Dr. Pane had to say!

Depending on the issue, yes. Something fixed as a child which hasn’t been a problem since or a minor issue, such as a congenital heart murmur which resolved on its own or with relatively minor surgical intervention, shouldn’t be a problem. Patients in anesthesia category ASA-II (patients with minor history such as described above) or ASA-I (patients with no history of heart issues) should be fine. Patients outside that bracket, such as patients who have received artificial valves, coronary bypass or a full heart transplant etc., would not be able to undergo anesthesia or surgery in an office setting.

If the patient’s problem is stable but just a little too much for the office setting, Dr. Pane says he might do it, but the patient would need to undergo the procedure in an ambulatory surgery center or day surgical center, if they’re candidates at all. It really depends on the issue and what the patient’s GP and/or cardiologist says about the patient’s fitness to undergo surgery with a reasonable degree of safety. All of this background, history gathering and legwork is done in the screening leading up to the surgery, so it is possible if the patient qualifies under current best practices.

 Regarding needing medical clearance before cosmetic surgery in the broader patient population: If you have any medical issues, a medical clearance will normally be required for the peace of mind of the patient, the surgeon and the surgical term, but more importantly to help ensure the safety of the patient. Also, it’s just generally good practice.

If you’re young and healthy with no preexisting medical history, you may only need routine labs to screen for potential problems which surgery or anesthesia might exacerbate. If you have a history of high blood pressure, diabetes, etc., those may be a bigger factor which requires consultation and signoff from your GP or managing specialist, depending on the situation. However, if the GP or managing specialist says everything’s okay and there’s no reason for you not to undergo the procedure, it should be okay.

Dr. Pane noted that he had gone through a consult the week before where the patient was cleared, but was cautioned that they were going to Miami for the surgery. At this time, Miami was making some unfortunate headlines regarding COVID-19, which added the risk factor for the patient and the team as well. The novel coronavirus and its carry-on effects remain factors, especially for out-of-state patients who travel in for surgery, because depending on the state they may have to quarantine when they return home.

Of course, all usual precautions and protocols should be followed, such as frequent handwashing, hand sanitizing, wearing a mask and limiting or avoiding close-quarters interactions with others outside your household. It’s also imperative, now more than ever, to follow any surgical aftercare recommendations diligently and thoroughly, to minimize risk of complications and help assure the best possible outcome. But generally speaking, given a young, healthy patient, there shouldn’t be any issues.

If you or someone you love has a question about anything regarding cosmetic surgery, the staff of Atlantic Coast Aesthetics is always happy to address your interests and concerns. Call us at (561) 422-4116; click here to contact us; or follow us on Facebook, LinkedIn, Twitter and of course Instagram! Your question might even be the focus of an upcoming Ask Dr. Pane segment, where we give you straight talk and real answers so you can make the best decisions for you regarding your cosmetic surgery journey. Remember, at ACA we believe the only bad question is the one you DON’T ask!