More than once, we’ve seen a patient for cosmetic plastic surgery, completed the paperwork, had the physical exam and scheduled her for surgery.

Then, she calls, saying she is with child and asks if she should go ahead with that face and neck lift… or hold off on surgery.

           (See some face & neck lift before and after pictures.)

Here’s the rub: almost all the procedures we offer are done under anesthesia. As you probably know, mother and fetus share a blood supply. So, the chances of harming the unborn child are very high if a general anesthetic is given during the first three months of pregnancy. Then, our marching orders become: “Please wait until after the child is born.”

          (Read more about our very modern anesthesia use.)

Now, we give female cosmetic surgery patients pregnancy tests before surgery just to make sure.

Many patients want to know if the same policy of no-surgery-for-expectant-moms is also in effect for facial fillers like Juvéderm^®, Restylane^®, Radiance, Bellafill (formerly: Artefill) and BOTOX^® during pregnancy.

After childbirth, we usually advise waiting six weeks and getting consent from the patient’s obstetrician. After the six weeks wait – but before surgery – we need another physical exam with all the necessary blood counts to make sure the patient’s body is functioning as well as if she had never been pregnant.

          (Read more about physicals before cosmetic surgery.)

In this case, the fillers do not enter the mother’s blood stream and are eventually metabolized by the body. Thus, having facial fillers or BOTOX^®, Xeomin^® or Dysport should not be any more harmful than any other medications the mom may be taking.

However, in medicine, we don’t have 100 percent certainty about all the interactions that may take place between various drugs and the body. Therefore, let’s also put facial fillers on hold until after birth.

You may have already guessed the next development. A proud mom wants to know if it’s O.K. to have the facial fillers now that baby has been born and is breastfeeding. Our response: it’s not likely to cause a problem, but since we’ve already delayed having a cosmetic surgeryprocedure, why take a chance now? Have the fillers after breastfeeding is concluded. Or, hold up on breastfeeding for the time being  if you really want facial fillers.