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HIV infection and rhinoplasty risks?
Jan 5, 2008

I am 46 years old and would like to have rhinoplasty. I had been near the stages of AIDS a few years ago. My viral load has been undetectable for about three years and my CD4's have remained at around 800. Twice this year I had to stop my meds. I became very ill within about two weeks and my viral load climbed into the 100,000 range. My CD4s dropped below 200. My doctor advised me against the rhinoplasty even when my CD4s were at 800 and viral load undetectable. I know there can be complications with this procedure even for healthy people. It's just that I feel the psychological overlay has been more than bothersome even detrimental. I've also always had immense trouble breathing through my nose. I tend to be a mouth breather especially in the night. I realize nothing is iron clad with a guarantee but what is the worst case scenario? I don't want to lose my nose to a secondary infection. Your response is gratefully appreciated.

Response from Dr. Frascino

Hello,

Why did your doctor advise you against having a rhinoplasty?? Having HIV/AIDS is not a contraindication for having recommended surgery. Studies have been done showing that healing is not delayed and complications are generally no more severe or frequent in patients with HIV/AIDS than in the HIV-negative population. Particularly if you are once again on effective antiretroviral medication with a controlled HIV plasma viral load and reasonable CD4 count, I see absolutely no reason you should not proceed with your procedure! If your HIV/AIDS specialist is the one who advised against the rhinoplasty, demand to know why. Also you could consider getting a second opinion from another HIV/AIDS specialist.

Dr. Bob



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