Gynecomastia, HIV and Cosmetic Surgery in New York
We were dismayed to read last month that a Manhattan cosmetic surgery practice denied gynecomastia surgery to patients with HIV. In the ensuing legal case, a New York judge ruled that by automatically rejecting infected patients, the practice violated the Americans with Disabilities Act.
According to an article posted on NBCNews.com, U.S. District Court Judge Analisa Torres explained in her ruling that cosmetic surgery practices have the responsibility to demonstrate why screening out patients with a medical condition is necessary. Since the doctors in question turned patients away automatically without investigation, the practice did not meet its obligation under the ADA.
We believe that had staff at the Manhattan cosmetic surgery practice investigated, they would have concluded that there’s virtually no reason to deny services to otherwise healthy HIV patients. Here’s why.
From the Patient’s Perspective
According to an article published in the Journal of the American Medical Association in 2006, highly active antiretroviral therapy (HAART) has transformed HIV from a disease causing early death into a chronic but manageable condition. The article reviewed a study comparing 332 matched pairs of HIV positive and non-HIV patients who underwent surgery for a variety of reasons. The research team found that the HIV patients had a slightly higher incidence of pneumonia following surgery and that 10 died within a year vs. 2 of the non-HIV patients (though no death appeared to be directly related to surgery). Other than those two findings, the study noted “no significant difference” in complication rates and nearly identical numbers of days in hospital and follow up visits.
More than ten years ago, then, researchers found that many HIV patients elect to undergo surgery to address physical issues that would not have been treated with surgery prior to HAART. Furthermore, the NBCNews article noted that the U.S. Supreme Court ruled that healthcare professionals may not hide behind ignorance to deny HIV patients medical services twenty years ago.
From the Practice’s Perspective
We have treated several male and female patients with HIV-positive status in our Manhattan cosmetic surgery practice. We view it simply as a medical condition that must be taken into consideration just like any other.
If a patient tells us he or she is infected, we take extra steps to understand their overall health, including viral load. When indicated, we coordinate with the primary care physician.
We do test prospective patients for HIV who do not know their status. There are two reasons for this. First, it’s important to inform HIV positive patients so they can take steps to safeguard their health as needed. In addition, the operating team needs to know in the rare event one of us is stuck with a needle containing HIV positive blood (in which case anti-infection measures can be taken).
It’s our goal to form open, mutually satisfying relationships with our patients. We have honest, two-way discussions about all the keys to successful cosmetic surgery, including health conditions, medications and so on. Guys with gynecomastia and HIV are special cases, not because of inherent dangers to the patient or medical staff, but because antiretroviral drugs sometimes trigger man boobs. The medications a gynecomastia patient takes always require discussion, as we need to evaluate the possibility of recurrence. With all that said, we have never turned away a patient because they are HIV positive.
If you live in or near Manhattan and cosmetic surgery is on your mind—for man boobs or another reason—give us a call at 212-570-6080. We’ll welcome you as an HIV positive person just like we do everyone else.