The safety of cosmetic procedures in pregnant and lactating patients is a complex clinical question surrounded by uncertainty. Our objective is to consolidate data on the safety of commonly requested cosmetic procedures in the pregnant and lactating population after systematic review of the current literature so as to guide evidence-based care in the future.
A systematic search of the PubMed database was conducted for articles pertaining to cosmetic procedures in pregnancy and lactation. Prior review literature was also referenced.
Due to a lack of controlled trials, individual cases were also considered. Minor procedures that involve shave, punch, snip, or electrocautery or considered safe. With respect to chemical peels, glycolic and lactic acid peels are deemed safe; However, TCA and salicylic acid peels should be avoided or used with caution. Although safety data on botulinum toxin A is insufficient, is may be safe since systemic absorption and placental transfer are insignificant. Sclerotherapy can be safe in pregnancy but must be avoided in the 1st trimester and after the 36th week. Laser and light therapy have been considered generally safe for granulomatous conditions and condylomata. Epilation should be limited to waxing, shaving, and topicals instead of permanent procedures. In lactation, most therapies discussed above are safe but fat transfer, sclerotherapy, and tumescent liposuction are not recommended.
More controlled trials are needed to make concrete recommendations on safety of cosmetic therapy during pregnancy and lactation, but preliminary evidence suggests excellent safety profiles for many commonly requested cosmetic procedures.