Are Submuscular or Subglandular Implants Better with Bleeding Disorders?

Am very active, and have VWD (low factor VIII and VWB factors.) PS feels have ample tissue to cover implant (34C/D), plus why cut into the muscle and cause more trauma when there is already anticipated bleeding complications. Working with a hematologist as well. Know many prefer submuscular, but does the situation warrant subglandular? Ever perform submuscular on a person with a known bleeding disorder?

Tags:

Comment on this

12 Doctor Answers | Asked by franney136 in Angleton, TX

Doctor Answers (12)
Community Comments (0)

Bleeding disorder

Yes, I have performed a variety of breast surgeries on patients with various factor deficiencies. I don't believe the sub-muscular versus subglandular approach would matter. Your bleeding times should be corrected prior to surgery and a hematologist should be involved.

Breast augmentation and bleeding disorders

Hi Franney, I would recommend having sub-muscular implants for two reasons. One, you will have less incidence with capsular contractions and less inferior displacement of implants. Two, the sub muscular plane is avascular (less vessels). As long as your hematologist is on board, you should not have any problems. Best wishes, Dr. H

Bleeding disorders and placement of breast Implants

First your bleeding disorder should be managed with the help of your hematologist during the perioperative time before any surgery. Once this is managed, then there is no difference what technique or placement is used for your implants. You should be fine with either submammary or submuscular placement. There is about the same amount of blood loss doing submammary or submuscular placement and this is usually very minimal. The decision on which location to place your implants in... more

Breast augmentation in patients with bleeding disorders

Once the blood deficiency is corrected sufficiently for you to undergo surgery you should under that surgery as if you did not have a bleeding disorder. That is the decision on whether to place the implants above or below the muscle should be based on the end result not on the bleeding disorder. To be extra safe you should have your surgery in a hospital where blood products are immediately availabe rather than an office or free standing surgery center. My response to your question/post... more

Breast implants and bleeding disorders.

If I am going to perform sugery on a patient with a bleeding issue, The workup is key and I work closely with a hematologist. I then choose the pocket which I think is appropriate for the patient.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Are Submuscular or Subglandular Implants Better with Bleeding Disorders?

If I was the surgeon I would opt for sub muscle. But no photos posted. Also I would do ONLY in hospital setting with Heme present, appropriate blood available.

VWD and BA

Your VWD alone does not "warrant" a subglandular placement of the implant. As long as your bleeding disorder is managed with the help of your hematologist you should be fine with either placement. The decision on which position to place your implants in should be made on the basis of the physical characteristics of your breasts. There are pros and cons to each which a board certified plastic surgeon will discuss with you. I can understand why you might... more

Bleeding Disorder and Breast Augmentation

With over 33 years of experience and having operated on patients with VWD, there is no indication to change my preferred approach to breast augmentation. In the vast majority of cases implants are placed in the submuscular position. With both approaches there is minimal blood loss usually less than and ounce. i have never found the submuscular approach to produce more bleeding and it has many advantages over submammary placement including more tissue coverage and decreased capsular... more

Von Willys and elective BAM

I agree with your surgeon, Just yesterday I operated on a middle aged women with VWD, we had her come in an hour earlier than normal, we coordinated her dose of DDAVP with her hematologist. She sailed through her surgery and today is feeling good. I chose to go OVER her muscle for the exact same reason your surgeon related to you. Good Luck

Breast augmentation with Medical Conditions

Yes, surgery is possible with appropriate pre-operative planning and management of the bleeding disorder. Consult with your hematologist to evaluate the appropriateness and/or timing of surgery. Of course, pick your surgeon carefully based on training and experience. Good Luck.