Over 40 and on Birth Control Pills; a Risk for Blood Clots?

I am 43 and take birth control pills. My plastic surgeon has not mentioned this as a risk factor for blood clots, but I have reading that it is. Should I be concerned? I am in good health.

Doctor Answers (2)

Usually advised to stop

+1
Birth control pills and estrogen replacement therapy should be stopped for four to six weeks before surgery in patients who are having surgery. The use of these medications has been known to increase the risk of developing blood clots in the legs. Please mention this to your surgeon to find out if you should stop taking your pills.


Toronto Plastic Surgeon
5.0 out of 5 stars 63 reviews

Blood clot risk with surgery

+1

Excellent question since safety should be your first priority when deciding on what plastic surgery procedure to have and who should perform it. Most patients having general anesthesia and operations longer than 1 or 2 hours probably form some blood clots in their veins from pooled static blood but the majority of these are clinically insignificant. The problem is when the clots become large, dislodge and travel to the lungs where they can be fatal. The risk for this happening is higher for certain types of surgery (higher for hip fracture surgery), older patients (low if under 40, moderate from 40 to 60 and high if over 60), if cancer is present or there is a history of having had cancer, if the patient is pregnant, if there is a history of previous blood clots, if the patient is obese, if there is a blood disorder present (lupus, phospholipid disorder...), if the patient is paralyzed, if the patient is confined to bed after surgery, if there is a history of congestive heart failure, if the patient is taking oral contraceptives, if the patient is a smoker and finally the length of the surgery.  In general we like to keep elective surgery time down to 5 or 6 hours but that is not always possible. Furthermore there have been cases where patients had fatal clots with only 5 hours of surgery because they were at high risk.

The most important thing is that your surgeon should be proactive in this by assessing your risk before surgery, position you properly on the operating table, get you out of bed early after surgery, have you quit smoking before surgery, use leg compression devices during surgery to maintain blood circulation during surgery and when necessary employ medications to prevent blood clots during surgery. That means you should be concerned and you should discuss this with your surgeon before surgery rather than online with doctors who have never seen you,  in all likelihood never will see you and do not even know what kind of surgery you are going to have. Temporarily stopping the birth control pills may be an option.

Aaron Stone, MD
Los Angeles Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.