Blood work-up might be in order

Robin T.W. Yuan, MD answers: Blood loss during Breast Reduction?

I gave birth 3 months ago and lost a lot of blood, I had to have a blood transfusion because I was anemic.

If I lost a lot of blood during childbirth will I lose a lot of blood during a breast reduction? Should I be worried about getting an elective surgery if I'm anemic?


Robin T.W. Yuan, MD
6 months ago

The main question is why you had so much blood loss during childbirth? If this was not related to a systemic problem such as a coagulation disorder but more of a traumatic situation, then it is probably not going to impact your reduction. You should certainly correct your anemia before elective surgery. This may be as simple as taking iron supplements but your gynecologist might want to consult with a hematologist to see if there is any other tests that should be performed to excluded blood disorders. If not, then reduction mammaplasty rarely requires blood transfusions although blood loss is a risk factor. Usually with the use of vasoconstricting drugs injected into the breast tissue and the use of electrocautery or liposuction to remove breast tissue and fat, blood loss is kept to a minimum. I have never (knock on wood) had to transfuse a patient despite large volumes of reduction. Your proactive concern for safety is laudable and smart.

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A: Blood loss during breast reduction

Brent Moelleken, MD
6 months ago

3 months after childbirth may be too early to be undergoing a breast reduction since the breasts are still changing.

With modern tumescent anesthetic techniques, the blood loss during breast reduction can be minimized.  When I was in residency, we routinely had patients autodonate blood.  Now, it is unheard of in our practice because of the minimal blood loss when breast recution surgery is performed expediently by a skilled surgeon using tumescent or superwet anesthetic techniques.

All patients undergoing an elective procedure should optimize their medical health before having surgery.

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A: Excessive Blood loss is unusual during breast reduction surgery

Susan E. Downey, MD
6 months ago

Child birth is a very different situation than elective breast reduction. There are factors which might cause a woman to lose a lot of blood during delivery (problems with the placenta is one) that are never seen during breast surgery. 

It is very unusual to lose a lot of blood during a breast reduction. That said, there are some other considerations. I would recommend waiting a while after your delivery to proceed with breast reduction.  First, you obviously had a difficult delivery --  I would want you back to your normal good health before proceeding with an elective procedure. 

Also, your breasts are still changing from the pregnancy. Even if you are not breast feeding it will take a while for your breasts to go back to a non-pregnant state. As a general rule it takes up to a year for everything to go back to a non pregnant state. Tell your plastic surgeon about your delivery problems, make sure you have clearance from your primary doctor before you go ahead and make sure that you give your body time to recover from the delivery.

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