Can Factor V Leiden Patients Be Candidates for Liposuction?

Factor V Leiden (sometimes factor VLeiden) is the name given to a variant of human factor V that causes a hypercoagulability disorder. In this disorder the Leiden variant of factor V cannot be inactivated by activated protein C.[1] Factor V Leiden is the most common hereditary hypercoagulability disorder amongst Eurasians.[2][3][4] It is named after the city Leiden (Netherlands), where it was first identified in 1994 by Prof R. Bertina. Studies have found that about 5 percent of Caucasians in North America have factor V Leiden. The disease is less common in Hispanics and African-Americans and is extremely rare in people of Asian descent.

Up to 30 percent of patients who present with deep vein thrombosis (DVT) or pulmonary embolism have this condition. The risk of developing a clot in a blood vessel depends on whether a person inherits one or two copies of the factor V Leiden mutation. Inheriting one copy of the mutation from a parent (heterozygous) increases by fourfold to eightfold the chance of developing a clot. People who inherit two copies of the mutation (homozygous), one from each parent, may have up to 80 times the usual risk of developing this type of blood clot.[8] Considering that the risk of developing an abnormal blood clot averages about 1 in 1,000 per year in the general population, the presence of one copy of the factor V Leiden mutation increases that risk to between 1 in 250 to 1 in 125. Having two copies of the mutation may raise the risk as high as 1 in 12.
It is unclear whether these individuals are at increased risk for recurrent venous thrombosis. While only 1 percent of people with factor V Leiden have two copies of the defective gene, these homozygous individuals have a more severe clinical condition. The presence of acquired risk factors for venous thrombosis—including smoking, use of estrogen-containing (combined) forms of hormonal contraception use, and recent surgery—further increase the chance that an individual with the factor V Leiden mutation will develop DVT.

So any surgery even liposuction will have a increased risks of clotting. Best to be examined by your chosen PS and hemotologist. Good luck Dr. B

Dr. Blinski has provided a very extensive and helpful education for all on this issue. Factor V Leiden is one of the  many differences in the blood clotting cascade that occurs in the normal population. The risk to you is that you are more prone to developing clotting during surgery or while you are recovering. There is no impact on wound healing, infection and other risks. In most situations, this status requires no treatment for everyday life but when you have elective surgery this  increased clotting tendency  needs to be discussed and managed.

A common option for patients needing only a small area of liposuction is to have the procedure performed under light sedation with local anesthesia. This mitigates the added blood clotting risk of general anesthesia. After liposuction you should have minimal pain allowing you to be up and moving around - further reducing your risk of developing a DVT. Other strategies may be considered but your condition is often safe to consider minor surgery under local anesthesia like liposuction. Get accurate information from your Plastic Surgeon and Hematologist and then make an informed decision.

Dr. Mosher