I am contemplating getting breast augmentation and abdominoplasty (mommy makeover) done. I was diagnosed in my late teens with Antiphospholipid Antibody Syndrome and am homozygous for Factor V Leiden. I have never had a blood clot and was only tested because my mother also has Factor V Leiden. Are these procedures I can have done with proper precautions and care, or should I not even think about it?
Mommy Makeover Possible with Multiple Clotting Disorders?
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Mommy makeover with a hypercoagulable clotting disorder.
Thanks for your question.
Mommy makeover usually involves abdominoplasty which in and of itself can have a higher risk of blood clots than some other surgeries because more pressure is placed on the intra abdominal veins when the abdomen is tightened.
Most surgeons take routine precautions such as compression stockings, pneumatic compression boots and a low dose of heparin or other anticoagulant and even in routine cases.
Factor five Leiden deficiency can make the risk of blood clots even greater.
I agree with others here that you should consult with a hematologist, but in similar situations I know that surgery can indeed be performed, usually with the addition of blood thinning agents before as well as after your surgery.
The key question in my mind is: is the additional risk acceptable to your surgeon, and is it acceptable to you? Even with appropriate measures you could develop a possible serious or life threatening blood clot.
With preventive anticoagulation you have an increased risk of bleeding post operatively.
With or without treatment there are risks that you must consider and ultimately be comfortable with. I truly understand the importance of this type of surgery in restoring a sense of being normal and a sense of self esteem but sometimes it is difficult to remember that not having surgery is an option as well.
Your hematologist and your plastic surgeon will have to guide you through what will be a challenging decision.
I am assuming that you had a full work up by a hematologist to reach the diagnosis of antiphospholipids syndrome and Factor V leiden mutation. This puts you at a very high risk for deep venou thrombosis nad pulmonary emboli. You are at high risk with any surgery under general anesthesia. You are a very high risk even with the all the precautions taken during and after surgery. Therefore you are not a candidate for elective cosmetic surgery.
Mommy Makeover with Clotting Disorders
The concern here is your increased risk for a blot clot (Deep Venous Thrombosis or a Pulmonary Embolus). I would recommend a formal evaluation by a hematologist. You will definitely require some form of DVT/blood clot chemoprophylaxis (medicine to help prevent a blot clot) and early ambulation. I would also develop a treatment plan to minimize the operative time to facilitate to your recovery. Please visit with a board certified PS to learn more about your options and risks.
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Mommy Makeover with Clotting Disorders?
Thank you for the question.
I would suggest that you consult with a well experienced hematologist and ask about your specific risks with elective surgery, given your specific clotting disorder. It is possible, as you say, that with proper precautions and care, that you may be able to undergo the procedure. Again, much will depend upon what the hematologists say.
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