Anemic--safe to have Smart Lipo with a 10.3?

Question

My hemoglobin was 10.3 when I did bloodwork for my smart lipo and my doc wanted to push my surgery by a month after taking RX Iron supplements. I have uterine fibroids and heavy periods from time to time. Realistically, do you think there will be improvements in a month of taking the RX? And should I be concerned about having the procedure in general? I'm trying to mentally prepare myself--I was disappointed to not have the surgery but glad they took precautions and now I know of my condition.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

When you have anemia, you don't tolerate surgery as well as when you don't have anemia. That means a higher risk for problems during and after surgery. Some of these problems have nothing to do with the amount of blood lost or not lost during surgery. Wondering what a month's worth of iron supplements will do for your anemia is not a matter of guesswork. Rather, your hemoglobin test is repeated to see if your hemoglobin improved...or worsened. Smart lipo or most lipo done by experts in lipo doesn't usually involve significant blood loss. However, true experts don't "roll the dice" with your health when getting you ready for cosmetic procedures. Perhaps, you should get your fibroid problem fixed first.

Ryan Rebowe, MD · Answer

Technically, Liposuction should be safe with that Hgb level, but I agree with your treating physician that the best thing to do is supplement an recheck the hemoglobin in one month. If you are making strides in terms of regaining hemoglobin, you may even consider postponing it longer until you are up to a normal hemoglobin level.

Jason Emer, MD · Answer

these are the types of questions you should be reviewing with your doctors. above 10 is safe but if you go below you can cause issues for yourself. you need to prepare. please speak to your physician. we do this frequently in our practice without issues.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical optimization with hormonal therapy (see link to help boost their weight loss before surgery and help them heal after).

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Gregory Chambon, MD · Answer

Yes, your hemoglobin can improve significantly taking Iron for 1 month.
Smart Lipo does not cause a significant amount of blood loss due to the laser cauterizing the fat tissue, so you are still a candidate.

Leonard Grossman, MD · Answer

When liposuction is being performed by a well trained plastic surgeon, the blood loss is extremely minimal during the procedure. Most patients don't even feel any different after such a procedure has been done. There is absolutely no need to have general anesthesia for liposuction. Propofol is sufficient when combined with tumescent anesthesia. The recovery is easy and the results should be good as long as the plastic surgeon is proficient. I hope this helps and good luck from New York City plastic surgery

Mats Hagstrom, MD (license on probation) · Answer

I suggest you talk to your primary care doctor about your hemoglobin level and get an assessment if this is related related to iron deficiency.

You could also consider scheduling the procedure so that the timing is ideally a week or two before your period(if possible).

I personally would not have an issue doing liposuction and someone with a hemoglobin of 10.3. correctly done liposuction has very little blood loss. For most young healthy people I did not order preoperative labs before liposuction.

Blood loss is limited by using sufficient amounts of tumescent solution and letting the solution stay in the tissues for 15 to 20 minutes before starting Liposuction.  When using good surgical technique there’s typically minimal blood loss with moderate amounts of liposuction. When plastic surgeons do not spend enough time placing tumescent solution or allowing the solution to take full effect blood loss can be significant and patients subsequently develop much more bruising that lasts much longer.

In your case your best option is to discuss this with your plastic surgeon and see if he’s willing to do the procedure at your current hemoglobin level if not improved with iron supplements.

Best,

Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Each plastic surgeon has a unique preoperative protocol based upon training and lifetime clinical experience. 
In general, in our practice, we recommend a preoperative hemoglobin of at least 11. Iron supplementation should bring your hemoglobin to a safe level within 1-2 months. 
We also recommend a visit to your gynecologist regarding the fibroid issue.
Best wishes...

Anemic--safe to have Smart Lipo with a 10.3?

Answers (7)

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