Birth control and breast augmentation. Have you seen issues in your own patients who stayed on it?

Hi, thank you for sharing your question. Some patients who stay on their birth control medication have developed pulmonary embolism, which can be fatal if not diagnosed early. You may have estrogen-free options which your doctor can advise you about.

Oral contraceptives are statistically the most frequent cause of blood clots in young women. The risk of a blood clot increases within 4 months of initiation and then decreases to previous levels within 3 months of stopping treatment. Surgery itself is a risk factor for a blood clot and can add to the risk associated with oral contraceptive use. In general, the decision to stop or continue birth control is dependent on your surgeon and your own risks for blood clots. In patients at higher risk for a blood clot undergoing a higher-risk surgery...discontinuation is certainly a reasonable thing. OCs should be stopped four weeks prior to surgery.

The main problem with birth control pills and surgery is the development of postoperative pulmonary embolism. That is blood clots developing in your calfs due to these pills. This occurrence is very rare. If you decide to continue to use the pills throughout your surgery, you need to be aware of this unusual complication. Careful monitoring for pain in your legs and any trouble breathing post op would alert you to see your doctor immediately. Personally, I have not had any of my patients develop this problem.

Dear vlu333,
birth control increases risk of pulmonary embolism. Every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

There are increased risks of tromboembolisam (blood cloths of legs and lungs) in patient undergoing major surgery while on birth control. However, short surgery like breast augmentation, healthy patient with no associated risks (obesity, history of blood cloths, multiple miscarriages), with proper intraoperative protection, should not present then low risk for DVT/PE. Discuss this issue with your surgeon again, please. Good luck.

Birth control is one of many factors that can affect risk of blood clots after surgery. The official risk scale (the 2005 Caprini Risk Model) gives it 1 point. A major surgery (like breast augmentation) is worth 2 points. If you have no other risk factors, the recommendation is to wear compression stockings and sequential calf compression massagers during surgery and to walk around at least 500 steps a day. There should be no need to stop the birth control based on standard recommendations.

It is common for plastic surgeons to recommend discontinuing the use of hormonal contraceptives, such as the pill, before a breast augmentation procedure. This is because estrogen from hormonal contraceptives can increase the risk of blood clots, which is a concern during surgery.

It’s essential to follow the guidance of your plastic surgeon and consult with your doctor about your specific situation. They can assess your medical history, evaluate the potential risks, and provide advice based on their expertise. They may also be able to discuss alternative contraceptive options that may be suitable during the pre-operative period.

I hope this helps,
Best of luck !

Thank you for your question. I have not had issues with patients who have remained on BCP prior to and after having a breast augmentation. However, it may be best to get clearance from the doctor who prescribed the BCP just to cover all your bases.
Best of luck!

I frequently see patients requesting breast augmentation on the oral contraceptive pill. Unless they have high risks factors for developing deep vein thrombosis post operatively (this is rare in any case), I advise them to continue on the contraceptive medication during the peri-operative period.

The risk with oral estrogen and surgery is the increase in blood clots. The risk is low and is less in younger women, but it is still present. A breast augmentation alone is a fairly short procedure, so the risk is lower than a long procedure. I have had no blood clots in any patient from birth control pills since the estrogen dose is low. Compression socks and getting up and walking will be helpful.