Must Take Heparin After Breast Augmentation, Should I Be Worried About That Causing a Hematoma?

This does not make sense to me. You are at increased risk of forming blood clots so the most dangerous time for you is on the operating room table when you could form clots while under anesthesia. That means when you need it the most you will not be medicated. I have operated on a number of patients cosmetic and reconstructive who took Lovenox before and after surgery and found it to be very safe.

Starting a blood thinner 3 days after surgery can be a disaster. I know of a patient 7 days out from a rhinoplasty who went jogging and had a sudden expanding bleed in the nose. Another a few days out from a facelift bent down to pick up a bar of soap in the shower and one side of the face suddenly swelled up with a bleed and subsequent clot. Now imagine those case scenarios with a blood thinner on board. Even if you say that before the thinner you are hypercoagulable that does not mean you are right on the normal line after taking the thinner because you cannot precisely control the level.

Risking your life because you don't want to pay for Lovenox is not logical because if something bad happens because you did not take it you will be paying a lot more.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Yes, if you have thrombophilia, you are at significantly higher risks to form a clot in your leg or lung.  Preventative treatment with a blood thinner, like heparin or lovenox will minimize this risk, but does increase your risk for bleeding complications.

Think of this from the downside:  if you get a pulmonary embolism, it could be fatal.  If you get a hematoma around the implant, you'll need a trip back to the operating room.  Clearly, in the greater scheme of things, that's a much lesser problem.

Ask your hematologist if wearing SCD's at home (you can rent the machine) with a couple of days of lovenox treatment would be adequate protective treatment.

Yes heparin after surgery will lead to a possible hematoma.  I understand that you have been "cleared" for surgeon but as the surgeon I feel I have the right to decide that this surgery is not in your best interest due to the necessary medical treatment that you require.  Best wishes.

Dr. ES