What can I do to get my iron up for clearance? And why is this important?

Question

I have lipo 360 and fat transfer to my breasts scheduled June 11. I went for preop may 13 and iron tested 11.8, I was told to take 325mg iron 3x a day and go retake my labs in a week I did and it came out lower 11.3. I'm waiting to hear from my dr Tues. I'm upping my iron, taking vitamin c and eating foods more that have iron. Can anyone help I dont want to reschedule my surgery. I was told he wants me at a 12.

Alex Campbell, MD · Answer

Thanks for your question. Best is to follow your specific surgeon's recommendations.  That said, you should begin to take Iron Sulfate 325mg three times a day as well as the dietary recommendations.

In addition to iron pills, we recommend a diet with plenty of iron (red meat, dark green leafy vegetables, lentils, dried fruits, nuts, and iron fortified cereals).  Vitamin C also helps your body absorb iron and so you can take iron tablets along with a source of vitamin C, like a glass of orange juice or citrus fruit.

Himansu Shah, MD · Answer

Thank you for the question. You are doing the correct treatment plan. If your hemoglobin level doesn’t improve I would recommend to see a specialist. It is best to follow advice from your board certified plastic surgeon. Good luck.

Jason Emer, MD · Answer

you need a full evaluation as to WHY your iron is low. you may need a treatment for a reason that you have low iron.  more iron maybe needed or blood transfusion/IV therapy. I suggest seeing an expert
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.

Daniel Barrett, MD · Answer

Dear nicolesam1,
based on your description, it sounds like you are doing right by taking iron supplements and food rich in iron. But every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Dallas Buchanan, MD · Answer

Thank you for your questions. It sounds like you are doing everything possible to help the situation. I would discuss things with your doctor and make a plan to have the labs checked again before surgery. It is likely that the efforts you are doing are going to take some time to show results and everything should be fine.Best of luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Kenneth Hughes, MD · Answer

It is always best to optimize your condition prior to surgery including treating anemia.  Taking the iron supplements and vitamins your physician prescribed along with eating dark leafy veggies, liver, lentils, almonds, dried apricots, beets, and other high iron foods should raise your iron level to 12 mg/dl.
Have your labs repeated a few days before your scheduled surgery.  If they remain low, ask your plastic surgeon if he/she recommends that you postpone your lipo until they reach a satisfactory level.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Mats Hagstrom, MD (license on probation) · Answer

I have a feeling you're referring to hemoglobin levels and not iron levels.  Hemoglobin levels represent the amount of red blood cells in your body. Actually it's the amount of hemoglobin which is the substance inside red blood cells.  A lower the normal level of hemoglobin may be related to iron deficiency but it does not necessarily mean that you're iron deficient.  There is a different test to determine iron deficiency and it generally has to do with the size and color of red blood cells.  So you may in fact not be ironed efficient though there is clearly a lack of information on both parts here.  Doctors want to patients to not have a substandard amount of red blood cells or hemoglobin to compensate for potential blood loss during surgery.  If the numbers you stated represent your hemoglobin level  then you're on the low-end of normal.  Personally I would be comfortable doing this procedure and someone with a hemoglobin of 11.  Typically we don't order any blood tests before these procedures.  It seems to be a routine among doctors in the Dominican republic to order a battery of blood tests before these procedures. Plastic surgeons and most surgeons  in the United States generally order less blood tests  then in the past on otherwise healthy people. Both liposuction and  fat transfer can we done with minimal blood loss by using sufficient amounts of to mass and solution and allowing this solution to sit in the tissues for 15 minutes before starting surgery.  Unfortunately many surgeons especially with procedures done under general anesthesia don't have the patience to sit and wait for 15 minutes before doing surgery.  I have never even come close to giving a blood transfusion after either liposuction or a fat transfer procedure and I've performed over 7000 of these in my career.  So this has to do with minimizing the chance of you needing a blood transfusion after surgery. It is basically for your safety. Ask your doctor to evaluate the cause of your low hemoglobin level ( i'm still assuming that that is the number you were referring to ) more thoroughly or ask your primary care doctor to help.  Best, Mats Hagstrom MD

What can I do to get my iron up for clearance? And why is this important?

Answers (7)

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