Breast Inplants with Aortic Heart Valve - is There More Risk?

Question

I am booked in for breast implants in October. However, after sending the surgeon a document from my last report from my cardiologist about my aortic heart valve he now wants a letter from my GP to say my condition will not cause complications to me heart. I am now reconsidering the surgery, my life is way more important to me than making my breasts the same size. I was hoping some doctors could advise me if the risks would be significantly higher with my heart condition.

James Apesos, MD · Answer

The risk is clot formation on your aortic valve
replacement vs bleeding from you surgery.  Have your doctors discussed stopping
the Coumadin (Warfarin) prior to surgery and perhaps started a bridging blood thinner
like Lovenox?  The risk is twofold
clotting the valve and bleeding from the breast implant. Cardiac clearance is
great, but it’s not really enough.  This endeavor requires
a real plan to protect the valve and not have bleeding.  I’d love to hear their plans.  I have the same patient in my practice now
and we are not 100% sure if placing implants will be a safe procedure.

Curtis Wong, MD · Answer

As mentioned, its always good to have the blessing of your cardiologist but having a heart valve doesn't preclude you from having an augmentation. But if you had open heart surgery, some planning must go into how the surgery is done to avoid wound complications. Augmentation is a clean procedure so in and of itself, should not jeopardize your valve.

Jeffrey Zwiren, MD · Answer

You need to get medical clearance considering your Aortic valve condition.  Having a breast augmentation should not place your cardiac condition at risk but it is better to be safe than sorry.

Barry L. Eppley, MD, DMD · Answer

The best medical advice about the adviseability of getting breast implants with your indwelling aortic valve is your cardiologist. His/her advice should guide your decision and the plastic surgeon is merely seeking clearance/documentation that you are not at undue risk for undergoing elective surgery.

Craig Harrison, MD · Answer

I have always been told to " trust your mamma and your gut". In your case unless your mom is a cardiologist you might cast a wider net. I might ask your surgeon to discuss your case with your cardiologist to better assess your risk/ benefit. Your valve replacement may not preclude you from reaching your goals. Best wishes

Tom J. Pousti, MD · Answer

Thank you for the question. You are wise to carefully consider the potential risk/complications associated with breast surgery. It would seem to me that your  cardiologist will be your best resource when it comes to helping  delineate the risk/benefit ratio involved. It may be that your plastic surgeon is simply being “extra cautious” when it comes to seeking input from your general practitioner.

	 After carefully considering your cardiologists' input, only you will be able to determine whether or not the degree of dissatisfaction with your breast size/symmetry is worth the “risks” of proceeding.

	 Sorry, I cannot be of more specific help to you.

	 Best wishes.

Matthew Concannon, MD · Answer

Thanks for your question. It sounds like your surgeon is simply making sure that the procedure does not carry any more risks than is necessary. I don't know how a GP would have more information for him than your cardiologist. The biggest risk of this, in general, is perhaps bacterial 'seeding' of your valve during the surgery; but this is very unlikely in a procedure such as this, and is much more of an issue with more "dirty" procedures, such as dental work. I am curious how your cardiothoracic surgeon placed this valve, I don't see a scar on your picture from when you asked about fixing asymmetrical breasts. He did an excellent job in that regard.

	At any rate, good luck, discuss this with your surgeon and your cardiologist, they will have the best answers for your individual case.

	Matthew Concannon MD

Robert T. Buchanan, MD (retired) · Answer

I suggest you see your cardiologist for clearance. The main risk should be seeding of the valve with bacteria from the breast ducts that are cut during the procedure. Because this seeding can also happen to the implant, we give you antibiotics before the procedure. While this does not eliminate the risk, it does reduce it significantly. Any more risks are those of surgery and why you need to see your cardiologist.

Breast Inplants with Aortic Heart Valve - is There More Risk?

Answers (8)

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