What is my blood tested for at my breast reduction pre-op appointment?

Question

I'm about to go in for a breast reduction pre-op. What kinds of things do they test your blood for? What should I make sure I go over with my PS?

Fadi Chahin, MD, FACS · Answer

The blood work that is required for any general anesthesia is as follows (please realize this could slightly differ depending on age, location, and any previous underlying issues

	 

	CBC-will test your basic blood counts, RBC, WBC, Platelets-this will rule out any infection, anemia that needs to be treated prior to surgery

	PT/PTT-blood clotting times

	UA-to rule out any urinary tract infections, or possible underlying issues pertaining to the kidneys

	BMP-Basic metabolic panel

	Medical Clearance-does a basic history and physical and clears the individual for surgery (this is not always required)

	UPT-urine pregnancy test

	EKG-is generally required for individuals over the age of 55 undergoing general anesthesia

	 

	Some questions to go over with your PS prior to surgery may include but are not limited to:

	 

	1. When will I be following up with your office? It is generally easier to set up the initial follow up appointment prior to surgery.

	2. If the surgery is in a surgery center, what lab will you be sending my specimies to, and can I recieve a copy of the final pathology report when it becomes available? This is good to keep for your records, as it will rule out any abnormal findings from the tissue that was removed.

	3. Will I have drains? If so, and you do not have the help at home to monitor them, can I be set up with a home health nurse to do daily drain care?

	4. Is there anything that I need to get and have available at home (i.e. gauze, ace bandage, additional front zipping sports bras)?

	5. Is this procedure in patient or out patient (if done in a hospital setting) and how long will I be in the hospita?

	6. What medications will I be taking post-operatively (i.e. antibiotic, pain medication, muscle relaxors)? Make sure that you get these perscriptions filled prior to surgery

	7. Approximately how many grams will be removed from each side (insurance based procedures generally will dictate the minimum amount, in grams, that must be removed in order for them to cover the procedure)?

	8. What are my financial responsibilities? Will I be responsible for anything additional after surgery? Can a portion of my procedure be covered through insurance?

	 

	Questions/ research to do pertainint to your doctor:

	 

	1. Is he/she board certified with the ABPS also knows as the American Board of Plastic Surgery? (This information can be found directly on the Board's website)

	*This is not to be confused with ASPS also known as the American Society of Plastic Surgery. This is a society that plastic surgeons can become members of, but does not necessarily signify they are board certified plastic surgeons.

	2. How many years has he/she been in practice?

	3. Can I see pre and post operative pictures of similar procedures?

	 

	Please remember to have realistic expectations as not everyone will have the same results. Good luck with your surgery and wishing you a speedy recovery.

	 

	Fadi Chahin MD, FACS

	Plastic and Reconstructive Surgery

	Diplomat, American Board of Surgery

	Diplomat, American Board of Plastic Surgery

James Knoetgen, III, MD · Answer

During your pre-operative appointment for a breast reduction, your blood may be tested for various factors to ensure that you're in good health and that the surgery can proceed safely. Common tests conducted may include:
1.	Complete Blood Count (CBC): This test measures the levels of different types of blood cells, such as red blood cells, white blood cells, and platelets. It helps to detect conditions like anemia or infection.
2.	Blood Typing: Knowing your blood type is crucial in case you require a blood transfusion during or after surgery.
3.	Blood Chemistry Panel: This panel typically includes tests for electrolytes, kidney function, liver function, glucose levels, and sometimes cholesterol levels. It provides a comprehensive overview of your overall health and helps identify any underlying medical conditions that may affect the surgery or your recovery.
4.	Coagulation Studies: These tests assess how well your blood clots, ensuring that you don't have any clotting disorders that could increase the risk of excessive bleeding during surgery.
5.	Screening for Infectious Diseases: Depending on your medical history and the protocols of the surgical facility, you may be screened for infectious diseases such as HIV, hepatitis B and C, and others.
6.	Pregnancy Test: If applicable, a pregnancy test may be performed to ensure you're not pregnant before undergoing surgery, as pregnancy can affect the safety and outcome of the procedure.
Your plastic surgeon or healthcare provider will determine which specific tests are necessary based on your individual health status, medical history, and the requirements of the surgical facility. These tests are conducted to ensure your safety during the surgery and optimize your recovery process.

Tom J. Pousti, MD · Answer

Congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations performed.

You will find, that depending on the practice, your age, medical conditions, that the preoperative workup ( bloodwork, tests…) will vary.  Generally speaking, for a healthy young female the “necessary” blood work can be minimized.  A pregnancy test may be indicated.

It will be very important for you to communicate your goals, concerns, and questions with your plastic surgeon. I would suggest that you write these down before your preoperative appointment. In my practice, I ask patients to collect "goal  pictures”  of breasts which they like, breasts that are too big, and breasts that are too small as well.  I find that the use of pictures is more helpful than the words “natural” or "proportionate” etc., which can mean different things to different people.

Again, your preoperative visit is a time to address any concerns that may cause you preoperative anxiety. Sometimes, I find it helpful to arrange for preoperative patients to speak with postoperative patients as well.

Best wishes;  hopefully you will be very pleased with the outcome of your planned procedure.

Robert L. Kraft, MD, FACS · Answer

Dr Chahin has described the PAT regimen very well. PAT is required in all the facilities in which I practice for cases involving sedation. The hospitals mandate it, as well as EKG and medical clearance. This is completely appropriate given the length of the procedure. In terms of the preop consult, this is a time for the surgeon to go over the operation once more, discuss postop instructions and to insure a meeting of the minds with respect to sizing. Management of drains postoperatively, pain management, timing of the postop visit,and what to look for in terms of problems which require the surgeon's immediate attention are also discussed.

Peter E. Johnson, MD · Answer

Actually lab tests are not needed for most unless there is a specific medical issue, or you are over age 50. We see patients one to two days before for markings and questions about care after the procedure.

George J. Beraka, MD (retired) · Answer

Hi.

	Talking about cup sizes is not enough.  Bring to your surgeon pictures of breasts that you like and that you think would fit well on your body.  Poor communication about this can lead to disappointment.

John Whitt, MD (retired) · Answer

I see all of my reduction patients on the day of or 1-2 days prior to surgery. At this visit I mark the areas of the incisions and answer any questions patients may have. I also go over post-op care. I have the anesthesiologist order pre-op tests since they will order only those that they feel are necessary.

What is my blood tested for at my breast reduction pre-op appointment?

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