With your medical history you are increased risk for developing blood clots (deep vein thrombosis) in your legs which could break off and travel to your lungs (pulmonary embolus). When you are on anticoagulants (blood thinners, Xarelto) now you are at increased risk for bleeding, especially during surgery. In this situation, I would talk with your hematologist about the risk of complications if you have the breast implant surgery. Typically, we would stop the blood thinners 2 weeks prior to surgery and then re-start the blood thinners the day after surgery. That way, you don't have the increased risk of bleeding during surgery and the only time off the blood thinners is 2 weeks. But, I must emphasize, this is up to your hematologist to decide the risk and if you can be off your meds for the 2 weeks prior to surgery. Always consult with a Board Certified Plastic Surgeon who performs breast implant surgery frequently to assure the best possible result. Good Luck!