Does having elevated factor 8, but no blood clotting disorder, mean I am likely to get a blood clot from lipo 360/bbl?

Question

I have a family history of blood clots, so I had a blood work done to test for a blood clotting disorder before my planned lipo 360/BBL. Everything was normal except pretty elevated Factor 8 & Factor 5. I met with a hematologist, who recommended prophylactic blood thinners either before or after surgery. He is coordinating with my surgeon about the timing. I’m now very worried about developing a DVT or PE. Does elevated Factor 8 mean I’m likely to develop a blood clot from this surgery, or is it simply an additional risk factor that can be managed with appropriate clot-prevention measures? Would this finding make you advise against elective lipo 360/BBL altogether?

Yasemin Aydinli, MD · Answer

Elevated factor VIII is a recognised independent risk factor for venous thrombosis, roughly doubling or tripling the baseline risk depending on the level, and combined with a family history it puts you in a higher risk category for surgery. It does not mean a clot is likely; it means the risk is meaningfully above average and needs to be managed, which is exactly what your hematologist is doing with prophylactic anticoagulation. What I want to add as a plastic surgeon is that a lipo 360 with BBL is already the aesthetic procedure with the highest thromboembolic risk, because of the long operating time, the fat injection and the period of reduced mobility afterwards. If you proceed, it should be in a hospital setting with mechanical calf compression, chemoprophylaxis timed with your hematologist, a shorter operation and early walking. In your situation this surgery may carry a real risk, so please ask yourself honestly whether the result is worth it for you before going ahead.

Mats Hagstrom, MD (license on probation) · Answer

Even if taking blood thinners, you are increased risk for having blood clots during or after surgery.
Being on blood thinners also puts you at risk forpotential increased bleeding.
This doesn’t mean that it’s likely to happen, but the chance is going to be higher than someone who doesn’t have this genetic predisposition. 
Best,
Mats Hagstrom MD

Does having elevated factor 8, but no blood clotting disorder, mean I am likely to get a blood clot from lipo 360/bbl?

Answers (2)

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