I want breast implants with pulmonary embolism history...Possible?

Question

I developed pulmonary embolisms post tummy tuck & breast lift surgery in 2009. I tested Negative for the genetic clotting disorder. I would like a breast augmentation and my surgeon feels confident there will not be a recurrence with proper ambulation and hydration post surgery. I am thinking of blood thinners to aid in the prevention...thoughts?

Ronald J. Edelson, MD · Answer

Your surgeon is correct that breast implants involve much less risk for pulmonary embolism than does a much longer procedure such as a tummy tuck.  However, if you had PE once, your risk is greater than the average person that you may get another.  Your risk overall is small, but all precautions to prevent an embolism should be taken if you do plan to proceed.  Some surgeons might use a blood thinner known as Lovenox as a precautionary measure.  Good luck!

Boris M. Ackerman, MD · Answer

Pulmonary Embolism RisksPulmonary embolism is a rather rare event in 
plastic surgery.  The patient's risk for this complication should be properly 
assessed and appropriate measures taken to minimize this risk. In you particular 
case, hopefully you were properly assessed prior to your tummy tuck for the risk 
of DVT/ PE and appropriate prophylactic measures were taken.  Based on your 
history most likely you should not be placed on blood thinners for your breast 
augmentation.  With proper selection of anesthesia and other considerations you 
should be able to undergo breast augmentation without any problems.

Robert Singer, MD · Answer

With a prior history of a pulmonary embolism, you have a greater risk of developing another Venous Thromboembolism (VTE), although the risk is lower than in a patient who has a genetic clotting disorder. It is not a contraindication to having a breast augmentation as long as you thoroughly understand the risks and have discussed them with your physicians. You should have a medical clearance by your primary physician and communication between him or her and your plastic surgeon before proceeding with the surgery.Most plastic surgeons would utilize all of the available preventative measures: treatment based on a VTE risk assessment scale, intermittent leg compression stockings, good hydration, chemoprophylaxis (blood thinners), stopping any birth control pills or hormones for 1 month before the procedure. In addition, I would suggest an overnight stay in a hospital with appropriate monitoring.Following the advice of anyone on this or any other website who would presume to tell you what to do without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of the procedure would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.Robert Singer, MDFACSLa Jolla, California

Arian Mowlavi, MD, FACS (license on probation) · Answer

Pulmonary embolism is a serious complication of surgery and indicates that you have an affinity to form clots especially when you are under general anesthesia. In order for you to complete your breast augmentation surgery safely, your surgeon should provide you double coverage against forming clots during surgery and these would include:1)compression boots to be worn around your ankles during surgery2)Lovenox therapy which will keep your blood thin during surgery.In addition, you should have your blood clotting ability checked with a simple blood test prior to surgery.

Frederic H. Corbin, MD (license restricted) · Answer

Your surgeon should evaluate you on the Caprini scale and determine the need for blood thinners.  That said you should do fineDr  Corbin

Martin O`Toole, MD, FACS - Account Suspended · Answer

Venous Thromboembolism (VTE) is a serious complication that can occur after any surgery but most commonly after operations greater than one hour, or those with prolonged immobility.  The blood clot can form during surgery or even up to a week afterwards.  The Caprini VTE Risk Assessment Model has been endorsed by the American Society of Plastic Surgeons (ASPS) as the tool to use in determining the proper risk and prevention in plastic surgery.  Visit plasticsurgery.org/vte.A previous history of a pulmonary embolism after surgery places you at a higher risk.  Therefore, preventive measures such as post operative anticoagulation (blood thinners), mechanical leg compression and ceasing any hormone medications are in order.  Placement of breast implants is reasonable in your case but your surgeon should consider which prophylactic measures are indicated.

Richard P. Glunk, MD (retired) · Answer

If you need blood thinners, do not have cosmetic surgery.  Pulmonary embolism is more likely with a tummy tuck than breast augmentation.  If your surgeon feels confident, listen to your surgeon.  A good surgeon would not risk doing the surgery if there was a high risk.

I want breast implants with pulmonary embolism history...Possible?

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