Leukopenia - could I be cleared for breast augmentation?

With clearance and discussion with your hematologist, you will be fine proceeding with breast augmentation. Your surgeon should always have a thorough discussion of risk profile with you prior to proceeding with surgery.

Dear Bluegrasslady84,

it is hard to tell for sure without an examination. You need to be healthy prior to any elective procedure so you might need clearance from a haematologist. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

In my practice I will ask the physician treating the condition in question to provide written medical clearance for the specific procedure I am going to perform. If they tell me the patient should not have the surgery or that it is high risk, I do not perform the surgery. All surgery carries risk, so if the specialist says it is low risk, we will usually proceed.

Also depends on if the neutropenia is primary or secondary to something else. The something else may be the dealbreaker.

Bottom line is I would not proceed with surgery unless I had written clearance from the hematologist.

Your hematologist is correct that there was always a risk with any operation if patients have leukopenia. However, even in patients who do not have leukopenia there is a risk with breast augmentation. The concern would be you being at an increased risk for infection. I would be sure that your plastic surgeon follows the well known 14 step protocol for decreasing the risk of infection and capsular contracture with breast augmentation and a no touch technique for insertion of your implants with a Keller funnel. Discuss this with your plastic surgeon in detail.

There is always increased risk of infection in patients with low WBC; that is the major risk to consider regarding your surgery. Providing that you are aware of the risks, decision should be yours. Good luck.

I don’t think that degree of leukopenia would be cause for concern with a breast augmentation. However I would have your blood count repeated prior to surgery

Leukopenia, which is characterized by a low white blood cell (WBC) count, can make it more challenging for your body to fight infections, as WBCs are crucial for immune function. With a WBC count of 1.8, it’s understandable why your hematologist would mention that there’s always a risk, as you may be more susceptible to infections or complications post-surgery. However, the advice of your plastic surgeon, who says you’ll be fine, could be based on other factors like your overall health, exercise habits, and lifestyle, which all point to good general well-being.
Here are a few things to consider:
1. Consultation with a Specialist: If you haven't already, it would be important to ensure that your hematologist and plastic surgeon are both on the same page regarding your condition. A multidisciplinary approach may give you the best insight into whether surgery is safe. Sometimes, additional testing or interventions might be needed to manage the risks.
2. Infection Risk: With leukopenia, there is an increased risk of infection, especially in a surgical setting where incisions and post-op recovery require a healthy immune response. Your surgeon may adjust the procedure or recovery plan to minimize infection risks. This could include more frequent monitoring, prophylactic antibiotics, or even modifying the surgery itself.
3. Surgical Timing: It may also be advised to wait until your WBC count is in a more normal range, especially if the low count is related to an underlying condition that can be treated. In some cases, a boost in your immune system might make you a better candidate for surgery.
4. Post-Op Care: Following the surgery, it's crucial that you're diligent with post-operative care to avoid infections, such as keeping the surgical site clean and following all aftercare instructions to the letter.
Given your hematologist's concern and your surgeon's reassurance, you may be in a situation where both experts have considered the risk factors. Still, a discussion about how to manage those risks post-surgery is essential, and you might want to explore whether your immune system can be supported in the lead-up to and after your surgery.
Your health should always be the priority, so any surgical decision, especially an elective one, should weigh both the benefits and the risks carefully.

The best thing you can do is speak with your hematologist about your interest in breast augmentation. If given clearance it will be up to your plastic surgeon if she/he is comfortable performing the surgery based on your exam, history, and surgical plan. There is some degree of risk to every surgery. You will need to decide with your specialists what is best for you.

If your hematologist clears you for surgery and your plastic surgeon places you on antibiotics, you should do well with a clean elective surgery.