Is it OK for me to continue with HRT if I am getting breast implant surgery next Friday?

Question

I take bioidentical progesterone cream along with bioidentical testosterone cream because I am perimenopausal. I am having breast implant surgery next Friday Nov 15th. Is it ok to continue this? I did not see it on the list of medications to stop using from my surgeon.

Reza Rod, MD · Answer

Thank you for your question. It is fine to continue with your HRT. I wish you well for your operation.

Mehmet Surmeli, MD, FEBOPRAS · Answer

Hi,

When considering hormone replacement therapy (HRT) and surgery, like your upcoming breast implant procedure, it's essential to understand the risks. HRT, particularly estrogen, can increase the risk of blood clots during and after surgery. To assess this risk, surgeons use the Caprini Risk Scoring System, which considers factors like age, medical history, and surgery duration. For longer, more complex surgeries (over 3 hours), stopping HRT is often recommended. However, for straightforward procedures like breast augmentation, which typically take 2-3 hours, there's usually no need to stop HRT as the risk increase is minimal.  It's important to weigh the benefits of continuing HRT against the slightly elevated risk of blood clots.  Stopping HRT can also cause side effects like blood pressure fluctuations. If you're using transdermal patches or gels for estrogen, there's almost no need to interrupt treatment. Ultimately, the decision should be made in consultation with your surgeon, considering your individual risk factors and the specifics of your surgery.

My comments and recommendations are solely based on your text and are subject to change. I always recommend a face-to-face consultation with a specialist to plan the treatment.

Best wishes, Dr. Surmeli.

Daniel Barrett, MD · Answer

Dear Sanantaria,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

In my experience, my patients did ok with these types of medications. Good luck. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dana Goldberg, MD · Answer

Taking HRT increases the risk of blood clots minimally, but this is not typically a high risk surgery for that happening, so there should be no problem continuing. Just be sure to avoid any cream on the chest or trunk the day of surgery so it doesn't interfere with the sterile prep or placement of EKG leads.

Connie Hiers, MD, FACS · Answer

It is best to ask your surgeon this question. I would allow you to continue the progesterone cream, but not estrogen or testosterone cream because of the increased risk for blood clots.

Camille Cash, MD · Answer

This question is best answered by your surgeon as opinions vary.  It is important that your surgeon is aware of all prescription, over the counter, and supplements that you take.  This is for your safety.  Though it may be fine for you to continue with your HRT it is best cleared by your surgeon.

Is it OK for me to continue with HRT if I am getting breast implant surgery next Friday?

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