Should I have surgery if I'm anemic and my hemoglobin is at 8.0?

Question

Hello, I am having a breast reduction tomorrow morning, question is my surgeon knows that I am anemic the drew blood testing my hemoglobin which I received a call letting me know that my iron was 8.0 I explained to the nurse what was going on which she let the surgeon know. The surgeon told her that everything should be fine and that she would see me on the day of surgery. should I wait for my hemoglobin to go up knowing possible risks of complications.

Keith Denkler, MD · Answer

Breast reduction surgery and its recovery involves some blood loss and time under anesthesia.You are starting low.Hope you waited.

Tracy Kayan, MD · Answer

Most surgery centers or hospitals have patients see their primary care physician or family physician to be "cleared" for surgery. A hemoglobin of 8 is low, I agree, but the question is whether or not you are always this low, or something is happening that made it this low acutely. For an elective procedure like a breast reduction, it may be worth it not to put your body in danger if you undergo surgery and lose more blood than expected. I would recommend you at least have your primary care physician clear you for surgery or look at your past blood tests to see if this is where your number always is.

Daniel Krochmal, MD, FACS · Answer

Thank you very much for your question.Every surgeon and anesthesiologist has their own criteria for operating.I personally would have delayed the case, as preoperative anemia introduces the possibility of increased risk.  Breast reduction is an elective procedure, so I would have waited until your blood levels were higher.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your post and provided information as well. Hemoglobin is the protein in our blood that carries oxygen to the body.  Anemia - low hemoglobin - increases the risk of surgery and anesthesia.  Your plastic surgeon and anesthesiologist will determine a good level of hemoglobin for you given your history and surgical plan.  It is important that your hemoglobin is at or above this level prior to surgery.  One of the major risks of any surgical procedure - especially liposuction - is bleeding.  Liposuction is part of the BBL.  If your hemoglobin is low, talk to your primary care physician.  He or she may be able to determine the cause of your anemia and suggest methods to increase your blood count and hemoglobin level. I suggest to make an appointment with a board certified plastic surgeon for a person evaluation.

Steven Wallach, MD · Answer

If you are anemic, it has been shown that there is an increased risk of potential complications.  Best to get worked up for your anemia and evaluated by your surgeon.

Tom J. Pousti, MD · Answer

Sorry but it is probably best not to proceed with breast reduction surgery at that hemoglobin level;  preoperative anemia workup will be important. Best wishes.

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

Different labs have different normal ranges. I would normally consider 8 gm/dl to be very low, about 2/3 of normal. If this figure came from the hospital I use I would not proceed with a BBR. I would advise that this was investigated, why is it so low? and corrected to a normal level which typically would be about 12-13 gm/dl or 120-130gm/L before surgery. Please be aware that you do not give the units for the '8' above or the normal range for the lab. where the result came from.The bottom line is you should take the advice of experienced well trained surgeons who know you medically and the normal ranges for results where the tests are carried out.Good luck with getting this checked and your surgery.

J. Garrett Harper, MD · Answer

That's a really low hemoglobin and you need to figure out why it's so low.  Do you have heavy menstrual cycles?  There is a new study out that tells us perhaps we should be scheduling these surgeries during a certain period in a woman's menstrual cycle to improve outcomes and healing secondary to hormonal trends.  I would be reluctant to have elective surgery with a hemoglobin that low.  If you developed a hematoma and it went down even more, you could become symptomatic.-JGH

Should I have surgery if I'm anemic and my hemoglobin is at 8.0?

Answers (8)

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