Am I at a high risk for blood clots during a Breast Lift with Implants?

Question

I had abdominoplasty in 2005. I ended up with a PE. I was on blood thinners for 9 months. However, in 2011 I had a breast lift with implants and fortunately I didn't have any complications and healed quickly. I am now interested in another breast lift with implants and abdominal etching. I keep getting screened out by doctors bc of my history of a blood clot. Am I at a higher risk now bc of what occurred 16 years ago? Even the best surgeons are screening me out! Why is this? I'm bummed.

Casey Anderson, MD, FACS · Answer

The greatest risk factor for a blood clot is a previous blood clot. You would like need clearance from a blood doctor to confirm your risk profile and then go from there. Beauty is important but you can't risk your health for it.

Leland Deane, MD, FACS · Answer

You are definitely at higher risk. The real question is how the surgeon will lessen that risk and make it acceptable. There are various ways to do this and they must be in sync with the surgeon's skill and plans. I agree with others that you should go on several consultations with experienced surgeons. Best of luck.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size. It is possible that surgeons are screening out not because of your blood count but because you are having a secondary lift and implants that can lead to nipple necrosis and complications. You may need the surgeons to clarify why they do not want to do your surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You should consult with a hematologist ( a blood specialist ) prior to surgery. Abdominoplasties have a high risk of blood clot  relative  to other procedures but get checked out first by a hematologist

Farbod Esmailian, MD · Answer

There is generally a higher risk for blood clots and PE with an abdominoplasty procedure and in general with procedures that require longer general anesthesia.  It sounds as though you were treated by your internist or hematologist?

I would want a clearance letter from your Hematologist for the next procedure.  I would want to make sure that the reason the blood clot happened was because of the procedure in general and not because you have an underlying clotting disorder.  If you do have some underlying blood clotting disorder, obviously that would put you at a greater risk with surgery.

Hope that helps.

Daniel Barrett, MD · Answer

Dear DrMe,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. You might need to get a clearance from your doctor prior to surgery. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Once you have had a blood clot, you are at higher risk of another, especially as you age.  Your surgeons understand the risk and want you to be safe.

Douglas Taranow, DO, FACOS · Answer

You are at a higher risk of a repeat blood clot vs the general public.  That being said, you should have a consultation with a hematologist and your plastic surgeon may consider giving you Lovenox post op to avoid the increased risk of blood clots.
Dr. Taranow

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

Thank you for the question and if cleared by a hematologist you should be a candidate for surgery though you may need to take blood thinners after for a short period of time. So go on some complimentary consultations with experts and compare recommendations after a full examination

Dr Corbin

Dr Corbin

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
What has changed since your last breast augmentation and breast lift? Is there more to this story? Are you obese? Are you diabetic? Do you demonstrate swelling of your legs? Do you have any other comorbidities?
Your history of previous PE will always keep you at increased risk. Clearance to proceed with any proposed surgery must be obtained from your primary care physician. If denied, be assertive and ask "why?"
Best wishes...

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