I Take Bio Identical Hormones and Having a BA...what is the REAL Risk?

Hi Docs- I'm taking a low dose bio identical HRT, along with small amounts of compounded testosterone cream. I don't smoke, not obese, work out like a fiend, in short, I'm very healthy. I'm getting a 24 rapid recovery BA in a few weeks. I will not be on the table over an hour. Is it REALLY a big deal to stop my HRT? I mean, come on, my hormone levels are way lower than a 35 yr old woman producing this on her own--do doctors tell THEM to shut their bodies down before a BA? signed: call me Skeptical..

Doctor Answers 9

HRT and Breast Augmentation

    Most plastic surgeons recommend stopping the hormones 2 to 4 weeks prior to surgery and resuming 2 to 4 weeks following surgery.

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Hormone Therapy Is A Risk Factor for Thrombosis

Thank you for your question.  You seem to be very committed to your health and exhibit a health sense of skepticism.   Unfortunately, most patients are not well trained on statistics and how to put risk into perspective.  HRT does increase your risk of postoperative thrombosis.  The data is convincing.  You are probably in the low to moderate risk category, but the risk is not zero.  General anesthesia is another risk factor.  Prevention strategies such as early walking and compression devices will help.  If you want to do as much as possible to reduce your risk, stop the hormones.  If you are willing to assume some small risk, then discuss this matter further with your surgeon.  Best wishes.

George Bitar, MD
Fairfax Plastic Surgeon
4.6 out of 5 stars 54 reviews

Real Hormonal Risk in surgery

Although taking hormones by a young, non smoker patient , prior to a relatively short surgery is considered in a low risk range, all routine DVT/PE precautions (pe sequential compression devices) during the procedure  should be taken in order.  However, due to controversy on this matter, stop the supplemental hormone therapy for a short time prior surgery should be considered. Share this with your Plastic Surgeon.


Ricardo Vega, MD
Mexico Plastic Surgeon
4.5 out of 5 stars 43 reviews

Hormonal risk in surgery

There are well known good studies that show that the risk of DVT/PE goes up in women taking the pill after 40, who undergo surgical procedures. To my knowledge, there have not been studies done that look at bio-identical hormones, but by extension, these would have similar if not greater risks. While breast augmentation is a short procedure, the great secret here is that DVT/PE's are one of the major killers of surgical patients. Hospital and surgeon groups are addressing this with studies as well as recommendations that  address risk factors such as this. We are like the airline industry and FAA; in medicine we err on the side of caution.We are also vigorously working to make procedures safer. Your doctors recommendation may sound like it is onerous but it is being done for your safety. The bio-identical hormones are similar but they are not the same as the one your body produces in their chemical nature and they do add risk. 

David R. Stephens, MD
Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews

BHRT risk

Well, "skeptical" - there actually is evidence in the Caprini risk factor assessment for DVT / PE that hormone replacement does increase the risk of blood clots to the point that it gets credited as a risk factor.

But, for a short operation, in a young, non-smoking patient, your other risk factors sound like they are low.  Have your doctor use SCD's (sequential compression devices) on your legs during surgery - and the odds are that you will be fine.

However, if you wanted to do every single thing possible to reduce your risk to the lowest possible level, you would stop the hormone replacement.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Hormone Therapy Cessation Prior To Breast Augmentation Surgery

Your questions are valid and may very well be true. But why take any increased risk, no matter how slight, for a very limited time of hormone supplementation abstinence. The risks to the alteration of your hormone levels would seem to be less than even the rare risks of potential complications from being on them. The risk of a very rare occurrence of a medical complication is not the same as that it can never happen.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Bio-identical hormones

No one knows the long term risks of these "bio-identical" hormones.  I would follow your surgeons recommendations.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Hormones and Breast Augmentation

Never go into a surgery without following your surgeons instructions.  Your safety is his upmost concern.  Good luck with your surgery!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 60 reviews

Hormones and DVT?

There is an increase in the risks of having blood clots in patients taking hormones - that's the bottom line. The actual risks depends on several factors which you have mentioned like time of anesthesia, type of operation, age and genetics. If you had no other risks factors at all then actual increase is pretty small. However, while a patient cannot change her age, genes and the operation being done they can certainly reduce the risks by stopping the hormones. Ultimately, that decision is up to you and your PS - Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 201 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.