I Have a Question Regarding the Use of Lovenox After Breast Surgery?

  There is a Caprini risk assessment model, which helps to gauge risk of DVT.  HRT does increase the risk as well as age, BMI, and a host of other factors.  If you are low risk other than HRT, I would have you stop the HRT before and after surgery and avoid the Lovenox.

There is not a consensus among surgeons for using Lovenox during surgery.  Early ambulation is probably your best protection against blood clots.  I would not typically use Lovenox in the case you describe.

I think your instincts are correct and I personally would have the same concerns if I were a patient.  Lovenox can introduce problems of its own, specifically the risk of extra bleeding and hematomas, and even the occasional need for a blood transfusion.  The risk of a blood clot should be very low in a patient like you with no history of blood clots and having the procedures you are having.  I prefer to avoid muscle relaxants in surgery (no paralysis, spontaneous ventilation), avoid prone positioning, and use compressive devices on the legs (almost all surgeons do this today), and get my patients up walking right away.  These habits keep the risk of a blood clot very low and don't introduce possible new problems.  Be sure you are having a vertical lift, which is the most effective type of breast lift.  I've attached some examples from my website.