Is breast augmentation an option if I'm on Warfarin for life?

Many patients who are on chronic anticoagulation with warfarin or other drugs, can safely undergo surgical procedures. In order to do so, they must generally be taken off those drugs for a time befor surgery to allow clotting to return to normal.High risk patients are often hospitalized, converted to heparin before surgery, then stoping heparin to operate. Augmentation is an elective procedure, and you dont want to take unreasonable risks to have it done.Discuss your risks throughly with your hematologist and your surgeon.

Hello, I think you will find that most surgeons will be very cautious about offering elective surgery given your history of a blood clot.  They might first consult with your hematologist and primary care physician, and determine what steps could be taken to reduce your risk of a recurrent postoperative blood clot.

This situation is highly complicated. You should seek the advice of a hematologist and get a second opinion on how long you need to be on Coumadin. Good luck. Dr. Aldo

Generally you would need to come off warfarin for a period of time before and after surgery to be considered a candidate for breast augmentation. This would require clearance from the physician who prescribes it. You may also need clearance from other specialists pending a review of your medical history. Visit with a board certified plastic surgeon near you for a consultation. She/He will advise what is necessary to be considered for this procedure.

You really have to weigh your risk of developing a clot against the benefit of having a breast augmentation.
Only your hematologist and perhaps hepatologist would know what your risk is for stopping your medication for surgery. Obviously when you require surgery for cancer, for example, then the risk/benefit profile changes and you would stop the Coumadin and risk a clot for the benefit of removing your cancer. 

Hi, thank you for your enquiry. This is an unusual question but very useful to discuss. In my opinion most reputable surgeons would be cautious of undertaking a breast augmentation for purely cosmetic purposes. However being on warfarin would not normally stop a surgeon operating if there was a medically valid reason (for instance after trauma).
The best advice would come from your current doctors (ie the one's that recommended the warfarin in the first place). If you are on it for preventative reasons, sometimes it can be changed for a different blood thinner (one which thins the blood but wears off faster and might be omitted for 24hrs to make surgery less risky). However, if you are on the warfarin for continued treatment this might not be possible.
If you must remain on warfarin only there might be options to perform breast augmentation through fat transfer. This has advantages and disadvantages compared to the traditional silicone implant method, which I won't elaborate on here, but the procedure (if appropriate) is less "invasive" and therefore usually causes less bleeding.
In summary I suggest you speak to your liver doctors or haematologist (whoever monitors your warfarin treatment) and speak to them about whether it can be changed or halted temporarily to allow elective surgery. Keep them informed of any discussion you have with a plastic surgeon.
Best of luck.

I think it would be best to have a conversation with your hematologist regarding the risks of stopping anti-coagulation.  If the risks are significant, it may not be worth it to pursue an elective procedure.  When patients need urgent surgery and are on warfarin we typically transition (bridge) them with a shorter-acting anti-coagulant that is stopped just immediately before surgery.  So surgery is always possible for patients on warfarin...but the risk may not be worth it.

Thanks for your question. I would suggest you meet with a plastic surgeon in an academic institution where they do cosmetic cases. If you need to be on warfarin for life, then I dont know if switching to another form of anticoagulation for the duration of the peri operative period is an option for an cosmetic case. Good luck!

You should work with the hematologist who manages your warfarin and the reason for why you are on it. For non-elective surgery, patients can be transitioned to a shorter acting anticoagulant, or even have a filter placed to limit risk of blood clots. That said, these are in cases where the procedure is important enough to outweigh risks of bleeding or stopping clotting. Cancer, trauma, etc. Breast augmentation is likely to not be important enough to your health to warrant the risks associated in this context.  You also need to consider, if you have a complication,  who pays for your medical care. It may be challenging to have your health care insurance cover an ICU stay or imaging or other therapies for an elective procedure under these circumstances. I am sorry that you are faced with these additional challenges when contemplating this decision.