Breast reduction blood clot preventives?

Question

I'm 34 years old going in for a reduction tomorrow. Previously diagnosed with MTHFR from a recurrent miscarriage panel. Homecystine levels are normal. Small clots were found in my placenta 4 years ago after delivery. I was on low dose asprin during pregnancy. I've notified my doc's office. Should I push for low dose lovenex or what can I do to lower my risk. I'm scared as I have two small kids.

Vincent N. Zubowicz, MD · Answer

Certainly deep vein prophylaxis is worthy of consideration based on your history. I was certainly discuss this with your surgeon. I'm not sure it's a good idea but certainly wouldn't criticize anyone who would use Lovenox.

M. Scott Haydon, MD · Answer

Thanks for your question. I can certainly appreciate your apprehension. Most of my patients are mothers and safety is a big concern. Your hematologist is really the best person to get a recommendation from to see how much risk you are at. Length of surgery can be an issue. Reductions typically are about 2 1/2-3 hours but can be longer for massive breasts. Using a anticoagulant of course helps reduce clot risks but can also significantly increase your risk of hematoma. Various things are done during the surgery to also reduce risk such as placing SCDs (sequential compression devices). I would not be opposed to you starting aspirin after a couple of days. Best of Luck!

Mark A. Schusterman, MD, FACS · Answer

I routinely use lovenox on patients who come to me with MTHFR syndrome.  Your risk is still low for any clotting complications but I would still recommend the lovenox post-operatively.

Craig Harrison, MD · Answer

Great idea to consider some form of risk reduction for a proposed breast reduction.  I would suggest that you get some direction in the most appropriate prophylaxis from your local  hematologist.  Best wishes

Breast reduction blood clot preventives?

Answers (4)

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