Are there alternative options for me to get breast implants as a Jehovah's Witness with no blood?

Question

I am 28, 62kgs. I am a Jehovah's Witness, so no blood, but am open to alternatives. I chose 300cc anatomical implants, inframammary incision. The day before my surgery I was advised the anaesthetist wasn't comfortable going ahead. I have now sent detailed information of the alternatives I can have - cryoprecipitate, erythropoietin, use of cell saver & haemodilution. I have now been advised that as my surgery is cosmetic, not urgent, the anaesthetist will not proceed. Is there any alternative?

Donald R. Revis Jr, MD · Answer

Good afternoon!I perform 400-500 augmentations a year and have been doing so for 20 years, and in all that time have never given a patient a blood transfusion, so I think there is no reason to worry!

Anthony Barabas, MBBS, FRCS (Plast) · Answer

It would be very usual to lose so much blood from a breast augmentation such that you would require a blood transfusion, and certainly not a situation that I have come across. I am also surprised that it was your anaesthetist who decided that you shouldn't proceed with surgery as I would have thought this was a conversation that should take place with the surgeon. However, even though extremely rare, the circumstance of having significant blood loss, and what to do in such a situation, would have to be discussed in detail beforehand. Even in such a situation there are options available other then giving blood as the first line treatment. I would recommend that your surgery takes place in a hospital with fully specialty medical cover 24hrs a day (including haematologists), rather than a hospital aimed primarily at performing cosmetic surgery.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  This appears to be a situation you should speak directly with your surgeon about to help clarify what may be taking place.  Although the risk of any significant blood loss during, or after, surgery is small it is a risk that you must accept if you are interested in implants.  Best wishes.

Adrian Richards, MBBS, MSc · Answer

Hello,I have been performing breast augmentations for many years and have never had my patients require a blood transfusion. As is was the anaesthetist rather than the surgeon that refused to do the surgery, it may be worth returning to the surgeon and getting their advice on the situation. There may be the option of performing the procedure at another location.It may also be worthwhile visiting other surgeons on the Specialist Register for Plastic Surgery with the GMC and whom has FRCS (Plast) after their name.It is very important to make any medical history well known ahead of your procedure, ideally in the consultation stages so communication can be had in early stages to avoid disappointment again. Wishing you the best of luck.

Simon Smith, BSc, MS, FRCS · Answer

You have no need to worry. I know of nobody who has needed transfusion after augmentation. A skilled surgeon should dissect the pocket to put the implant in using one swab at most, so a few mls of blood at tops. Even in the rare event of a postoperative haematoma, you really only lose a few hundred ml - not enough for you to become haemodynamcally compromised or to need transfusing.

Marcus Davis, MBBS, MRM, FRCSEd (Plast) · Answer

many thanks for such a great question and I am sorry that you have experienced such a late cancellation.
It is not usual for anyone to suffer much blood loss from a breast augmentation - I would not expect to need to use more than a single small cotton surgical swab for the whole of this surgery such is the minimal blood loss.
It is the norm to have a conversation with your surgeon in clinic about what products and alternatives you are willing to receive during a worst case scenario, and each and every hospital should have a policy in place for patients such as yourself as well as consent forms to cover possible eventualities. It is also normal for your surgeon to discuss with the anaesthetist well in advance about any medical conditions or advanced directives that might be in place for each patient, not to mention pre-operative assessments including checking your blood count. If needs be the anaesthetist can always see you then self in clinic pre-operatively, although this is very rarely required.
I would suggest you don’t give up on your ambition of a breast augmentation and consult with a surgeon on the Specialist Register for Plastic Surgery with the GMC and whom has FRCS (Plast) after their name.
I wish you the best of luck.
Marcus

Are there alternative options for me to get breast implants as a Jehovah's Witness with no blood?

Answers (6)

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