Elevated Liver Values and Breast Reduction?

My pre-op blood work came back normal, except for elevated liver enzymes. My primary care and the plastic surgeon both independently suggest this isn't something to be concerned about with regards to breast reduction surgery. In my best guess, the values are a result of having recently used Wellbutrin or using Ibuprofen for treatment of genuine migraines. I do enjoy having a liver, so I'm concerned about that the ramification might be to my liver of post-op pain meds. Any thoughts here?

Doctor Answers 5

Elevated Liver Function Tests and Planned Breast Reduction?

Thank you for the question. It never hurts to question concerns such as abnormal blood work. Unless you receive a good explanation from your primary care physician, you may want to seek an explanation from a specialist ( possibly a gastroenterologist who specializes in liver disease?).  If it is decided to proceed with the breast reduction procedure make sure your anesthesiologist is also  aware of the elevated liver function tests.

 Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Elevated liver values and breast reduction

This must be brought to the anesthesiologist's attention and, regardless of your plastic surgeon and internist's feelings, he must make a decision here. I would first like to know what your baseline bloodwork looked like and whether any liver abnormality existed or had been investigated. If not, it should be looked into even if it means postponing the surgery. Liver abnormalities can affect metabolization of anesthesia and pain medication. Any abnormality should be ruled out in the interest of safety. At minimum, a repeat blood test should be performed to rule out an inaccurate result.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 41 reviews

Liver blood tests

if one or more of the liver function values is slightly high, don't worry about it.  the surgery will not affect it.  I don't even get these tests pre-operatively, because the information it gives in an otherwise healthy person is usually not very useful.  If the tests are grossly abnormal, your surgeon might repeat the blood tests. If they are still abnormal, referral to a specialist may be necessary.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Elevated Liver Values and Breast Reduction?

It is smart of you to be concerned and ask questions. I think as long as your primary physician is comfortable with your having the surgery and the postop pain meds, you need not worry. One thing you might speak to your surgeon about is the use of a postop pain pump. These devices use a local anesthetic rather than any of the narcotics. We use them frequently and find the patients that choose this route use little to no pain pills.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Abnormal preop labs

This is a great question for your plastic surgeon and primary doctor. Since there are no lab details provided, and I do not have the advantage of taking a medical history and doing a physical exam, there is not much that I can add.

Presumably, your plastic surgeon and primary medical doctor have done a medical history and a physical exam, and reviewed the labs, so they have the correct data available, and if have asked them, you have their opinions.

You can always get a third opinion, but it needs to be in person with all available lab results. Breast reduction is an elective procedure, so you have time. Perhaps this is just pre-op jitters, but the most concerning thing to me about your question is that you might trust an uniformed expert opinion over an informed one. If you do not trust your doctors, this is a larger problem that needs to be corrected before surgery.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 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.