Can I get a breast lift while on Coumadin?

Question

Im 5'1 and used to weigh 185 pounds and my breasts were DDD now I'm 109 pounds and my breasts are now around a C. I'm on Coumadin from a stroke I had when I was 16, because I have factor VIII clotting disorder. I'm now 28 and my breasts are extremely saggy. I'm very self conscious to the point where I have to see a psychologist, and it's not helping. Would I be a good candidate or is the Coumadin a major problem?

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size.

This could be done on anticoagulation that we would coordinate with your doctor.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Bennett Yang, MD · Answer

Hello and thank you for the question. I understand your concerns and goals. Unfortunately, you have a high risk condition that may make this procedure unsafe. Coumadin as you already know is a very powerful blood thinner. In your condition with factor VIII, you are at a high risk for having bloodclots, DVT, after surgery. Although it may be possible to perform in a hospital setting using intravenous medication such as heparin to temporarily manage the clotting disorder, it would still pose a high risk. Typically, in these cases, surgery is only performed if medically needed. A breast lift, is considered cosmetic surgery and thus not medically necessary. I know that is not the answer you were hoping for, but it is honest. Best to you.

Sanjay Azad, MS, FRCSEd · Answer

Thank you for your enquiry. I believe you have lost quite a lot of weight and are considering a breast lift. This may also warrant an augmentation, as a simultaneous procedure, if there is a volume issue.
Coumadin is a blood thinner and if you stop it suddenly it would not be advisable as you are at risk of having sudden blood clotting and a repeat stroke. So for this reason the Coumadin has to be 'bridged' with another blood thinner which is not going to cause excessive bleeding during surgery. A competent haematologist can help out with a proper regime for bridging the period of surgery.
So Coumadin itself is not an issue.
Best of luck in your journey and warmest regards.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well.. I will have to say that everything you're taking has to be discussed by your surgeon, besides that the medication you're telling us, has to be coordinated as well by your hematologist to see what will be the next step.

Surjit S. Rai, MD · Answer

Thank you for your question. Usually for patients on Coumadin we would need to bridge you to Lovenox for surgery. This would have to be coordinated with your hematologist. The more concerning issue for me would be your Factor VIII clotting disorder. This places you at a high risk for blood clots perioperatively (especially if you are stopping your long term anticoagulation). In my opinion the risk to your health and possible risk of blood clots and death is too great to take the risk for a breast reduction procedure. I understand heavy and saggy breasts can negatively affect your quality of life but just make sure to discuss your complete medical history with your surgeon so they can work closely with your hematologist and if they pursue surgery to do it in a safe manner.

Regards,

Surjit S. Rai, MD

Dallas Plastic Surgeon

Regards,

Surjit S. Rai, MD

Dallas Plastic Surgeon

Peter E. Johnson, MD · Answer

You can have a breast lift however it will take a bit of coordination with your hematologist. Generally we have patients off coumadin and transition to lovenox until several days after the procedure, and then resume the coumadin. Medical clearance and coordination takes effort, but can give you a safe opportunity and better look after your successful weight loss.

Ronald V. DeMars, MD (Retired) · Answer

We all have experience doing elective cosmetic surgery for patients on anticoagulants, but the coumadin has to be replaced for a few days with a different anticoagulant and the change needs to be coordinated between the physician prescribing the coumadin and the plastic surgeon.

Can I get a breast lift while on Coumadin?

Answers (7)

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