Low hemoglobin. How serious is this? Should I delay my plastic surgery plans?

Question

Hi All, Had my blood work done and it appears I have a low hemoglobin count. I was intending on getting some facial work done (a facelift, necklift, chin implant, buccal fat removal) and because I am 38, blood work is not always required prior to surgery. (I had it done for potentially starting a new medication) I'm wondering how serious this is, and if I should delay my plans for plastic surgery until this is remedied. If so, I'd be so bummed. Pics included for specific numbers

Kenneth D. Steinsapir, MD · Answer

First, let me say that generally the facelift is safe. Usually blood loss is limited. However it is elective surgery. You have a seriously low hematocrit. This limits the oxygen carrying capacity of your blood. If you have any sort of unanticipated serious bleeding which is always a possibility though rare, that is foreseeably likely to require a blood transfusion. In my opinion, it is not appropriate to perform elective under the circumstance. If a surgeon does not get a medical clearance for this type of surgery, they are a bozo. Do not have surgery with a bozo. This is elective surgery. Yes you first need to have your severe anemia worked up and fixed before having elective surgery. This is precisely why we send patients for medical clearance. Your internist may send you to be assessed by a hematologist for this assessment. Please get the care you need.

Alan Gonzalez, MD, FACS · Answer

Hello @Nala Eyes Thank you for your question. You need clearance from a hematologist before surgery and discuss this issue with your Plastic Surgeon because low hemoglobin is a risk and it depends on every specialist the requirements for every surgery. I would not operate with low hemoglobin levels, for my patients I would prescribe iron supplements and take the test again in 1 month. Best wishes!

Cory Bovenzi, MD · Answer

Hi and thanks for your question! Even though facelifts/ chin implants/ buccal fat removal procedures usually have minimal blood loss, the low hemoglobin of 8.8 is concerning. I would recommend reaching out to your doctors since a hemoglobin level that low is concerning for an underlying medical condition causing you to have such low levels. I would not proceed with any cosmetic surgery until the hemoglobin can be brought up and the underlying cause of the anemia is addressed. Best of luck!

Stephen Prendiville, MD · Answer

Your Hemoglobin is slightly low but not alarmingly so.  I do recommend that you see your Internist to investigate potential causes before surgery, and take care to maintain a healthy diet.

Zoran Potparic, MD · Answer

Although blood loss in face lift surgery is minimal, it is still important to be within normal range of hemoglobin/iron. It is in your best interest to regulate your anemia (with a help of your PCP) and consider your surgeries afterwards. Good luck.

Ronald J. Edelson, MD · Answer

Your hemoglobin is slightly low which is not unusual for mentruating women. Your surgeon may recommend iron supplements . The surgery you are gaining has mi no mail risk of blood loss but the decision will be up to your surgeon.

George Yang, MD · Answer

Hi, I think for the sake of your health, postponing the surgery may be prudent. Ask your primary care doctor and surgeon what they think. Although this may appear to be an inconvenience from a scheduling standpoint, if the bleeding is more than expected you may require a blood transfusion. Why risk that, for a scheduling inconvenience? This is an elective procedure and ideally everything goes smoothly without a hitch, but why operate when the situation is not ideal. On the bright side your cholesterol numbers are great, which makes me suspect whether you are a vegan or vegetarian. Without red meat, your iron intake may be insufficient and may benefit from ferrous sulfate supplements to your diet amongst other things. Hope you found some value in the comments. Good luck on your facial procedure when you have it in the future. Best, Dr. Yang

Scott C. Lindsay, DO · Answer

Thanks for your question. An 8.8 is not a normal level and you should seek to remedy this prior to any major surgery. Otherwise, you are at risk for needing a blood transfusion. Best of luck.

Derek Fletcher, MD · Answer

I recommend delaying surgery until the cause of your anemia is identified and treated and your blood levels have returned to normal range. The reason for your anemia may be more important than the anemia itself. Work with your PCP to reach an accurate diagnosis. This may require subspecialty referrals and may take several months to complete.

Darryl J. Blinski, MD · Answer

You have a very serious anemia that would preclude you having any elective surgery. Best to see a hematologist ASAP. Do not have facial surgery until healthy.

Low hemoglobin. How serious is this? Should I delay my plastic surgery plans?

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