Breast surgery tomorrow and I am anaemic; surgeon said it would be safe although I made have to do a transfusion after?

My results came back today and the surgeon said it would be safe although I made have to do a transfusion after. Is this normal for surgery to go on and it be monitored?

Doctor Answers 13

Cosmetic Breast Surgery While Anemic - Possible Transfusion Needed

SAFETY FIRST! If there is already talk of  a blood transfusion before your surgery, that does not bode well. Find the cause of your anemia first, fix it, and then come back for surgery. Cosmetic breast surgery is elective surgery, not life-saving surgery. And in your case, it may be life-ending surgery. Optimize your health first. I'm disappointed your surgeon  hasn't directed you in the direction of safety first. We are taught to first, "do no harm."

Sacramento Physician
4.7 out of 5 stars 6 reviews

Anemic before breast augmentation

Thank you for asking about your breast augmentation.

  • You should ask your regular doctor to review the test.
  • While a very mild anemia - common in many young women - is not usually a cause of concern before a breast augmentation, most anemias are diagnosed and treated before any elective surgery.
  • You should certainly not be so anemic as to require transfusion -
  • So step one, get the copy of your lab report and ask your regular doctor.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Anemic and breast reduction

I agree with Dr Wallach. Anemia should be treated before, not after, surgery. This is an elective procedure and should be delayed until the basis for the anemia is elucidated and, then, treated appropriately. In my hospitals of choice, the anesthesiologists would decline to proceed as well. 

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Anemia and surgery

To suggest you need a transfusion after surgery is probably not the best way to proceed. Often if the anemia is significant a workup is necessary and patients are then treated accordingly, commonly with iron until the levels have improved.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast surgery tomorrow and I am anaemic; surgeon said it would be safe although I made have to do a transfusion after?

Anemia is a pretty loosely defined term and it can be mild or serious.  Many women are iron deficient and mildly anemic but breast augmentation surgery should be a near bloodless procedure and talk of a transfusion is of concern.  Review your lab results with your internist and plastic surgeon to determine whether you might be better off waiting for proper treatment of your anemia to reduce the risk of an elective procedure.  Best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Breasts reduction with severe anemia

Dear Kiela,

    Cosmetic surgery is purely elective. You do not have to have it but rather you want to have it. As such , complication rate should be reduced to a minimum. If your blood count is so low that you might need transfusion after a procedure with minimal blood loss, I would recommend to postpone surgery until your Hemoglobin is in normal range. Blood transfusion is not with 0 risk and it is better to treat you orally or with shots and raise your blood count. More over, do you know why are you so anemic ? Were the possible reasons for it investigated ? 

    Remember that an ounce of prevention is better than a pound of cure !

    Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive.

                           Best of luck,

                                                 Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 124 reviews

Blood transfusion in cosmetic surgery

It depends how anaemia, why, and what operation. In general, this is entirely elective surgery and I would tell my patients that I would correct the anaemia first. 

Personally I can see very little reason to put a patient in a position where they might need a transfusion when it could be avoided. 

Richard D. Price, MBBS, MD, FRCS(Plast)
Cambridge Plastic Surgeon
5.0 out of 5 stars 5 reviews

Anemia before surgery.

It is always best to have a good blood count prior to surgery.  In general  we like to avoid the risk of transfusion if possible.The decision to proceed will in some cases depend on the risk of bleeding for the procedure you are considering. A breast augmentation for example usually has minimal bleeding and low risk of postoperative bleeding. A breast reduction usually has more blood loss. In a patient with a normal blood count even if there is unexpected bleeding you would likely have enough reserve  avoid transfusion. If your count is low you may not have that backup reserve. This will be a judgement call with you and your surgeon and pivot on the tolerance you both have for the possibility of transfusion. If you are not comfortable delay the surgery and seek medical guidance to build up your blood  count.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 104 reviews

Anemia and surgery

With limited information, it's hard to advise you.  Breast augmentation typically has very little blood loss.  Breast reduction or lift can have more blood loss and put you at risk for needing a transfusion.  If you are in a higher risk category and you were my patient, I would definitely cancel your case until your blood levels were back to normal.  This is elective surgery and putting you at risk for transfusion is not in your best interest.  You could potentially get a virus transmitted through a blood transfusion that could lead to hepatitis or HIV (both potentially fatal).  

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

It all depends how anemic.

When having elective surgery it is best to optimize your health preoperatively.  If you are VERY anemic this should be treated before an elective operation is done.  Talk to your surgeon and perhaps your primary physician as well as the anesthesiologist prior to surgery.  Good luck!

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.8 out of 5 stars 76 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.