Is 138,000 platelets too low for rhinoplasty?

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  I recommend obtaining clearance from your primary physician and hematologist prior to surgery.  This will be the safest way to proceed.   
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Hi Joey,

I would need to know why your platelets are low before proceeding. If there is not a clear explanation, I would have you see a hematologist before planning surgery especially since this is an elective case. Thank you very much for your question, and I wish you the best. 

Mark G. Albert, M.D.

NYC Aesthetic Plastic Surgeon

Decisions about lab abnormalities and surgery can be a little confusing. Close numbers are usually allowed but how close is close? The patient history is important. If there is no history of spontaneous bleeding or bruising then it is likely you will be fine with surgery. There can be lab errors and platelets can be missed in the count if they are a little large. Also there are medications that can lower your platelets (like antacids) that don’t cause clinical issues. Most important is the function of the platelets and that is represented by a normal medical history and a lack of bleeding problems after a prior surgery or a dental procedure for example. With all that being said, if you are uncomfortable then see a hematologist even if it delays your surgery. There is no reason to add extra stress to the situation. 

 It's probably best to get clearance from your primary care physician or hematologist before electing to undergo cosmetic surgery with a low platelet count. It's important to try to prevent nosebleed situation the first two weeks after a rhinoplasty procedure  with low platelets.

Thank you for your question.  While your platelet count may be slightly less than the laboratory lower limits of normal, they are well within the range of being able to perform a rhinoplasty and many other procedures. Some patients with levels as low as 80,000 can have surgery without excessive bleeding. You probably already know that when platelets are low that patients should avoid aspirin, ibuprofen or Motrin, and other Non-Steroidal Anti-inflammatory Drugs (NSAIDs).   When I have patients with low platelets, I take extra precautions to be certain that all bleeding as been controlled by the time I finish the case.  Because some of the medications that we use during a rhinoplasty may start to loose their ability to control bleeding, selection of an experienced Board Certified Plastic Surgeon or Otolaryngologist will help make it more likely for him or her to complete the procedure during this time period. Discuss this with your surgeon, but it does not seem likely that there will be a problem with your particular platelet count.  Good Luck.