I am planning to have breast augmentation, I had blood clots during pregnancy. Hemotologist did blood work No clotting disorder

Question

I am planning to have breast augmentation. I am concern about the history of PE i had during my second pregnancy. I was on blood thinner and later postpartum my haematologist did blood work to check if any factor missing causing clots. Reports cane clean and it was ruled that pregnancy was reason. I am concern as breast augmentation is surgery. Surgery may trigger clots. Please advice way forward.

Drew Davis, MD · Answer

You can safely have a breast augmentation with the history of a PE during pregnancy. I advise coordinating the surgery with your hematologist to see if any blood thinning medication is indicated for your breast augmentation. Sometimes it is recommended that you hold your oral contraceptive pills if you take them. Many times for patients with your history, no further treatments is needed for a short, straightforward surgery like a breast augmentation.

Semih Yildiz, MD, FEPOBRAS · Answer

A prior pregnancy-related PE does not automatically rule out breast augmentation, but it makes this a higher-risk elective surgery that needs formal clearance and a clot-prevention plan before proceeding. Clean thrombophilia labs are reassuring, but they do not erase the history of a PE; the key is whether your hematologist and surgeon agree your current risk is acceptable and what prophylaxis is needed.

Before scheduling, I would ask for written hematology guidance on perioperative anticoagulation, stopping any hormones or estrogen if applicable, compression devices, early walking, hydration, and whether medication such as low-molecular-weight heparin is recommended after surgery. Also keep the operation as short and straightforward as possible, avoid combining procedures, and use an accredited facility. If your risk score is high or the hematologist is uncomfortable, postponing or avoiding elective surgery is the safer choice.

Chet Mays, MD · Answer

Thank you for submitting your question! A hx of a PE or blood clots/blood clot disorders would not be a reason you wouldn't be able to get surgery done. That would absolutely be something you would want to talk to your surgeon and the nurses about so they are aware of your hx prior to surgery. There is medications you should be given prior to surgery, precautions taken while you're in surgery and precautions post surgery to reduce your risk of that happening again. I would recommend consulting with a board certified plastic surgeon like myself so we can create a surgical plan that is best for you and your goals!

Brian K. Reedy, MD · Answer

Thanks for your question!
This is something you will have to discuss with both your plastic surgeon and family physician. You may need to get  medical clearance prior to having surgery. .  Schedule a appointment with a board certified plastic surgeon to discuss your options. Best wishes!

Jonathan Heistein, MD · Answer

Hi.  Even though it is likely that there would not be a problem, I would definitely consult with your hematologist prior to having elective breast surgery.  Your hematologist may want to put you on a blood thinner to be safe, and if so, you will need to discuss the associated issues with your surgeon.  Hope that helps.  Best of luck!

Jeffrey M. Darrow, MD · Answer

You are correct that after any surgery there is a risk of blood clots, and that after having had a prior blood clot, you have a slightly higher risk of having another one. However, a breast augmentation is a very short surgery, compression boots should be used during your surgery and you should be immediately ambulatory and walking around after your surgery. All of these things are in your favor for having a very low risk for having a blood clot after your breast augmentation.  If you are concerned, you may ask your hematologist to give you a short course of Lovenox, an anticoagulant which can start to be given 12 hours after your surgery to lower your risk even further.  best wishes.

Daniel Barrett, MD · Answer

Dear Monisan1989,
it is hard to tell for sure without an examination. You will need to get clearance from your doctor prior to surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Your history puts you at increased risk for blood cloths during surgery in general anesthesia. Considering that breast augmentation is relatively short surgery , it is very likely that usual peri operative prophylaxis with compressive stockings and postoperative early ambulating would be sufficient to prevent next episode of embolism. This is something that you need to discuss with your surgeon before surgery. Hope this helps.

Ashley Thorburn, MD · Answer

If you've had a history of blood clots during pregnancy, it's crucial to inform your plastic surgeon about this medical history before undergoing breast augmentation. Even if your hematologist has confirmed that you don't have a clotting disorder, the history of blood clots is a significant factor that your plastic surgeon needs to consider when planning and performing the surgery.Here are a few considerations:1. Medical Clearance: Your plastic surgeon may ask for a medical clearance from your hematologist or primary care physician to ensure that it is safe for you to undergo elective surgery. This may involve a review of your medical history, current health status, and any relevant laboratory test results.2. Preventive Measures: Your plastic surgeon may take certain preventive measures during the surgery to minimize the risk of blood clots. This could include compression stockings, medications, or other strategies to promote circulation and reduce the risk of clot formation.3. Postoperative Care: Following surgery, it's important to adhere to your plastic surgeon's postoperative care instructions. This may involve specific activities, medications, and monitoring to reduce the risk of complications.4. Follow-Up with Healthcare Providers: Maintain open communication with both your plastic surgeon and hematologist during the entire process. They can collaborate to ensure that your breast augmentation is as safe as possible given your medical history.Always prioritize your health and safety, and be sure to have a thorough discussion with your healthcare team about any concerns or questions you may have. Your plastic surgeon will guide you through the preoperative evaluation and provide recommendations based on your individual health profile.

Brian Widenhouse, MD · Answer

Thanks for your question. Since the test you had didn't show a problem, it seems like you should be fine to proceed with a breast augmentation. However, you should discuss your history in detail with your plastic surgeon. 
Best of luck!

I am planning to have breast augmentation, I had blood clots during pregnancy. Hemotologist did blood work No clotting disorder

Answers (15)

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