Low Platelets and Rhinoplasty Surgery

Question

I have low platelet count that fluctuate between 40,000-86,000 and would like to know if it's safe for me to undergo rhinoplasty. I do not experience any symptoms related to low platelet. Thanks

Kevin Sadati, DO · Answer

Dear rhinoplasty patient from New Jersey,
	This matter should be investigated by your surgeon and a hematologist. Slightly low platelet count is not a contraindication to rhinoplasty, but your platelets are very low and this may require some pre treatments and close observation in a hospital. Good luck

William Portuese, MD · Answer

A low platelet count can lead to severe nosebleeds after a rhinoplasty procedure. The nose is quite vascular and has a propensity to bleed in some patients. Compounding the bleeding issue with a low platelet count would increase the potential for a severe nosebleed. If you are serious about pursuing a rhinoplasty consider consulting your hematologist about a platelet transfusion. A platelet count of 50,000 is too low to undergo a rhinoplasty without risk of severe bleeding complications.

Eric M. Joseph, MD · Answer

You ask an excellent question that needs to be addressed before considering Rhinoplasty Surgery. If you're completely asymptomatic, then you may not need any intervention. If you have a history of easy bleeding or bruising, or if you've had excessive bleeding after a dental extraction or prior surgery, then you'll likely be at high risk for a bleeding complication after your nose job.

	Nasal bleeding is the most common complication associated with rhinoplasty surgery in patients with normal platelet count and function. In that regard, get advice from a certified, reputable hematologist. Ask if it would be best to have your surgery performed in a hospital setting where hematology consultation could be available in the event of a bleeding problem.

	I hope this is helpful for you.

	Regards from West Orange:

Earl Stephenson, Jr., MD, DDS, MBA · Answer

My not be advisable.  The nose has a very robust circulation and having fluctuations in your platelet count may not be the best situation for a potential rhinoplasty patient.  Get several opinions from board-certified plastic surgeons.

	Dr. ES

Scott Trimas, MD · Answer

The nose is one of the most vascular or well supplied areas of your face. Even if you clot normally, you may need the extra platelets to prevent a delayed nose bleed after surgery. I would recommend that you obtain the medical clearance of a hematologist or blood specialist after your have consulted with your rhinoplasty physician about what needs to be done. I hope thisi information helps.

Stephen Prendiville, MD · Answer

I agree with the other Surgeons on this topic. Asymptomatic thrombocytopenia (low platelets) will not necessarily preclude you from Rhinoplasty, but surgery should only be planned after consultation with your Hematologist.

Anand G. Shah, MD · Answer

This is to be investigated by your surgeon, primary care physician, and likely a hematologist prior to engaging in elective surgery.

John Philip Connors III, MD · Answer

Probably not a great idea, until it is fully investigated by your Rhinoplasty surgeon as well as, and most importantly by a Hematologist. Although the number of circulating platelets is important, it is their ability to FUNCTION properly that is of utmost concern. Your hematologist will check a bleeding time to help fully evaluate. Also, it will depend on the extent of surgery, per your Rhinoplasty surgeon, whether it is advisable to proceed. Some of the manuevers we use generate more risk of bleeding than others (in-fracturing of nasal bones, septoplasty, etc.) and therefore may not be advisable.

	Good luck!

	Dr. C

	johnconnorsmd.com

Peter A. Aldea, MD · Answer

For us to be able to form a stable clot and stop bleeding after an injury or surgery we MUST have a certain number of FUNCTIONING platelets. 
There are certain disorders which are associated with a lower number of platelets (either because they are not being produced or are broken up as by a large spleen). At certain levels, spontaneous bleeding may be seen (which is particularly dangerous if it happens to be in the brain, or intestine for example).
NO ethical surgeon would take a risk of nonstoppable bleeding during a non-urgent much less, cosmetic surgery. Most of us would require a blood doctor / Hematologist see you to asses your bleeding risk and enact any corrective action, if possible, to reduce all preventable risk BEFORE Cosmetic Surgery.

Dr. Peter Aldea

Darryl J. Blinski, MD · Answer

As my esteemed colleague Dr Penderville states, and I agree. Get a full hematology clearance in writing. From MIAMI Dr. Darryl J. BLINSKI

Low Platelets and Rhinoplasty Surgery

Answers (13)

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