Rhinoplasty for Patient on Lovenox?

Is it impossible to have rhinoplasty if one is on Lovenox for a Factor 2 & 5 blood clotting disorder?

Doctor Answers 4

Consult a hematologist on nasal surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Anch,

As stated previously, the nose is quite vascular. During nasal surgery we take extra measures to reduce the bleeding from the nose.

Lovenox is designed to thin the blood, and generally increases the bleeding tendency.

The best approach for you would be to consult with your hematologist to determine what actions, if any, can be taken to allow you to undergo nasal surgery.

Your plastic surgeon in conjunction with your hematologist would determine the best course of action.

Good luck with your procedure.

Manhattan Plastic Surgeon

Rhinoplasty on Lovenox?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The nose is a highly vascular structure, and bleeding in healthy individuals is a concern. Being on Lovenox generates an even higher degree of concern for this complication. You may require cessation of this in the pre-operative and post-operative periods.

However, I would proceed with caution. Seek consultation with your hematologist regarding the perioperative management and whether it is advisable prior to seeking a rhinoplasty consultation.

Must get clearance from hematologist

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is not possible for somebody to undergo a rhinoplasty while still currently taking Lovenox. Patients must have all blood-thinning drugs out of their system prior to a rhinoplasty surgery. They must also keep these drugs out of their system for two weeks after the surgery as to prevent nosebleeds. This needs to be discussed with the patient’s hematologist, who must give clearance to proceed so that there are minimal risks due to hemorrhaging and bleeding from the nose versus having other medical issues regarding blood-clotting disorders.

Caution before proceeding on Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Having a bleeding disorder is a relative contraindication to certain types of surgery. For example, I would never perform a blepharoplasty in a patient with any bleeding disorder because of the risk of blindness. I would also strongly discourage rhinoplasty or any cosmetic surgery for anyone with a significant bleeding disorder

If a rhinoplasty was indicated for functional reasons, I would consider it. I have done reconstructive surgery on patients who were on very strong blood thinners which mimicks a bleeding disorder, but it makes the surgery potentially much more difficult. You should use caution before proceeding with this. Hope that helps.

Samson Lee, MD
Seattle Facial Plastic Surgeon

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.