Stopping birth control before surgery for breast lift and implants (6 plus hours)?

This is an important question. Birth control pills can increase your risk for clotting especially in the first several months. I would discuss this issue at length with your gynecologist and plastic surgeon for specific recommendations tailored to you and the procedures performed.

You should stop taking birth control pills and estrogen replacement therapy about four to six weeks before surgery because of the risk of blood clots. If your surgeon advised you to stop, then please listen to them.

Being on BCP does increase your risk of a blood clot.  This can be fatal if it occurs in your lungs.  If your surgeon has requested that you go off your BCP, then that would be prudent.  Otherwise, you are taking a risk with your own health.  Whatever you decide to do, make sure you communicate your decision/concerns with your PS.Best,

It is the estrogen that is found in most birth control pills that is the concern.   Estrogen is not found in your thyroid replacement hormone.   There are many different types of Hormones.   They all do different things and have different side effects.   I am 100% in agreement with stopping your BCP's at least 2 weeks in advance.  It will definitely decrease your risks of getting blood clots.  Blood clots can kill you!   Stopping your BCP's will not.   Be safe!As to the comments about your surgery taking 6 hours....?  Without seeing you and knowing the exact details of your surgery, it is difficult to know whether or not this is reasonable.  It would usually take me 5 hours for this combo and I think this is about the average. Some people may do this much quicker.  Quicker is not always better.   Often quicker can be sloppier or without as much attention to detail.  If your surgeon is good and has a good record of safety, trust him/her!     

Birth control increases the risk of blood clots.  I typically don't require my patients to stop birth control but you should follow your surgeon's instructions as he not only knows your health history, but he is your surgeon and he has his requirements.  ac

Dear Abogmenko,
The reason your doctor is suggesting stopping the birth control two weeks before surgery is because it is well known that birth control pills increase the chances of deep vein thrombosis (blood clots) and even more dangerously pulmonary embolism (blood clot which breaks off and flows to the lungs). A pulmonary embolism can be fatal. That is something that cannot be undone. No one can give you a percentage risk, but the risk factors for DVT are age over 40, operation over 30 minutes, presence in the body of cancer, history of prior DVT, abnormally high red blood cell levels and of course birth control pills.
I am more concerned about why surgery of breast lift and implants would possibly take six hours of general anesthesia. In our center, we generally prepare for one and a half to two hours total for the procedure. You may want to get a second opinion and be sure you are going to a board certified plastic surgeon.
I hope this has been helpful to you.
Robert D. Wilcox, M.D.

THe literature suggests that birth control pills increase the risk of DVT, but I do not routinely have patients stop it. Some surgeons do request patients to stop it, and others do not.

First of all, 6 hours??!! Wow! That's a really long time for what you are going in for. Is this surgeon really that slow? That contributes more risk than your birth control pills (BCPs) would ever contribute. Length of surgery has been shown to correlate with many different complications including pressure sores, wound infections, pulmonary problems, hypothermia ... We all tend to be fairly civil on this board but really really slow surgeons need to be monitored. In a typical hospital setting the surgeon's peers through peer review would be aware. The problem we are having these days is most of us do surgery in private facilities where peer review is not as common or strict. I do my work in my own center also by the way. Okay, rant over.I never tell someone to stop birth control pills. And no one I know does either. You are correct that your hormonal balance is all related. And thyroid levels are particularly susceptible to many other factors. My advice is do not stop at all. Just be sure your doctor uses pneumatic stockings on your legs. Also, in my center we also do a Thrombosis Risk Assessment called a Caprini Score. All surgical facilities should do this. Dr. Joseph Caprini developed it. Many have written about it. Google it for more info. I'm also including a link to my breast augmentation consult video.

While contraception places you at slightly higher risk for a DVT, I have never told a patient to stop birth control. If you did and turned out to be pregnant later, that would be a big, big problem. Six plus hours is a long operation for an augment/pexy and I am a slow surgeon. Know that if you stop birth control and then resume, you would need to use alternate forms of contraception. If you are given antibiotics, some of them will negate the oral contraception. I recommend that you discuss these matters with your gynecologist who can interface on your behalf with the plastic surgeon.

Although the side effects of stopping birth control pills may be unpleasant, they are not dangerous or potentially life threatening. Oral contraceptives increase the risk of forming a blood clot in the leg (DVT) by two to three times normal. The DVT can be dangerous or even life threatening if it breaks off and goes to the lungs. So although the risk of a DVT is small for an otherwise healthy 25 year old non-smoker, we find it prudent to discontinue birth control pills before major surgery.Thyroid medicine has no effect on the formation of blood clots so we usually continue this before surgery.