Previous provoked PE - best plan for upcoming breast augmentation?

Question

Hello, I am having a BA in August, and I had a Proveked PE due to pregnancy. I don't have any clotting disorder, and I ended up having another pregnancy 3 years ago. I was put on Lovenox for the whole pregnancy, and everything went successfully. I am having a BA in August, and this is the recommendation that the surgeon is having. I would like to see what you guys think. I am scared !! But I met with my hematologist, he's putting me on Lovenox 24 hrs after surgery for 7 days, and the surgeon is doing 275CC over the muscle, will be doing general anesthesia, and he will be doing small lipo under my armpit since I had excessive milk that travels to under the armpit. Surgery is 2 hours an 15mins. The surgeon will be using a leg compressor. What do you guys think of this????

John LoMonaco, MD, FACS · Answer

Without all the details,  you seem to have a low risk score for a future blood clot.  My approach would also be tailored, as you surgeon and hematologist have decided.  Its all about balancing risk and possible side effects. As with every surgeon, be sure your doc has hospital priviliges at a nearby facility in the rare case that you need extra care. Best wishes from Texas !

Semih Yildiz, MD, FEPOBRAS · Answer

A prior pulmonary embolism does not automatically rule out breast augmentation, but it makes the preoperative plan much more important. The key issue is not the implant size itself; it is whether your hematologist and your surgeon agree on your clot-risk category, timing of Lovenox, compression, early walking, anesthesia plan, and whether adding even small axillary liposuction is worth the extra operative trauma and time.

If both doctors have reviewed your history and cleared the plan, this can be reasonable, but the anticoagulation instructions should be written clearly before surgery, including when to restart, how long to continue, and what bleeding signs to report to your surgeon or care team. If you develop chest pain, shortness of breath, fainting, calf pain, or one-sided leg swelling after surgery, seek urgent care immediately rather than waiting for routine follow-up.

Previous provoked PE - best plan for upcoming breast augmentation?

Answers (2)

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