Warfarin and Plastic Surgery

Let me know your experience/thoughts with plastic surgery while you were prescribed to be on warfarin (blood thinner).

I recently was diagnosed having a blood clot and was put on warfarin. The warfarin doesn’t treat the clot, but helps prevent it from traveling thru the blood system so the body can naturally treat it. The typical procedure is to stay on warfarin for around six months. My understanding is they don’t even check to confirm the blood clot is gone. Unfortunately I was tested and have (type 5?) genetic blood condition and will be on warfarin the rest of my life. Since warfarin thins the blood, there is obvious concern of additional bleeding during surgery.

For planned surgeries, a person temporarily stops taking warfarin prior to surgery and then restarts after surgery. I found this out while scheduling a colonoscopy. We will wait the six months before doing the colonoscopy before temporarily stopping the warfarin.

The plastic surgeon I planned to use seems to want to steer me away from plastic surgery. Plastic surgery is elective and due to my blood condition, I have increased blood clotting risks. He hasn’t said he wouldn’t do the surgery. But he would at least recommend doing multiple smaller surgeries over time vs one, long session of multiple combined surgeries.

I’m trying to figure out if the surgeon is just being cautious or if I have a significant increased risk. All surgeries have some risks. Am I doubling the risk due to my blood condition?

Hi Brian.  You may have Factor V Leiden, which is a hereditary blood clotting disorder of varying severity.  You need the  input of your hematologist in conference with your plastic surgeon to move safely forward with any surgery. Different forms of Factor V exist, some carry more risk than others si=o you need expert advice from the doctors caring for you.

I agree with what Dr L said, and sounds like you have Factor V Leiden mutation, the most common inherited form of thrombophilia.  Yes,  since you are hypercoaguable you do have an increased risk, with all surgeries performed, not just plastic surgery.   Within that mutation there are heterozygous and heterozygous patterns, depending on your genentic make up your surgeon can decide on safety of surgery, along with age, gender, overall health, smoking, etc.  Make sure you have a good hematologist.  Your hematologist and plastic surgeon should work together to manage your mutation to have a good surgical outcome.  Switching to injectibles may be an option. 

Thanks for the feedback.  I'll ask my primary doctor more questions about by blood condition.