Hemoglobin Numbers/Recovery...Closeness of Procedures

I've been a long time lurker of this forum, but now since I am really getting plastics I am going to jump in with a question first.

I am scheduled for a full lower body lift on June 8th (with anchor cut on the front).  My Hemoglobin is 11.2.  He will perform my LBL with that number, but today expressed great reservation about my plan to have a second surgery with thighs and arms.  I ideally wanted them all done this summer.  He is worried about blood loss, and that my Hemoglobin may not recover to a comfortable level for him to perform the other two procedures.

Can you guys who have had procedures closer together what your hemoglobin numbers were like?  Can I expect it to bounce back?  I have nothing to base this on.

Thanks for any help you offer.

Your hemoglobin is low, and this is common in WLS patients no matter the type of surgery.  Iron, folate, B12, and protein absorption problems all may play a role.

It is incumbent on the surgeon who will be causing bleeding and expecting good healing / best results to be knowledgeble on the common deficinecy states of his patients, and either treat them himself or refer to someone who can

You should expect to have iron, transferrin, TIBC, B12, folate, pre-albumin, iron saturation, and ferritin levels all checked along with a review of your "red blood cell indicies."  These tests will clearly identify the type of anemia you have, and thus dictate the treatment(s)  you need and for how long you need them.  Followup labs to minotor progress are essential.

Anemia does not develop overnight, so naturally correcting anemias like this can take weeks, and depleted iron stores may even require an iron infusion.  So labs must be drawn many weeks or months before surgery so your surgeon has time to "tune you up" and "fix the fixables" to insure a safe surgery.  Simply taking supplements without a proper understanding of the cause of the anemia is poor medicine.

Plastic surgeons create huge incisions and require massive healing from their patients, who naturally may have porblems getting nutrition or may not be aware that "eating for recovery" is totally different than "eating for weight loss" or "eating for maintainence."

In my opinion, plastic surgeons should lead the way in identifying and treating these disorders, so be sure your doc is playing a proactive role ion making your surgery both safe and successful.

I want to add my experience to what Dr L said.  I just had extensive plastics (LBL, BA/BL, and arm lift).  Before doing so, I consulted with 5-6 surgeons.  Two of them are well known for having experience dealing with WLS patients, and these are the only two that really stressed what Dr L said - the importance of labs, making sure I had no deficiencies before the surgery, etc.  The others, who were just local plastic surgeons I spoke to......not so much.  When I asked those guys about iron, protein, my labs, etc.,  they kind of blew it off and said all I needed was a form giving me medical clearance from my PCP. 

Even though I took great care to ensure I was at peak nutrtional status prior to my surgery, I still had some minor wound separation (who knows if it's related - the fact is I did too much with my arms when I wasn't supposed to) - but  I can tell you the incisions and healing are a MAJOR big deal so don't take any chances.  And most importantly find a PS that understands the needs of WLS patients.

That's my 2 cents....

I just had LBL done on Thursday and my numbers were a smidge low.  I ended loosing more blood than expected and hemoglobin dropped to 7.6.  I ended up with 2 transfusions and a total of 4 units of blood.  I'm okay now (very weak), but you don't want to mess around with having surgery when you're body isn't ready for it.

Take the advice of your surgeon and wait if you need to.

Good luck!

I had my surgery canceled last week because my hgb was 7.2  (has been 5.8 for weeks so i thought that was great..lol) I always run low my surgeon stated although there was not much bleeding risk with my abdominal plastic I ran a risk with lipo. So he is willing to go forward with my surgery anything over or at 10.5 (Becuase of my hx everyone is diff). I'm currently doing iron infusions for the next 8 weeks hopefully i can reschedule before it gets to hot. It takes 6 weeks to form a good blood cell my doctor stated.  I personally know that my low anemia an oxygen level makes me a wacky emotional mess so wouldn't want to be too low for back to back surgeries. Good luck

Preparation to anticipate blood loss, especially before LBL, can go a long way to preventing a transfusion afterwards.  

Another huge benefit you can do yourself is cardio condtioning, which allows your heart and vascular system to compensate for blood loss.  Ask my patient ShellyMor about that anytime..she is not in her 20s, but she was so conditioned that after an extensive LBL and BL done together she was flying through her recovery in just 7 days !