Platelet count of 120 and gynecomatia surgery

[Leokuk16]

My cosmetic surgeon asked me to go through the routine tests before gynecomatia surgery. The results indicated that I have mild  thalassemia trait with my platelets count 120 (normal range being 150-450) with giant platelets seen and my APTT at 23.6. The surgeon is advising against the surgery  as he said I might have issues with healing (clotting etc) and coming back from anaesthesia. All the other parameters are normal and I have no other health issues. I checked my old blood reports from 2012 and 2014 and my platelets count was 125 and 130, I highly doubt that it will ever come back to the normal range. Experts kindly suggest me what to do. Thanks in advance 

[Dr. Elliot Jacobs]

I have had a few patients in a similar situation.  Best is to consult with a hematologist and discuss the proposed operation with him/her.  Understand that it is imperative that you have a reasonable ability to form a clot. Surgery undoubtedly interrupts many small blood vessels, which may continue to bleed post op without ability to properly clot.

Sometimes a pre-op platelet transfusion can help you get through the surgery and its immediate aftermath -- if you hematologist suggests it.

Good luck!

Dr Jacobs

[Leokuk16]

Thank you Dr. Jacobs for your moral boosting response, as I was thinking I will have to live with this condition for the rest of my life with no hope to feel comfortable in myself. My Cosmetic surgen also suggested a consultation with Hematologist, however he never explaind all the details you have provided. I will be consulting him next week, Also I would like to know how successfull were cases you handled that were similar to me. As my life is already complicated enough with bad genetics and gynecomastia, and I am not sure if I am ready to handle more complications. Iam 33 years old currently. 

[Dr. Elliot Jacobs]

I have had no complications in my patients who were similar to you.  In fact, a platelet count of 120 or above may be perfectly adequate (without the need for a pre-op platelet transfusion) -- but the opinion of a hematologist would be invaluable and also reassuring.

Dr Jacobs

[Dr. Schuster]

I agree with Dr. Jacobs. However it is important to realize that it is not just the number of platelets that determine your ability to clot, but also how well they function. A bleeding time test would be very helpful to determine if there will really be a significant increased risk of prolonged bleeding. A hematology consult should certainly be done.