Commentary on: Contraceptive Vaginal Rings: Do They Pose an Increased Risk of Venous Thromboembolism in Aesthetic Surgery?

Abstract

I congratulate the authors on their article entitled “Contraceptive Vaginal Rings: Do They Pose an Increased Risk of Venous Thromboembolism in Aesthetic Surgery?” in this issue of Aesthetic Surgery Journal .1 The article is a case series of two aesthetic surgery patients with postoperative venous thromboembolism (VTE) in the setting of vaginal contraceptive ring use. Multiple studies have associated high-estrogen states (either exogenously delivered or from pregnancy) with increased VTE risk.2-4 Vaginal contraceptive rings are, by their nature, designed to be convenient and discreet. Both women in this case series denied contraceptive use at their preoperative visits. The ring device is replaced monthly, and thus it is plausible that the patients simply forgot that the device was present. In addition, patients may report oral or injected medications to their physician, but may not report implanted devices. As over 18 000 women in the United States currently have vaginal contraceptive rings in place, the author's suggestion that surgeons specifically query for these devices seems imminently reasonable. This study should in no …