Lovenox Before Surgery or After? Any Major Bleeding Complication if Before in Your Personal Experience?

It is appropriate to use Lovenox both before and after surgery. The risk of bleeding is slightly higher if administered before surgery but not excessively so.  If Lovenox is administered 6-8 hours after surgery and compression boots are used after surgery then you can reduce the risk of bleeding without appreciably increasing the risk of a blood clot.  Having said that, abdominoplasty does have a higher risk of a blood clot compared to other cosmetic procedures. The use of peri-operative Lovenox is not only appropriate but a good idea.  This is a medical decision that should be made with your surgeon. Best wishes.

Thank you for your question. Depending on your surgeon and your Caprini score (DVT risk assessment), you may have Lovenox administered before surgery, after surgery, or both.  There is enough evidence that Lovenox does not significantly increase the risk of hematomas or bleeding and may be beneficial in reducing DVT and PE (pulmonary embolism) risks.  Best to check with your surgeon regarding your procedure and risk factors.  

Patients that are at high risk for pulmonary embolism may be placed on Lovenox in the early postoperative period. In my own practice I discourage patients from having abdominoplasty if the risk of pulmonary embolism is inordinately high.