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I Am Taking Oral Birth Control Should I Stop It the Pills Before my Tummy Tuck?

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I Am Taking Oral Birth Control Should I Stop It the Pills Before my Tummy Tuck?

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This topic is somewhat controversial;  there is no “standard” or official recommendations that  can be made here. Although it is thought that the use of estrogens (or the natural higher concentration of estrogen seen during later pregnancy)  may lead to a greater incidence of thromboembolic events (clot formation and lower extremities and/or lungs),  there is no  "standard of practice”.   Some of the studies I have looked at demonstrate a 9 time greater risk of admission to a hospital for treatment of  thromboembolic  events (1:2000) for women who use oral contraceptives, compared to women who  do not use oral contraceptives (1:20,000).  These studies do not involve surgical patients.   Some studies Involving surgical patients report that for those women taking an  estrogen containing oral contraceptive and undergoing elective  major surgery there is a doubling of the risk  of deep venous thrombosis, relative to the general population.

The risk seems to be somewhat dependent on the type of oral contraceptive, and the quantity of estrogen involved. Other risk factors include obesity,  inherited blood clotting disorders,  a previous history of deep venous thrombosis,  cancer patients,  certain auto immune diseases,  inflammatory bowel disease, hypothyroidism, renal disease,  long-distance air travel…

The stopping of oral contraceptives prior to surgery may be of concern to patients/physicians at the risk of pregnancy is high,  due to improper technique or low success rate.  There are papers published recommending the continued use of oral contraceptives for this reason.  These authors recommend careful attention to the use of  venus thromboembolic prophylaxis during the time around surgery.  The alternative strategy  is to switch women to progestin only pills,  as this does not have a high association with thromboembolic events.

On the other hand, there are many authors, based on their studies, who recommend stopping the use of oral contraceptives prior to surgery.  The  recommendations for the length of time, prior to surgery, that these medications should be stopped vary; the optimal time for cessation is not known.  The most common recommendations I have seen is to stop the use of estrogen related containing oral contraceptives 4 weeks prior to surgery.

Ultimately, you will need to check with your own plastic surgeon ( and possibly OB/GYN physician) for their recommendations. As I mentioned above, these recommendations will vary from one practice to another.  In my practice,  given that we know the risk of venous thromboembolic events are cumulative ( and we want to do everything we can to decrease risk),  I recommend stopping oral contraceptive pills four weeks  prior to  major elective surgery  and the use of an alternative method of birth control.  Of course, the use of other measures such as early ambulation and the use of  pneumatic compression stockings are routine.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 794 reviews

Ask your surgeon

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You should stop taking birth control pills and estrogen replacement therapy about four to six weeks before surgery because of the risk of blood clots. However, please ask your surgeon for their advice.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 74 reviews

Oral contraceptives and surgery

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oral contraceptives and surgery

as you can see..  the answers are not totally straight forward. there is a general risk scale that can assess your personal risk..  history of clots.  family history , weight etc.

how long have you been on the pills..  the type of contraceptives..  

discuss these multiple factors with your surgeon

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 21 reviews

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Birth control pills

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I recommend my patients stay on their contraceptives.  The risk of a clot from the birth control pills is small, but on the other hand you don't want an unexpected pregnancy.  Best to check with your surgeon.

Ronald J. Edelson, MD
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I do not ask my patients to stop taking the pill prior to tummy tuck, unless they or a family member has previously had a blood clot.

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James Southwell-Keely, MD
Sydney Plastic Surgeon
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Because of the increased risk of blood clots most doctors would have you stop your birth control prior to surgery. It is also important to know that antibiotics can interfere with the effectiveness of birth control so you must be careful. You should discuss this with your surgeon and follow their instructions, but you should be off at least a month but if not, than a couple of weeks.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
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Birth Control and Tummy Tuck

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Every surgeon has a different opinion regarding this.  I usually do not recommend that you stop taking your birth control medication prior to surgery.  There is a slight increase chance of blood clots in women that take birth control.  This can easily be prevented by early walking after surgery. 

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Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
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I Am Taking Oral Birth Control Should I Stop It the Pills Before my Tummy Tuck?

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This is a question best answered by your surgeon.  Birth control pills are a minor contributor to deep venous thrombosis risk.  Unless you have other risk factors, they probably do not need to be stopped, but it's likely you won't need them because having tummy tuck is excellent birth control for at least a few weeks.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

Should Birth Control Pills be Stopped Prior to a Tummy Tuck?

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Safety should always be the primary concern in any elective surgery. Since it is known that taking birth control pills increases the risk of developing deep venous thrombosis (DVT) which can travel to the lung and be potentially life threatening, especially in a larger surgical procedure like a tummy tuck, it is recommended in the valid scientific literature that the BCP should ideally be stopped for 1 month prior to surgery and for 2 weeks postoperatively. This should be discussed with your plastic surgeon and an alternative method of birth control should also be discussed with your gynecologist.

 

Robert Singer, MD  FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.5 out of 5 stars 15 reviews

When to stop birth control pills prior to an abdominoplasty

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There are several risk factors for the development of deep vein thrombosis one of which is hormone replacement therapy and birth control pills.  If possible it is best to stop taking any type of estrogen product for 2 - 4 weeks prior to surgery. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.