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I Am Having a Full TT and BBL, With Lipo in Full Back and Arms?

I am having a full TT and BBL, with Lipo in full back and Arms, on November 8th, I was given Lovenox 40/0.4 ML INJ, I was wondering if I, that I am 24 yrs old, have never had surgery, no heart problems, no health issues so far thank GOD, or children if that makes any difference, do I honestly need to purchase these injections? Because they gave me a prescription for 7 days, at that is pretty expensive for me at this moment. I would really appreciate your response. thank you

Doctor Answers (6)

Use of Lovenox

+1

As you know Lovenox is being used to prevent clots following surgery.  Tummy tuck combined with other procedures does increase the risk of this complication.  Not all surgeons recommend using Lovenox post surgery, but if yours does, it is best to follow his or her directions.  I personally do not use Lovenox because of the bleeding risks and the standard for its use in Plastic Surgery has not become the standard for most surgeons.  You should be aware also, that  a major risk factor for blood clots is having an overly lengthy procedure.. I limit surgery only patients to no longer than 6 hours.


San Diego Plastic Surgeon
5.0 out of 5 stars 12 reviews

Lovenox

+1

I hate to say this but, if you can afford all these procedures, why are you quibbling about the cost of the Lovenox which is a token amount by comparison? Your surgeon is concerned about the risk of blood clots. Personally, I think this is a lot of surgery, a long surgery, and that you are exposing yourself to these risks by trying to do it all at once.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

Risks of a full TT + BBL + lipo of the arms

+1

Dear Rodriguezgurl,

I understand your financial concerns, but I think it is a heck of a lot of procedures all at once ! why taking this risk ?

you may be in good health, but how long will you be under general anesthesia ? at least 5 hours ? which is probably why your plastic surgeon prescribed you this Lovanox to alleviate the potential risks of blood clots. the longer under anesthesia, especially for us women, and for TT procedures, the more we can develop blood clots.

and by the way, why do you need a TT at 24 if you never had children ? did you loose a huge amount of weight ? you do not mention anything.

Aesthetic surgery is to make you look nice, so put all your chances on your side: yes, you should buy the Lovanox.

But you should discuss with your surgeon the need of all these procedures all at once: in my book, this is way too much.

your surgeon should be a board-certified plastic surgeon.

Good luck !

Florence Mussat

Florence Mussat, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Lovenox in combination with TT, BBL

+1

Patient Safety is the number one goal of all plastic surgeons.  Following right behind this is excellent clinical outcome with a satisfied patient.  The role of Lovenox in cosmetic procedures has been on the rise due to the increase in vigilance of avoiding fatal and medically significant complications such as venous thromboembolism. 

The combination of abdominoplasty and large volume liposuction (which I am assuming you are having this done in order to harvest enough fat for a BBL) would be among the riskiest procedures that would be performed in concert due to the inherent risk of venous thromboembolism in abdominoplasty and risk of fat embolism with liposuction.

The risks of lovenox are surgical bleeding.  Many studies have been published on the role of lovenox with cosmetic procedures.

 

If you are hesitant to purchase the lovenox, you need to have a discussion with your surgeon. 

 

I have used lovenox for some of my patients if there is a preexisting bleeding disorder.  I am fortunate not to have had any clots or bleeding episodes with this patient.

Both the surgery and the medications are expensive, however, there is no price that is too great for your own personal safety.  Best wishes for a successful procedure.

Stephen M. Chen, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 16 reviews

Lovenox after TT

+1

The purpose of the lovenox is to  decrease the chances of blood clots in the veins and possible migration of these clots to the lungs (pulmonary embolus). Of all the procedures done by plastic surgeons, TT has the highest incidence of such problems. 

Some surgeons advise its use to all patients, some never use it, and some use a risk stratification system, such as the Caprini score. I obviously do not have your complete medical info, but based on what you note in your question, the only risk you have is a surgery of more than an hour, which rates 2 points, but that puts you in a low risk status for which those of us that use the Caprini score would use non-pharmacologic methods to lower the risk (sequential compression devices during surgery, sometimes after.

You can Google a Caprini score worksheet and review it with your surgeon and come to an agreement.

Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

The use of Lovenox has risks and these need to be weighed against possible benefits.

+1

If you don't have any risk factors for a deep venous thrombosis, it is certainly not mandatory that you take Lovenox before your surgery.  Taking Lovenox is not innocuous.  There is a risk of excessive bleeding, sometimes necessitating blood transfusions.  I take other steps to reduce the risk of a blood clot, including avoiding paralysis (using a different type of anesthesia), avoiding prone positioning during surgery (avoids pelvic pressure), and of course using compression devices on your calves and getting you up walking right away (and limiting operating room time).  This is a controversial topic in plastic surgery today and some surgeons recommend blood thinners more than others.  But you need to know that it is not clear that the new risks justify the intervention and expense, expecially when you have no history of blood clots.  Your surgery is coming up soon.  You could discuss your concerns with your surgeon.  If he or she is adamant that you need the Lovenox, you may want to reconsider your decision and possibly get another opinion.  I have attached a link to my website should you wish to read more.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 36 reviews

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.