Safety of Lovenox with Abdominoplasty Procedure?

I am scheduled for abdominoplasty with liposuction. I recently had a friends sister pass away 2 days post op from a PE. I still want to proceed and my PS recommended lovenox the night before surgery and also the next night after surgery to help relieve my fears. I have no known risk factors that are associated with blood clots. I am now worried about bleeding risk if I were to do the Lovenox. I don't want to avoid one problem and put myself at risk for another. What are your recommendations?

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7 Doctor Answers | Asked by gracelee

Doctor Answers (7)
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Lovenox??

With a family history of DVT/ PE it might be prudent for you to see a Hematologist before your Lipo-Abdominoplasty. A work-up could determine if you at increased risk for DVT/ PE possible due to a blood disorder. However, there is really only one clotting disorder that requires pre-operative Lovenox-Factor V Lyden Deficiency. According to several Hematology colleges all other disorders would require Lovenox 12 hours post-operatively. This is the standard in our surgical practice... more

Risk of blood clots vs. risk of bleeding with Lovenox treatment with tummy tuck

My condolences on the loss of your friend's sister. You ask a very understandable question in the light of this information, but let me put another question to you. If your friend's sister were killed in a motor vehicle accident, would you start using a motorcycle to avoid that MVA risk? Perhaps a bad example, but you wisely understand that trading a very minimal risk (truly) of a fatal blood clot after tummy tuck surgery for a perhaps slightly-higher risk of post-operative bleeding--perhaps... more

Use of Lovenox for Tummy Tuck

The use of Lovenox, or any medicine (chemoprophylaxis) should be done on an individual basis and based on the patient's individual risk factors. Intra-operative sequential compression stockings (SCDs), good hydration and early ambulation should be standard of care in order to reduce the chance of DVT and PE. Make sure you discuss your complete medical history with your surgeon so that you can come up with the right plan. You are right to be concerned about the possible side effects of... more

Chemoprophylaxis with Lovenox and tummy yucks

While chemoprophylaxis is not commonly used for a straightforward tummy tuck, it is used in high risk patients commonly and those with other conditions that increase the risk of DVT( Clot in the leg) formation. It does however have a slight increase risk of hematoma formation.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Anticoagulation and Abdominoplasty

The American Society of Plastic Surgeons(ASPS) formed a task force to develop recommendations for prevention of Deep Venous Thrombosis(DVT) and Pulmonary Emboli(PE). These are complications of surgery that can be life threatening and should be treated aggressively. Using the guidelines issued by the task force, most patients who undergo an abdominoplasty are candidates for anticoagulation. In our office, instead of using Lovenox, we use Arixtra which can be administered 8... more

Lovenox for abdominoplasty

Lovenox for deep venous thrombosis has its own risks and side effects. Although it reduces the risk of DVT, it has other complications and I would not use it on request, for alleviation of psychological concerns, without a documented reason to do so---and that type of reason might preclude surgery to begin with. There are other modalities including compression devices and ambulation (which is often limited by the side effects of Lovenox) which can reduce the potential for DVTs. more

Lovenox and abdominoplasty

The use of Lovenox for trying to prevent deep venous thrombosis is not the routine for most plastic surgeons performing tummy tucks, unless there is a medical reason for doing so (I.e. need for anticoagulation, previous history of DVT). The use of sequential compression devices, keeping well hydrated before, during and after surgery and ambulating regularly after surgery will help decrease the risk of DVT.