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Tummy Tuck Without Lipo? What is Surgery Time if I Did My Breasts at the Same Time? (photo)

i have a consultation coming up and i have it in my head I DO NOT want lipo (affraid of risks). My first question is whether i get lipo or opt out is the price usually the same? second im thinking about doing boobs and tuck what is surgery time, i have a huge fear of blood clots and trying to decide if its to long of a surgery and if i should take lovenox to help my fears. i just had a baby four months ago and plan on loosing ten pounds before TT. Im 5'4 and currently 135 pounds

Doctor Answers (8)

Fears about blood clots with breast lift and tummy tuck surgery.

+2

Your questions are appropriate, but should be directed at your plastic surgeon. Blood clots are rare, but always a very real concern of every plastic surgeon. Long operations increase the risk of clots, but only by a tiny bit, since most all of us utilize active compression boots to continually "pump" the blood in our patients' legs while they are immobilized on the operating table. Also, if you are having liposuction of the hips at the same time as tummy tuck, your body will need to be rolled on the operating table, and your circulation and pressure points are helped by these motions.

Your risk for developing blood clots may be more related to the trip home from your surgery, or dehydration if you have nausea and vomiting after surgery, than the actual surgery itself!

Lovenox does not "prevent" blood clots (nor do active compression boots), they REDUCE the risk of this problem. But compression boots do not increase another risk--bleeding--that Lovenox does. Everything has pros and cons; it's not just "taking Lovenox to help fears." You and your surgeon must weigh the pros and cons of such choices, just as you should consider the risks of two operations and recoveries if you split up surgery into two parts.

A breast lift (with implants already in place, per another question you asked) will add several hours to the several hours of a tummy tuck plus liposuction. One long(er) operation and one recovery has certain (very low, but real) risks. Doubling those with two short(er) operations may actually be a fool's bargain, and more costly to boot. Discuss this with your surgeon and don't think taking Lovenox is an "easy answer" to your concerns. Bleeding and re-operation adds another whole set of (minimal, but real) risks. I hope this helps; the real discussion must be with your plastic surgeon. Best wishes! Dr. Tholen


Minneapolis Plastic Surgeon
5.0 out of 5 stars 125 reviews

Liposuction is safe. Lovenox is usually unnecessary and carries its own risks.

+1

Lots of questions there and good ones.  First of all, your reason for not having liposuction needs to be addressed.  Liposuction is very safe if done by qualified plastic surgeons.  You need it to properly contour your upper abdomen and flanks (love handles).  Without it, your tummy will look flat but you will not have an ideal hourglass shape.  (check out my website if you like to see examples)  Yes, have your breast augmentation at the same time.  Life is too short to be coming back unnecessarily for more surgery. 

 

Why are you so afraid of blood clots?  Have you had one in the past?  It is a valid concern, but there are several ways of reducing the risk, including limiting operating time, using compression devices on your ankles and calves during surgery, avoiding anesthetic gas and prone positioining, and early ambulation after surgery.  Lovenox is usually not necessary and can cause problems (unless you have a particular reason such as past history of blood clots).  You really don't have to lose any more weight.  Hope this helped.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 34 reviews

Mommy makeover after pregnancy

+1

Thanks for your questions.  First of all, if you get liposuction in addition to tummy tuck, your cost of the surgery will be higher.  Most surgeons charge by the amount of time we take to operate.  When additional surgery (such as liposuction) is done, it will take more time to operate, therefore, surgeon's fee as well as facility fee/anesthesia fee will be higher.  However, if you need liposuction, you should get it at the time of tummy tuck.  Please ask your plastic surgeon whether you need liposuction in order to have a better contour.  The risks of liposuction is very low when done by experienced plastic surgeon.

 

If you get breast augmentation with tummy tuck, it will probably take about 3-4 hours; if you need breast lift with breast augmentation and tummy tuck, it may take 5-6 hours.  I understand your apprehension regarding blood clots.  We, plastic surgeons, will do our best to do the safe surgery.  As long as you ambulate right after the surgery, the risk of DVT (blood clot) is very low.  If you have hyper-coagulable state, your plastic surgeon may give you Lovenox after the surgery.  

 

Lastly, you should wait till you lose all your baby weight prior your surgery.  You want to be at your goal weight and stable at that weight for at least 3 months prior to your surgery. Best wishes. 

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 38 reviews

Tummy Tuck, Liposuction & Breast Surgery after Pregnancy

+1

Although you are probably OK 4 months after delivery, Lovenox has few risks and does lower the risk of blood clots in Tummy Tuck surgery which has one of the highest risks of that problem. I would also highly recommend that you let your surgeon decide about the liposuction. From your picture it appears as though you will probably need some liposuction to blend the abdominoplasty into the rest of you. The liposuction is usually part of the tummy tuck and adds minimal risks. You also definitely need to lose the remaining weight before surgery to reduce your risks further and allow a better result.

 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Tummy tuck with breast and lipo is fine with lovenox

+1

I would strongly urge you to consider "complementing" the tummy tuck with liposuction of at least the flanks (hips or love handle areas).  The torso is just not complete if you only do a tummy tuck which address the anterior torso only.  Every patient I have ever seen that had a tummy tuck without liposuction of the hips has eventually come back and had it done later.  Adding the breast surgery at the same time is also a reasonable thing to do but that is a personal thing.  I do these combination surgeries routinely each week and often use lovenox and patients do excellent without any issues with blood clots.

James F. Boynton, MD
Houston Plastic Surgeon
4.5 out of 5 stars 19 reviews

Tummy tuck and Breast Augmentation

+1

I recommend some liposuction in every tummy tuck patient as it will improve the results.  If you opted out of the liposuction it will not change the price in most patients.  Breast augmentation is commonly combined with a tummy tuck.  These procedures can be done together in 3.5 to 4 hours usually.  Most of these patients do well without using  Lovenox but in higher risk patients I occasionally will give Lovenox to help prevent a DVT.  My office is in your area and please feel free to call if you would like a free consultation.

 

Sincerely,

Gary Hall,MD 

Gary Hall, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 24 reviews

Liposuction with tummy tuck, combining tummy tuck with breast surgery

+1

Tummy tucks are usually combined with breast surgery and not staged, provided the patient is healthy and does not have a personal or family history of blood clots.  Liposuction, even to a minor extent, is almost always performed, if only for contouring.  The risk is very, very low when the surgery is performed by an experienced board certified plastic surgeon in an accredited surgery center.  A caring surgeon will take many precautionary steps to avoid blood clots.s

An experienced surgeon can usually perform both procedures in less than 4-5 hours.

Nevertheless, it is not a mistake to stage the procedures, especially if they are more involved than usual, although this involves inconvenience and greater cost to the patient.

Blood clots are infrequent but can occur, whether liposuction is performed or not.  The risk is higher with large procedures, with combined procedures; in sedentary, heavyset patients, or in patients taking hormone supplementation or with a family or personal history of blood clots.

It is often advisable to go to an Aftercare after the surgery.  Some Aftercare facilities have registered nurses on the premises, have their own Medicare accreditation, and can monitor blood oxygen levels, administer medications and intravenous fluids if necessary.  This allows monitoring of the patient's vital signs after surgery and gives the patient the definite impression they are being taken care of!

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Tummy tuck without lipo

+1

Thank you for the question and the photo. Generally speaking, most patients will need liposuction with tummy to improve you contour. That decision is usually made during the consultation. If your plastic surgeon determine you need it then I think you should get it. Your concern about blood clots and lovenox should be address during your consultation. With few exceptions, lovenox is not given during tummy tuck and breast augmentations.

My advice for you is to wait. Lose the weight and then get a consulatation with a board certified plastic surgeon. You can find a surgeon from the American Society of Plastic Surgery website.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 3 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.