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Tummy Tuck an Option for Patient on Wafarin, with Spleenal/renal Shunt?

asked 2 years ago by angeldreams in indiana
Latest answer by Carmen Kavali, MD
Question viewed 378 times
Tags: abdomen

I had a baby in Jan 2008. After my baby was born I found out I have blood clots in 2 of the 3 main veins that go to my liver. The clots will be there forver. My doctors put a spleenal-renal shunt. It has been 2 years in March.

I had 87 staples and was told I have a small hernia. I take Warfrin. My stomach is lop-sided. I have been asked when my baby is due. I am 5'6 130lbs. The more weight I lose the more I look pregnant. :(

15 answers to Tummy Tuck an Option for Patient on Wafarin, with Spleenal/renal Shunt?

ANY Cosmetic Surgery could be Lethal in a Patient on Anticoagulants with Portal Hypertension

The Condition you are referring to is Portal Hypertension. Owing to the severe increased pressure in the blood supply between the gut and the liver (due to severe clots), varices form in the lower esophagus which are prone to fatal bleeding. To reduce that pressure you underwent a splenal-renal shunt allowing blood from the gut / liver system to drain into the left kidney vein decompressing the portal system. However, to keep the last liver vein from clotting, you were placed on blood... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

I would not chance it

Your life is more important than your appearance. I would not risk performing a purely elective surgery on you--your medical risks are simply too great.

Carmen Kavali, MD
Atlanta Plastic Surgeon

A tummy tuck should probably not be performed on a patient with major medical problems.

I won't say that you would never be a candidate but I certainly would not operate on you. A tummy tuck is a purely aesthetic and elective. With an operation that would require reversal of the coumadin, your risks, in my opinion, do not justify the procedure.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon

Tummy tuck and shunts

You are absolutely not a candidate for a tummy tuck with a history of a shunt for liver disease. The risk is too great.

Steven Wallach, MD
Manhattan Plastic Surgeon

Tummy tuck too risky for a patient on warfarin and with a splenorenal shunt

Tummy tucks are an extremely popular and effective way to contour the abdomen. Patients need to remember that this is a significant surgery with elevation of the great deal of tissue. Patients on warfarin are at significant risk for the development of collections of blood and difficulty with wound healing. If you already had a significant risk of blood clots, you may develop a blood clot after significant abdominal surgery such as a tummy tuck. For this reason, it is not advisable... more

B. Pat Pazmino, MD
Miami Plastic Surgeon

www.miamiaesthetic.com

No tummy tuck for you unfortunately

As has been said by all the others, any elective surgery on you could be lethal and should not be done. Just try to stay healthy and don't be too critical of your tummy.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Tummy tuck not option for patient on Wafarin, with spleenal/renal shunt

Sorry, I would not recommend any cosmetic/reconstructive operation in someone with your history. Please consider the risk/benefit ratio in undergoing the proposed operations. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

You are at extremely high risk with ANY surgery given your history

Hi there- If you were my sister, wife, or mother, there is no way I would allow you to consider this, or any other aesthetic surgery. This could kill you. Be careful- it has been my experience that if you wave enough money in the air, you will find a surgeon willing to do this on you- do not let them.

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Tummy tuck is notrecommended

A person's health is important in any result. Having portal hypertension, being on Warfarin tells me that your medical issues are more important than any tummy tuck. I would advise against it.

Francisco Canales, MD
Santa Rosa Plastic Surgeon

This is risky

Anticoagulated, you are at risk of bleeding. Without anticoagulant, your shunt may close, and you may get dvt/pe's. Quite a choice to force for elective cosmetic surgery. If you find a surgeon to do this, I am sure he will want to work closely with your hematologist, and the shunt doctor. Think long and hard about it.

Scott E. Kasden, MD
Dallas Plastic Surgeon

Please do not risk your health with surgery

There were a reason for the blood clots at the first place and your treatment is blood thinners. You may have genetic predisposition to the clot formation. If you are taken off the blood thinners for the abdominal surgery, you have very high risk for the blood clots. Try abdominal girdle and do not seek a surgeon that may accept your case without understanding the risks.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

You can't always get what you want

Major medical problems are a contraindication to cosmetic surgery. Sometimes we can work around them, but if you are clot prone and have portal hypertension you would be risking your life for this procedure. As the other doctors said, it is not worth the risk.

Walter D. Gracia, MD
Arlington Plastic Surgeon

Not a good candidate for surgery

Based on your description, you are not a good candidate for surgery. Tummy tuck or abdominoplasty is an elective procedure for healthy patients. Based on your medical conditions and your blood-thinning medications, elective cosmetic surgery is contraindicated. Good luck.

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Do no harm

That is part of the pledge we took upon becoming physicians. Deal with your health -- the cosmetic surgery could kill you. With those severe medical problems you are not a surgical candidate for elective cosmetic surgery.

William B. Rosenblatt, MD
New York Plastic Surgeon

Tummy tuck in patient with spleno-renal shunt.

I agree with Dr. Aldea's review of your condition. If you remain on your lifesaving blood thinners, you risk bleeding from surgery. If you go off them, you risk additional clotting and/or increased portal venous hypertension which feeds back to your abdomen and increases the potential for complications from surgery. In any case, if you are significantly distraught, you should undergo evaluation in a university hospital setting with an intensive care unit.