With my first pregnancy at the age of 19 I developed a DVT and pulmonary embolisim. I was put on Lovenox shots. With the following 2 pregnancies I was also put on lovenox for the duration of the pregnancy and 8 weeks post partum as a preventative measures. I have been to a hematologist and taken multiple testing for blood disorders but nothing was found. Can I get a tummy tuck and lipo for fat graffting to buttocks or am I too high risk?
Developed DVT and Pulmonary Embolism, Too High Risk to have TT, Lipo, and BBL?
Doctor Answers 4
DVT and cosmetic surgery
I have performed surgery on patients with a similar condition, but they required a work-up by their hematologist first. The hematologist ok'd their surgery and gave recommendations for prophylaxis
Previous Bloos Clots (DVT) and Pulmonary Embolism GREATLY raise the Risk of TT, Lipo, and BBL
Whiled it is reassuring to know that a full workup has failed to find a congenital disorder causing increased clotting your are at a VERY high risk for a repeat blood clot which may be fatal. A previous episode of blood clotting and embolization to the lungs raises your risk for another such event by over 15 times!
Moreover, the risk of blood clots formation with possible clots going to the lungs depends on the duration of the surgery and subsequent immobility. Tummy Tuck, liposuction and fat transfer to the buttocks is NOT a short operation and would FURTHER raise your risk. Therefore you may be safer in NOT having these operations. If you must have them, you may want to consider having a temporary blood clot filter trap placed in your largest vein, the inferior vena cava, to catch any clots that form in the perioperative period.
You really should discuss this with your surgeon.
Peter A Aldea, MD
Cosmetic surgery with a history of blood clots
One of my patients had a history of blood clots in the deep veins of his legs. With the aid of his internist he received low molecular weight heparin around the time of his abdominoplasty and sailed through surgery without complications.
You are at greater risk of having another DVT since you had one in the past even though that one was originally related mechanically or hormonally to the pregnancy. However with the proper precautions taken around surgery such as taking molecular weight heparin before/after surgery and application of pneumatic compression stockings during surgery you should be able to undergo the surgery safely.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
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High risk for DVT/PE
You are correct in that you are at high risk for repeat DVT/PE especially since that is the biggest risk of a tummy tuck. You should very carefully evaluate how much you really need these entirely elective procedures vs the fact that you could possibly not survive and seek many opinions from real plastic surgeons and trained vascular specialists. It may well be that diet and exercise is going to be the best plan for you.
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.