After a pulmonary embolism, how likely is a doctor to work with you?

Question

I had a pulmonary embolism three years ago and two years ago I had weight loss surgery. Now I am looking towards getting a mommy makeover as well as a Brazilian butt lift. How likely our provide us to work with me.

Caner Kacmaz, MD · Answer

It is recommended to postpone plastic  surgery for a minimum of 4 weeks from the pulmonary embolism event because of the high risk of recurrence in the first 4 weeks.

Daniel Barrett, MD · Answer

Dear keyosha623,

it is possible to get elective procedures after pulmonary embolism. However, you will need to get a clearance from your doctor. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Daniel Careaga, MD · Answer

Nothing gets my eyebrows raised higher (despite the Botox) in a consultation than when a patient tells me they have had a blood clot in the past. Pulmonary embolism (PE) are blood clots that usually form in the lower extremity or pelvic veins and can travel to the lungs which can be VERY serious. The questions I ask are was this due to pregnancy, surgery or trauma. Were you worked up by a hematologist? Do you have any genetic abnormality that predisposes you to blood clots? How long ago was it? Have you had more than one? Are you still on blood thinners? These are all exceedingly important questions that your surgeon must know. Having said that, yes, certain patients with prior history of PE can have surgery but I always coordinate with their hematologist. S/he may make recommendations for post-operative blood thinners and ultimately are the ones that decide if it is safe for you to have surgery. As a caveat, I would definitively counsel against combining a MMO with a BBL. The lengthy surgery time plus larger blood loss and inflammation is increases your risk of another PE.

Guler Gamze Eren, MD · Answer

Hi from Istanbul!Thank you for your question. The reason behind your pulmonary embolism should be verified before getting a cosmetic surgery. Your blood tests and prior consultation should be done by a chest/pulmonary disease physician. If the risk is low you can get a surgery under heparinization. You can start with a less risky intervention.Best Luck

Samir Hasan, MD · Answer

In general, it is safe for patients to undergo plastic surgery after pulmonary embolism, assuming it was an isolated incident, and they have medical clearance for surgery. Sometimes, I will require patients with a history of pulmonary embolism to be seen by a hematologist or cardiologist prior to surgery to ensure they are safe candidates. I have personally operated on multiple patients who have had blood clots or a pulmonary embolism in the past, but that were otherwise healthy at the time of surgery, and they did very well during and after surgery. It is best to consult with a board-certified plastic surgeon to determine the best option for your case.

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your question,

While it is possible to undergo plastic surgery after a pulmonary embolism, it requires careful consideration. The plastic surgeon would need to collaborate with other healthcare providers to assess the patient’s overall health, ensure that the risk of clotting is minimized, and determine the safest course of action.

It’s essential to:

After a pulmonary embolism (PE), the likelihood of a plastic surgeon agreeing to work with a patient depends on several factors, primarily the patient's overall health, the severity of the PE, and the specific risks involved. The primary concerns after a PE are the patient's cardiovascular stability and the risk of another clot forming, which can be heightened by surgery, especially aesthetic or reconstructive procedures.

Ensure they’ve fully recovered and are cleared by their cardiologist or pulmonologist.
Take extra precautions to prevent blood clots, such as using blood thinners or compression stockings.
Adjust the surgical plan based on the type and complexity of the procedure.

Sincerely, 
Dr. Emmanuel Mallol

Christine Rodgers, MD · Answer

Hi Keyosha623, Any patient with a history of a pulmonary embolism is at an increased risk for recurrence specifically after surgery. As the mommy makeover and Brazilian butt lift are elective procedures, most likely your surgeon would recommend you obtain hematology clearance and recommendations to prevent clotting; DVT/PE, following surgery. I would always defer to your surgeon as well. Thanks and hope that helps!

Eric Swanson, MD · Answer

You are correct that many plastic surgeons will not be comfortable doing your surgery with that history. Or they will want to place you on blood thinners "as a precaution." The first question is what caused your pulmonary embolism (and often the cause is unknown). Obviously, you had weight loss surgery after your pulmonary embolism and evidently did not have a problem. In my practice, patients are screened with ultrasound to be sure they do not have a deep venous thrombosis (which usually causes the pulmonary embolism) before surgery, the day after surgery, and 1 week after surgery. Also, I do not use muscle paralysis during surgery, which lowers the risk. I recommend against routine anticoagulation because it can cause unnecessary bleeding and does not reduce risk (although many doctors believe it does). So you need a surgeon who is well-versed on doing the surgery safely and using ultrasound surveillance to detect an evolving blood clot.

John LoMonaco, MD, FACS · Answer

Having a safe surgery after a previous pulmonary embolism Is an attainable goal  With proper preparation.

One of the most important factors is the reason for the pulmonary embolism.   This could have been due to a genetic clotting disorder you have, certain medications you may have been on, an injury, and other factors.

Your surgeon should question you carefully about these items and can then move forward.   If you have a hematologist your plastic surgeon should consult with them for recommendations.

Medications to prevent blood clots can be given immediately after surgery And other measures can also be taken during the recovery to minimize the formation of blood clots

Lawrence Iteld, MD · Answer

Some patients who have a history of DVT/PE can have subsequent cosmetic surgery, some may not. It is essential that the Plastic Surgeon communicate with your hematologist to understand your medical history, the cause of the blood clots, current treatment, risk of future clot, and if your blood thinners can be temporarily stopped for surgery.

We have successfully completed surgery with may patients in your circumstances. Please meet with an experienced, board-certified surgeon to explore options.

We have successfully completed surgery with may patients in your circumstances. Please meet with an experienced, board-certified surgeon to explore options.

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