Stopping Lovenox injections what is the protocol so I don't get another DVT after my lipo touch up.

Question

I developed a large DVT within 2 weeks after my lipo touch up. My Dr. put me on Lovenox injections for 20 days. Is this sufficient amount of time? What do I do after the injections? What is a safe protocol to make sure I don't get another DVT. What are the risks stopping the injections.

Dallas Buchanan, MD · Answer

Thank you for your question. Listen very carefully....do not stop the Lovenox until instructed to do so by your physician. For patients with a DVT, the current recommendations (to my knowledge) are to continue on anti-coagulation for a minimum of three months. This is to treat the DVT and prevent a PE (pulmonary embolism) which can be deadly. If you PS told you to stop the Lovenox after 20 days, I would go see your regular doctor or another medical specialist (hematologist) for a second opinion because I think this is under-treatment. To answer your question, the risk of stopping the injections to early could be grave so I would take this very seriously. Be safe!

Erika Sato, MD, FACS · Answer

You need to see a hematologist asap to have a hypercoagulable workup to see what the cause for the DVT was. You are at increased risk of a DVT for two weeks post op after you are exposed to general anesthesia lasting >1h. You are also at increased risk if you are on any sort of birth control or hormone replacement. This includes IUDs and arm implants. Most PS recommend that you stop all birth control or hormone replacement two weeks before and two weeks after. There is no way to really check this, so we just recommend it and hope the patient listens. You are also at increased risk if you are sedentary - don't get up and walk around multiple times per day. After surgery when people are in a lot of pain, they tend to not get up enough. Lastly, you are at increased risk if you are a massive weight loss patient or have a genetic predisposition. The hematologist will  figure out which of these caused your DVT and will give recommendations for on-going treatment.

Ben Gbulie, MD, FACS · Answer

HiThanks for your question.A DVT is a major complication and could lead to a fatal pulmonary embolus if not managed properly. Ideally you need a full hematologic work up (to diecipher if you have a predisposing condition) and treatment for anticoagulants for at least 6 months for a first time event.You should continue the Lovenox for now and have your PS or primary physician refer you to a hematologist for the appropriate treatment.I hope this helps.....

Connie Hiers, MD, FACS · Answer

It would be best to ask your medical doctor about protocol for surgery, and get a medical clearance. If your medical doctor advises no surgery at this time, please listen. Please make no changes with your Lovenox until suggested by your medical doctor. Many physicians have patients continue with daily Lovenox starting the day or next day after surgery as preventive.

Stopping Lovenox injections what is the protocol so I don't get another DVT after my lipo touch up.

Answers (4)

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