Birth Control Pills and a Tummy Tuck?

Thank you for your question! For my patients having any procedure, I require they stop taking birth control 2 weeks prior to and 3 weeks post surgery. Best of luck!

This is an important question. Birth control pills can increase your risk for clotting especially in the first several months. I would discuss this issue at length with your gynecologist and plastic surgeon for specific recommendations tailored to you and the procedures performed.

You should stop taking birth control pills and estrogen replacement therapy about four to six weeks before surgery because of the risk of blood clots.  Many surgeons advise stopping them. However, please ask your surgeon for their advice.

There is data to suggest that the risk of a deep venous thrombosis (DVT) are elevated during prolonged anesthetics in patients currently on oral contraceptives. Cessation of these has been advised by some for 4-6 weeks but this is, by no means, a standard practice and may depend on the estrogen content of the medication. It generally will not change the technique but concerns for prhophylactic treatment o DVT such as TEDs/SCDs may be elevated. IF you are at higher risk for DVT consultation with a hematologist for anticoagulant therapy may be an option but his may be asssociated with a higher risk of postoperative bleeding and need for transfusion with its attendant risks.

The previous responses explain the issue, which is small but increased risk of blood clots that could embolize to the lungs which is a very serious complication. If your surgeon has recommended that you discontinue your BCP's before your tummy tuck, it is probably good advice.

 This topic is somewhat controversial;  there is no “standard” or official recommendations that  can be made here. Although it is thought that the use of estrogens (or the natural higher concentration of estrogen seen during later pregnancy)  may lead to a greater incidence of thromboembolic events (clot formation and lower extremities and/or lungs),  there is no  "standard of practice”.   Some of the studies I have looked at demonstrate a 9 time greater risk of admission to a hospital for treatment of  thromboembolic  events (1:2000) for women who use oral contraceptives, compared to women who  do not use oral contraceptives (1:20,000).  These studies do not involve surgical patients.   Some studies Involving surgical patients report that for those women taking an  estrogen containing oral contraceptive and undergoing elective  major surgery there is a doubling of the risk  of deep venous thrombosis, relative to the general population. The risk seems to be somewhat dependent on the type of oral contraceptive, and the quantity of estrogen involved. Other risk factors include obesity,  inherited blood clotting disorders,  a previous history of deep venous thrombosis,  cancer patients,  certain auto immune diseases,  inflammatory bowel disease, hypothyroidism, renal disease,  long-distance air travel… The stopping of oral contraceptives prior to surgery may be of concern to patients/physicians at the risk of pregnancy is high,  due to improper technique or low success rate.  There are papers published recommending the continued use of oral contraceptives for this reason.  These authors recommend careful attention to the use of  venus thromboembolic prophylaxis during the time around surgery.  The alternative strategy  is to switch women to progestin only pills,  as this does not have a high association with thromboembolic events.On the other hand, there are many authors, based on their studies, who recommend stopping the use of oral contraceptives prior to surgery.  The  recommendations for the length of time, prior to surgery, that these medications should be stopped vary; the optimal time for cessation is not known.  The most common recommendations I have seen is to stop the use of estrogen related containing oral contraceptives 4 weeks prior to surgery.Ultimately, you will need to check with your own plastic surgeon ( and possibly OB/GYN physician) for their recommendations. As I mentioned above, these recommendations will vary from one practice to another.  In my practice,  given that we know the risk of venous thromboembolic events are cumulative ( and we want to do everything we can to decrease risk),  I recommend stopping oral contraceptive pills four weeks  prior to  major elective surgery  and the use of an alternative method of birth control.  Of course, the use of other measures such as early ambulation and the use of  pneumatic compression stockings are routine.I hope this helps.

When we consider a patient for a tummy tuck, the most important consideration is the patient safety. We carefully screen patients and obtain medical clearances when necessary. In the preparation of your tummy Tuck, it is essential that you inform your plastic surgeon of all the medications they were taking and all of your current medical conditions. Especially let your plastic surgeon know if you are taking oral contraceptive pills and if you are a smoker. This is extremely important information. Be sure that you only work with a plastic surgeon who is board-certified by the American Board of Plastic Surgery. Such a specialist will be able to carefully evaluate you, take into consideration your medications and medical history, and create a surgical plan that will help you meet your goals but more importantly will be safe for you to embark on.

Surgery and taking birth control pills both increase the risk of forming blood clots in the legs--a condition known as deep venous thrombosis or DVT. By stopping birth control pills several weeks ahead of surgery, some of the risk of DVT (which is a serious postopertive complication) can be reduced. 

Abdominoplasty has a risk of deep vein thrombosis and pulmonary embolus.  There is no conclusive evidence that oral contraceptives increase the risk with surgery, however, to reduce the risk I advise to stop oral contraceptives at least 2 weeks prior to surgery.

Regarding: "Birth Control Pills and a Tummy Tuck?
Is it ok to continue taking birth control pills and have a tummy tuck? Is treatment handled any differently if you continue taking them?"

Tummy Tuck surgery is associated with a higher risk of blood clot formation than other shorter operations and those done on other parts of the body. Taking estrogens or birth control pills greatly increases the risk of blood clot formation and even the possibility of clots going to the lungs. As a result, birth control and estrogen supplements should be stopped 2-3 weeks before surgery to reduce these risks.

Dr. Peter Aldea