Blood Clot Risk with Mommy Makeover

I'm planning to have breast aug in combination with a tummy tuck. I am also having an umbilical hernia fixed. I understand the surgery is somewhere around 5 or more hours. My question is how much greater is the risk of a blood clot when having these surgeries combined and being under general for that length of time?

Doctor Answers 17

A number of factors should be considered in assessing risk of a blood clot after a mommy makeover.

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There are many factors to consider.  The first is whether you have had a previous blood clot.  Probably not or you would have mentioned it.  Then the type of procedure.  Yes, a tummy tuck does pose more risk of a blood clot compared to other plastic surgical procedures.  The breast augmentation probably does not add much in the way of risk.  Another factor is operating time.  Five hours is on the lengthy side for this combination (but not unusual among surgeons).  But many experienced surgeons can do it in three hours, including repairing the umbilical hernia.  Another factor is the type of anesthesia.  Using paralysis probably increases the risk.  I prefer a total IV anesthesia avoiding paralysis (rather than the traditional general endotracheal anesthesia) for this reason and have encountered very few blood clots during my 23 years in practice.  Almost all surgeons today use compression devices on the legs.  Some surgeons add a blood thinner, Lovenox, but this medication probably causes more trouble in the way of increased bleeding than its possible benefits.  Getting up walking right away is also important.  If you wish to read more, I've attached a link to this part of my website. 

Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Blood clots and tummy tucks

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The length of surgery, combination of multiple procedures, and certain other risks factors (which would include smoking and birth control medications) all can increase the risk of DVT (deep venous thrombosis). The reason we worry about DVT is that we worry that a DVT can embolize, or travel, to another location, like the lungs. Also, DVT's can cause pain and swelling in the leg.

There are a variety of mechanisms to reduce DVT risk. Each of these mechanisms has its advantages and disadvantages. They include the use of compressive stockings, foot pumps, sequential compression devices ("squeezy boots"), and the use of anticoagulant medications like Lovenox. Check with your surgeon about his/her approach in your case. For example, Lovenox can reduce clot risk but increases bleeding risk - every surgeon must decide what role these different strategies play in the care of his/her patients. Some facilities have very specific protocols based on risk factors - check with your surgeon and facility.

One thing that is not controversial is that early ambulation is a very important postoperative technique to reduce the risk.

Hope you have a great outcome.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 22 reviews

Minimize time in OR to minimize risk!

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Deep venous thrombosis and pulmonary emboli can represent life threatening conditions.Several risk factors are associated with the development of DVTs.These include the length of the surgical procedure, use of hormonal replacements or birth control pills, cigarette smoking, obesity, a history of cancer, family history of hypercoagulability, advanced age and a previous history of blood clots.
The combination of abdominoplasty, umbilical hernia repair and breast augmentation can be performed in a single setting.When these operations are performed together, safety has to be the first priority.
For this reason, we believe that the length of the procedure should never exceed 4 to 6 hours.Complications such as deep venous thrombosis and pulmonary emboli increase significantly when these numbers are exceeded.An experienced surgeon and surgical team that focus on efficiency can minimize the length of the surgical procedure.We often use another surgeon as a first assistant to help with this process.
In addition, every patient is evaluated for their DVT risk.The majority of patients are asked to use anti-embolic compression stockings, maintain hydration and ambulate frequently.In patients who have multiple risk factors, anticoagulants such as Lovenox may be necessary.If you have plans to travel in the immediate post-operative period, make sure you discuss this issue with your plastic surgeon.
It’s important to remember that every patient’s situation is unique.For this reason, treatment needs to be individualized for every patient.In the absence of other risk factors, the length of your procedure shouldn’t increase your risks for DVTs.

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Mommy Makeover

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The added risk is minimal and usually for long procedures, they have warm beds, and inflating stockings on your legs to decrease the risk.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Blood Clot with Surgery

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Thank you for your question.

Yes, the risk of blood clots are present with ANY surgery and the risk does increase with increased time in the operating room.  There are precautions that can be taken - such as, using compression stockings during the procedure and having the patient move the legs after surgery when at home.

No surgeon can ever guarantee that this won't happen BUT can take precautions during the procedure and after so please have a discussion with your surgeon to make sure that you are comfortable proceeding with surgery.

Best Wishes!

Mommy makeover is very safe.

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It is safe and usual to do the procedures together.  If you are older or overweight, then we do the surgery using blood thinners which markedly reduce the risk of clotting.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Mommy makeover, tummy tuck

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The risk of dvt may be increased with longer surgery. Other factors would include weight, medical problems, family history and hormone replacement therapy.

David L. Abramson, MD
New York Plastic Surgeon

Blood clot risk with mommy makeover

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There is a risk of blood clots with all surgery, and the longer the procedure, the greater that risk.  This is due to the fact that the blood in your legs usually circulates with muscle contraction, but that does not happen as efficiently when you are asleep on an operating room table for 5 hours, not moving your legs.  Obesity, smoking, birth control pills, a cancer history, and any family history of blood clots increase that risk.  No one can gaurrantee you a 0% risk of a blood clot.  That said, mommy makeovers are very common and safe procedures.  The risks are minimized by using compression boots at the time of surgery that squeeze your calves and help to cicrulate bloodflow.  It is also important that you understand that the risk is not merely time spent on the operating room table but also in the postoperative period.  I tell all of my patients that, with the permission of your surgeon,  it is also important to get out of bed and walk around after surgery and keep well hydrated.    

B. Aviva Preminger, MD
New York Plastic Surgeon
5.0 out of 5 stars 6 reviews

#mommymakeover, #tummytuck, #breastlift, #breastaugmentation

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Dear lotsobabies,

Thank you for your question.  The short answer is yes- there is an increased risk with longer surgery.  These operations of often combined with excellent outcomes.  There is a lot of work being done in the area of blood clots- the main risks being- BIRTH CONTROL PILL, DIABETES, SMOKING, AND BEING OVERWEIGHT- these 4 factors significantly increase your risk of problems.  Post operative blood thinners may be considered- this will depend on the practice of the surgeon. Definitely you should have compression garmets during surgery and be up and about right after your surgery.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Blood Clot Risks are Low with Mommy Maker

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Although there is an increased risk of blood clots with the combination and length of surgery required for a mommy makeover, those risks can be easily reduced.  Using calf compressing and proper positioning during surgery will decrease your risks.  Importantly, the use of twilight anesthesia will decrease your risks as well  - yes, a mommy makeover can be done quite safely and easily with twilight anesthesia!  Also, maintaining post-operative hydration and early and frequent walking will decrease your risks.  On the other hand, birth control pills and smoking increase your risks. You should be able to have your surgeon explain your risk and what is recommended and planned to reduce them.

Randy J. Buckspan, MD
Austin Plastic Surgeon
4.6 out of 5 stars 10 reviews

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.