Is It Odd That my Plastic Surgeon Doesn't Require Lab Work? (photo)

      There is no evidence based medicine to support performing laboratory work prior to tummy tuck surgery in a young, heathy individual.

Usually for the healthy 23 year old patient the special blood work is not required for the surgery. However, every facility has its own requirements. Typically every patient 50 years old and older needs  EKG, CBC,  SMA-7 and also the  surgical clearance from the primary physician to undergo surgery under general anesthesia. Patients in this age group are considered higher risk; therefore for the safety all the precautions should take place. If the patient is under 50 years old and has some health issues usually surgeon will decide if the patient needs additional health check by his/her primary physician. Pregnancy test is usually all that is required for the HEALTHY under 50 patient.

It is clear that you still have several questions and do not feel completely comfortable with your consultation. With elective surgery it is important to feel like you will be well cared for throughout the surgical experience. Some patients find it helpful to have more than one consultation before making a decision about the procedure details and which surgical team they choose for their elective procedures. The opportunity to ask more questions and be reassured is before surgery. The decision to do lab work or other investigations prior to surgery is based on the findings during the consultation and is highly variable. For a tummy tuck I feel it is important to do some limited screening tests because this is considered a major operation by all Plastic Surgeons and Anesthesiologists.

Best Regards,

Dr. Mosher

Thank you for your question and photo. First the lab work. I do not get lab work for a healthy 23 year old patient either. With the tumescent technique for a tummy tuck and liposuction, there's no significant blood loss. The examination you describe sounds a little superfluous. Besides skin removal your abdominal muscles need to be tightened as well. Even from this limited view, I believe you would need liposuction of your bra rolls, arms, hips and waist with the tummy tuck. Otherwise, your cosmetic outcome will be less than desirable. You are not over analyzing and do have the right concerns. Even though your surgeon "supossed to be very good" he nedds to have better bedside manner and you need to feel comfortable with him beyond his paper qualifications. Remember, this surgeon is taking care of you postop and he needs to be there for you. You should see his postop photos in similar cases like yours. Seek a second opinion if you do not feel confident in having surgery with this surgeon. Good luck.

If you are 23 years old and in good general health, no pre op labs are really needed. Personally, I get a basic blood count in all patients. Surgeons used to get a whole battery of lab tests prior to surgery, but for the most part found out they were a waste of money in a young healthy individual. I used to think a pregnancy test pre op, but patients can have unprotected sex a day or two before surgery and a pregnancy test would not pick it up ( especially if the test is done a week before surgery ).

For a healthy 23 year old, only blood count and pregnancy test is necessary prior to an anesthesia. Perhaps he will discuss the risks at your preoperative appointment. Liposuction could help reduce the size of the flank (love handle) area. Good Luck!

In NY, this would be a deviation from the standard of care. I would not operate without pretesting and my anesthesiologists certainly would not be willing to participate in the case. Evaluation is not a substitute for clinical findings from a laboratory. Not a year goes by where a significant anomaly is not picked up on routine pretesting. You are not over-analyzing but are showing good judgment here.

Routine laboratory tests may not be needed before a tummy tuck. If you are young and healthy, and your plastic surgeon evaluated you, then omitting tests may be acceptable.

A thorough abdominal exam to check for diastasis recti or any possible herniasare vital to good abdominal surgery results and avoiding complications.  A thorough discussion of risks, alternatives is also standard.

There are indications for the blood work that are based on the patient's age,medical history and the planned procedure. I would recommend liposuction and tummy tuck to achieve the best results.