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

I'm 23, so it said lab work/ blood tests weren't necessary. He is board certified and is supposed to be very good, but I found it weird that he didn't need anything. He also only had me lift my shirt up to my ribs and lower my pants a bit and touched my skin twice to show what he would take off. (Not much of a physical exam) I also could swear I need lipo but he says I don't, so I'm worried it won't look as good as it can. He also didn't discuss risks. Is this normal? Am I just over-analyzing?

Doctor Answers 16

Pregnancy test maybe all tha you need

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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.

Preoperative labs are often a waste of money.

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I get preoperative labs on patients who

  • are expected have a significant blood loss (a full body lift with liposuction patient for example)
  • have a history of anemia or excessive bleeding
  • are on medications that can cause electrolyte imbalances such as some blood pressure medications

For vigorously healthy patients undergoing elective surgery, most lab work is not necessary but a good history and physical exam is necessary for every patient as well as a discussion of the nature and the benefits and risks of surgery. 

No pretesting before tummy tuck

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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.

No Lab Work for Tummy Tuck in Healthy 23 year old

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

No Lab Work and no Physical Exam

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We routinely get lab work on preoperative patients if their health condition indicates the need for the studies. Most healthy cosmetic surgery patients do not need lab work. But I cannot imagine taking a patient to the OR for a TT without a good physical exam and especially an evalujation of the abdominal skin, fat layer, and deep muscles looking for diastasis followed by a 30-45 minute discussion of options and risks.

Lab Work before Tummy Tuck

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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.

Consultation styles will be very different from one surgeon to the next.

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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

Abdominal exam to check for diastasis, hernia is vital to good abdominal surgery results

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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.

Lab work prior to major surgery, is it necessary?

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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.

I am 23 years old and having surgery for which my PS didn't perform any blood tests. Is this normal?

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Although there are many surgeons who do not performb lood tests on young, healthy patients, we do so in our office especially for more extensive procedures like a Tummy tuck. Yopu should also have a proper physical exam.Your PS should review with you the procedure(s) including possible compications. You should have a good understanding of your procedure before proceeding. Ultimately, though, you need to be comfortable with your PS. If you have any doubts you should seeka second consultation. Good luck!

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.