Previous clotting patient - what should I look for/ask when searching for a doctor?
Doctor Answers 6
Tummy tuck with history of blood clots
Although you have a history of blood clots in the past, this does not automatically preclude you from having the tummy tuck and lipo. I have treated many patients in my practice with similar situations. I prescribe prophylactic Lovenox for all my tummy tuck patients to reduce their risk of blood clots and use standard measure such as sequential compression devices for all surgery patients. I also require all patients to discontinue smoking and hormonal birth control for a period before and after surgery as they can increase risk of blood clots. In patients with a history such as yours, I have them see their hematologist for clearance prior to surgery and to get recommendations for any additional precautions that may be recommended. Good luck with your procedure!
Tummy Tuck If At Risk For Blood Clots?
Tummy tuck with liposuction is at higher risk for blood clots than other types of plastic surgery. Standard prophylaxis in the operating room includes compression stockings, sequential compression devices (SCDS) aka intermittent pneumatic compression, a pillow under your knees to avoid stretch of the vessels at the back of your knees, and a Bair Hugger warmer blanket. If the facility doesn't provide these basic things or your plastic surgeon glosses over or does not mention all of these important items, go elsewhere. Additionally, your plastic surgeon should have you complete a form that delineates your risk factors for clotting (Caprini score). This score will help determine if you need prophylaxis beyond what is standard (in addition to early ambulation). Your hematologist may also have recommendations. Best of luck.
You probably can go ahead and have a tummy tuck but it is a good idea to have the hematologist make recommendations. He may want you to take lovenox or another anti-clotting med to avoid the risk of clots. Best of luck.
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You can safely have a tummy tuck provided you are still cleared by hematologist. Likely you would again recieve Lovenox and I recommend limiting the procedure to avoid extra risks. I perform liposuction of the flanks but not the back at the same time as a tummy tuck. Proper post op hydration with IV fluids overnight, compression devices on your calves, and early walking, etc should keep risks for DVT low. After tummy tuck, risk for blood clots can persist for a month or longer- as long as you are active, you should do well.
An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.
Blood clots after surgery
Hello and thank you for your question. I'm sorry to hear that you suffered from a deep vein thrombosis but this does not necessarily prohibit you from future surgeries. As long as your DVT was treated and there is no further clot you may still be a candidate for surgery. DVT prophylaxis with lovenox shots may be required before and after your surgery. It is best to check with your hematologist prior to any surgery
Finding the right surgeon
Hello and thank you for your question. It is very common to develop clotting disorders during pregnancy which are no longer detectable after delivery. You have done all the right things in following up with a hematologist. If you obtain medical clearance from your hematologist, then you can proceed forward with plastic surgery consultation. It is very
important that you thoroughly research your surgeon before committing to
surgery. It is a good idea to research your surgeon's educational background,
online reviews, before & after pictures, and speak with anyone who you may
know who has had surgery with that surgeon. During your consultation, make sure
that you don't feel rushed and make sure that you have adequate time with your
surgeon and not just their patient coordinator or nurses. If the majority of
your consultation is spent with someone other than the surgeon, this is usually
not a good sign. The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified expert surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
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.