Which is better for a tummy tuck, Lovenox or Arixtra?

Each surgeon has their own opinion and protocol regarding use of Lovenox post op in tummy tucks. Personally, I do not because of the risk of bleeding. If you have further questions about the MTFHS gene, and its implications in your particular case, consider a consult with a hematologist.

Arixtra and Lovenox are both effective for chemo-prophylaxis for a blood clot.  Lovenox is a form of low molecular weight heparin and does have a small risk of heparin induced thrombocytopenia (HIT) which is a serious medication reaction that can cause clotting.  With a history of having had a blood clot and having received heparin in the past, you could have been sensitized immunologically to heparin.  I would recommend Arixtra for prophylaxis because it does not have a risk of HIT.  If the blood thinner is used 6-8 hours after surgery, your risk of a blood clot can be reduced without a significantly increased risk of bleeding.  Nonetheless, the risk of bleeding after surgery is not zero and should not be minimized. You should go into surgery with a good understanding to the issues at hand. All the best.

I coldnt agree more iwth Dr. Kunkel. All patients I see with history of DVT are sent to a hematologist for evaluation for baseline hypercoagulability and to discuss prophylaxis. It is possible that a TT  may not be for you.

Both medications are effective at reducing the risk of DVT in high risk patients in combination with mechanical prophylaxis such as compression stockings and early ambulation. Both do, however, increase the risk of post-operative bleeding complications, even life-threatening bleeding. One advantage to arixtra is that it is more effective when the first dose is given after surgery, allowing your surgeon to assess the surgical site post-operatively and make the decision to use or not use anticoagulation based on your exam, thus avoiding a major bleeding episode, but also increasing your risk of a clot.  Your enzyme deficiency and history of prior DVT do make you a high risk for DVT/PE, so you should carefully consider any elective surgeries. 

Given your history I would recommend a consultation with a hematologist prior to having your surgery to get best advise on how long and at what dose you need to take anticlotting medication.  You are certainly at increased risk and I would not operate on you with this history without hematology assistance in management.  Tummy tucks are the #1 cause of DVT in plastic surgery.