What Are The Chances of DVT and PE After Tummy Tuck?

Question

I was reading a lot of comments about this topic and most surgeons say it happens but it's rare, then I read it's 1/300 w Tummy tucks will develope this issue. My questions to the surgeons out there is in your practice how many times have you dealt with this issue out of how many years, and does your practice use blood thinners with your patients?

Armando Soto, MD, FACS · Answer

Hi there-

	As my colleagues have informed you, as long as you are having your tummy tuck performed by a surgeon Certified by The American Board of Plastic Surgery, in a facility accredited by the JCAHO or AAAASF, and with your anesthesia provided by a certified provider, your risk should be very low (on the order of 1% or less for DVT).

	It is not possible to give you a better estimation of your particular risk without knowing a lot more about you- because it turns out that a lot of the risk factors for these complications have to do with the individual patient's health history, age, and the details of the surgery.

	So the bottom line is that the best person to help you understand what your risk of this (and any other) complication would be is the Board Certified Plastic Surgeon you choose to do your surgery.

Jeffrey E. Schreiber, MD, FACS · Answer

I utilize compression stockings and massage boots during all cosmetic surgery procedures. When I admit patients overnight for an extended stay, I also place them on blood thinners to help prevent DVT's and PE's.

Jourdan Gottlieb, MD · Answer

A large series of patients was studied and reported in our primary journal a few years ago, and the incidence of DVT (deep venous thrombosis) was reported as 1.2%, and the incidence of PE (pulmonary embolus) as 0.8%. These are low numbers, but are not low enough to ignore. These represent serious complications.

	Certain factors add to the risk for an individual patient:

	
		age greater than 40
	
		use of oral contraceptive or hormone replacement therapy
	
		surgery lasting over 30 minutes (all tummy tucks)
	
		personal or family history of hypercoagulation disorders (blood clots too easily)


	There are pathways that your surgeon can use to guide therapy to decrease your chances of abnormal clotting. The treatments include calf compression during surgery, and certain anticoagulation medicines, such as Lovenox. 

	I have had two patients that that I now of who had problems like these, one with DVT and one with PE. It is likely that there were more that didn't have enough symptoms to lead to any evaluation which might have made the diagnosis. For example, my face lift patient that had a PE had only shortness of breath as a symptom, but an ultrasound of her legs revealed DVT as the source, but if she never had the PE, I would probably never have known about the DVT. 

	For tummy tuck patients, I often, but not always, use Lovenox as an anticoagulant. I always use calf compression.

Leonard T. Yu, MD · Answer

This is a small but real risk with tummy tucks. Have been in practice over 22 years and never had a patient with a DVT or PE despite never using drug DVT prophylaxis. Would consider it if patient is overweight or has history of DVT or plan multiple procedures.

Ronald V. DeMars, MD (Retired) · Answer

That is a definite concern but a low risk. The risk goes up with obesity, smokers, and patients on birth control pills. I don't personally use blood thinners but do use intermittent compression stockings during and immediately after surgery. I think the risk is pretty low because I have had only one case of DVT in 30 years of active practicce.

George J. Beraka, MD (retired) · Answer

Hi.

	1)  Risk is low enough that I recommend  tummy tuck to members of my family.

	2)  For patients who are fit and healthy, only mechanical measures are necessary  (compression stockings, maintaining normal temperature, etc.).

	3)  For patients with risk factors (overweight, older, etc.), tummy tuck is done with blood thinners.  When properly used, blood thinners do not increase risk of bleeding.

What Are The Chances of DVT and PE After Tummy Tuck?

Answers (6)

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