Can I get a tummy tuck while still taking a low dose aspirin?

Question

I've lost over 130lbs through diet and exercise and getting closer to a healthier BMI for a tummy tuck. I have my diabetes under control my A1C is in the low 6's. I had a heart attack four years ago where I received a stent. My cardiologist will give me the ok for surgery as long as I don't stop taking an 81mg dose of aspirin a day to prevent the stent from getting a clot. My question is can I get a tummy tuck while still taking a low dose aspirin?

Leila Kasrai, MD, FRCSC · Answer

It depends on the opinion of your surgeon, as each surgeon has their own pre and post op instructions. Typically, aspirin should be avoided before and after surgery, however your surgeon may have a different opinion.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding undergoing a tummy tuck while taking a daily low-dose aspirin. First of all, congratulations on your incredible 130-pound weight loss — that is an amazing accomplishment and a strong step toward improved health and surgical readiness.

Your case is complex but not uncommon, especially among patients who have had cardiac events and are now seeking body contouring after massive weight loss. The use of 81mg aspirin (baby aspirin) is standard for patients with a history of stents or heart attack, as it helps prevent clot formation within the stent. However, aspirin also increases the risk of bleeding, which is a significant consideration during and after a tummy tuck.

While many plastic surgeons prefer patients to stop aspirin prior to surgery, there are cases — like yours — where it is safer to continue aspirin. The key is to coordinate closely with both your cardiologist and your plastic surgeon. If your cardiologist gives you a clearance letter stating that aspirin must be continued, and you are otherwise stable (with a controlled A1C, normal labs, and no other bleeding disorders), most board-certified plastic surgeons can still safely perform your tummy tuck, but with some modifications.

These may include:

Using meticulous hemostasis (bleeding control) techniques during surgery

Avoiding or limiting the use of drains

Delaying certain combinational procedures (e.g., liposuction) if bleeding risk is too high

Keeping you under careful monitoring during the early post-op period

Possibly using a wound vac or other technology to support healing if needed

Your surgeon may also choose to do your procedure in a hospital or accredited surgery center with cardiac anesthesia support if there’s any concern.

So yes — you can get a tummy tuck while on low-dose aspirin, if your cardiologist requires it and your surgeon is experienced with high-risk patients. Make sure you choose a board-certified plastic surgeon who is comfortable working with post-cardiac patients and has performed tummy tucks on individuals with similar medical histories.

Thank you again for your question and your dedication to your health journey. You’ve come a long way, and with the right team, you can safely complete your transformation.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS

Jeffrey M. Darrow, MD · Answer

Congratulations on your weight loss.  Performing surgery while you are on ASA to protect your stent from clotting could result in bleeding and other complications afterward.  Surgeons usually avoid operating on people on the ASA for this very reason.  A single aspirin will affect your body’s ability to make clots for 2 weeks. Therefore, most surgeons want their patients off aspirin for two weeks prior to any surgery.  You may ask your cardiologist and/or hematologist whether there is a medication which you could substitute for ASA for the 2 weeks before surgery which would protect your stent and could be reversed immediately before surgery, so your surgery could be performed safely and then you could resume your ASA 12-24 hours after surgery.  You should undertake this clearly understanding that this is a higher risk procedure than most tummy tucks, and you, your plastic surgeon, cardiologist and hematologist have to decide whether you would accept this higher risk benefit ratio.

Leyla Arvas, MD · Answer

Hi, before undergoing any surgery, it's important to disclose all medications and medical conditions to your surgeon and cardiologist, including your use of low-dose aspirin. While taking aspirin may increase the risk of bleeding during surgery, your surgeon and cardiologist will work together to assess the risks and benefits of continuing the aspirin versus stopping it prior to surgery.
In general, most surgeons prefer patients to continue taking low-dose aspirin during a tummy tuck procedure to minimize the risk of blood clots forming, especially given your history of a stent placement. However, they may advise you to stop taking aspirin a few days before the surgery to minimize the risk of excessive bleeding during the procedure. This decision will be made on a case-by-case basis, taking into account your individual medical history and risk factors.
It's important to follow your surgeon's and cardiologist's advice regarding your aspirin use and any other medications you are taking. They will provide you with detailed instructions on when and how to take your medications before and after the surgery, and will monitor your condition closely during and after the procedure to ensure your safety and well-being.Thankyou

Tommaso Addona, MD · Answer

Thank you for your question.
Prior to any elective procedure, you will be required to get pre-operative clearance with your primary care provider. A short series of tests will help your doctor determine whether or not your body is well enough to undergo the procedure and anesthesia. With a past medical history of heart attacks, you will likely need to undergo an additional cardiac clearance. Oftentimes, you will need to be off of all medications prior to surgery in order to decrease the risk of bleeding and complications. I recommend speaking with your plastic surgeon to discuss your concerns.

Caner Kacmaz, MD · Answer

First of all, congratulations on your weight loss success. It's inspiring. Taking aspirin before any surgery will increase your chance of bleeding and hematoma formation. Despite its benefits in preventing cardiac complications, aspirin treatment will need to be discontinued before your surgery due to the risk of bleeding. 
However, in patients with stents, I would recommend you not stop taking aspirin. In my opinion, the risk outweighs the benefit but of course, you need to ask your surgeon and cardiologist as well and make a decision together. Good luck.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. I would suggest obtaining clearance from your cardiologist to make sure it is safe to undergo surgery. The Aspirin usually gets stopped at least 4 days before surgery. Again given your history this should be performed in a hospital setting and medical clearance would need to happen before hand.

Daniel Barrett, MD · Answer

Dear sthunder24,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

No, you will need to be off aspirin before having surgery or you may have issues with bleeding and hematomas. If needed, you can be started on Lovenox for the procedure. Usually, most cardiologists will allow patients to come off aspirin for a short time to have surgery when they have not had any stents, surgery, or cardiac issues in over 6 months.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss! This question must be answered by your surgeon as opinions vary.  Aspirin and similar medications pose a bleeding risk during surgery. Typically patients stop taking aspirin prior to surgery and can restart it shortly after.  It will be up to your surgeon to determine if she/he is comfortable performing your procedure while you are still taking aspirin.