Is a tummy tuck with lipo safe for a patient with atrial fibrillation? Age 42 5'11 and 215 pounds. I have sleep apnea also.

Question

I am a 42 year old female who recently lost 100+ pounds through diet and exercise. I I have a history of high blood pressure and diabetes but both have been resolved through weight loss. My fear is that I currently have a-fib as well as sleep apnea. I know that I have to have cardiac clearance but I would like to know is it safe for a AFib patient to have a tummy tuck and what are the risk of developing a blood clot if I do not have a history of blood clots. Over health is currently good.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry,  I suggest you discuss your goals with your cardiologist and make sure he/she is comfortable with proceeding to have elective surgery, best of luck.

Daniel Barrett, MD · Answer

Dear chanteeh,as long as your condition is under control, you should be safe. You would need a clearance from your cardiologist prior to surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Cara Downey, MD · Answer

As with all elective surgery, the risk of potential complications needs to be weighed. The risk of developing a blood clot during a tummy tuck is about 0.34% (1/300). Adding liposuction likely increases this risk partly because it increases the time under anesthesia.( I am assuming that you are on medication to keep you in sinus rhythm and that you have permission from your cardiologist). If you decide to do the surgery, you and your surgeon should at least try to minimize your risks by an expedited operation (standard abdominoplasty should only take about 120min) medications to keep the blood from clotting (lovenox), sequential compression devices before and during surgery and early ambulation after surgery. Of course, by using lovenox, you are at an increased risk for perioperative bleeding so observation and meticulous hemostasis would be necessary too.

Susan Buenaventura, MD, FACS · Answer

You are a candidate from the weight loss standpoint but are certainly high risk, for the a fib and the sleep apnea.  You will need a team working together to determine the answer to this question.  Start with your sleep apnea doctor to see if your treatment is optimized and if there is anything else you can do to improve it.  See you cardiologist and discuss your desire for major elective surgery.  Will they agree to let you move forward and stop blood thinners if needed?  Also see your primary care to discuss the possibility.  See a BC plastic surgeon to determine the # hours of anesthesia and that you will likely be safest paying to spend a night in the hospital.

Bruce K. Smith, MD · Answer

Many patients with atrial fibrillation require surgery and do very well. The greatest concern is the anti coagulant or blood thinner that is usually recommended for patients that have atrial fibrillation. It is generally not recommended to have major elective surgery while taking blood thinners. It would be best to see if you are a candidate for cardioversion so that you can get off your blood thinner prior to your elective surgery. I would discuss your options with your cardiologist first and gain clearance prior to considering elective surgery.

Scott E. Kasden, MD, FACS · Answer

Hi ChanteehAs you are aware, A-Fib is a serious condition.  It does not need to be a deal breaker however.  The best way to proceed is to visit with your cardiologist to determine what precautions you need to take to have a safe procedure.Tummy tuck is a procedure that is associated with DVT /blood clots.  Obesity increases the risks.I would discuss with your plastic surgeon anticoagulation/DVT prophylaxis with something like Lovenox.Be sure that you continue to use your CPAP and consult with your endocrinologist as the stress of surgery may necessitate supplemental glucose control.All the best.sek

Emily B. McLaughlin, MD, FACS · Answer

Thank you for your question. Congratulations on your fantastic weight loss. I'm sure you're frustrated now with your healthier weight you have gained more skin laxity. You did not state whether or not you're on anticoagulation for your a fib. If this is the case, you need your prescribing to physician to determine if it is safe to hold this for the immediate surgical period. Many surgeons use Lovenox after abdominoplasty...this is a form of heparin the patient injects just under the skin, designed to address the concern for blood clots related to this procedure as one of the most serious potential complications after tummy tuck is a blood clot in the legs that can go to the lungs: a pulmonary embolism. If your a fib is stable, controlled medically and you do not require routine anticoagulation, I would imagine a surgeon in your area would consider proceeding with abdominoplasty with or without the Lovenox option. The sleep apnea is a less serious concern for the procedures you are considering but important to note nevertheless and you want your pulmonary function optimized prior to surgery. Hope you find a solution...good luck!

Robert Brueck, MD · Answer

If your overall health is good the question is are you on blood thinners and if you are you would have to come off of them and that entails some risk for sure so getting a cardiac clearance is a must.r

Manuel Belen, MD - Account Suspended · Answer

Hello,Thank you for sharing the information, it is a pleasure for me to answer your questionIt is recommended that you consult with a cardiologist, to evaluate you, and depending on the results if you are in optimal condition to perform any procedure, you could have many risks in surgery.I hope this answer will help youMy best wishes for you...

Daniel Greenwald, MD (in memoriam) · Answer

Atrial fibrillation is not a contraindication for surgery, but the risks are slightly higher.  In our practice we would need a clearance from your cardiologist and a pre-operative assessment by the anesthesiologist.  For a surgery that includes tummy tuck and/or liposuction I would recommend a hospital setting as opposed to a surgicenter or office theater.  The key to safety is coordination between the cardiologist, the anesthesiologist, and the surgeon.

Is a tummy tuck with lipo safe for a patient with atrial fibrillation? Age 42 5'11 and 215 pounds. I have sleep apnea also.

Answers (10)

More Tummy Tuck Questions

Would it be possible to do a tummy tuck on a person with a large horizontal scar? (photos)

Pleating after Tummy tuck and lipo 360, 12 days post op, is this permanent? (photos)

2 weeks post-op TT. When do repaired abdominal muscles reach their maximum healed strength, i.e. risk of tear is "0"?

I am 16 days post TT and my belly button is burning, is this a concern? (Photos)

2 weeks post tummy tuck and now experiencing swelling after drain removal, is this normal?

WE SEND PRETTY
EMAILS