Thank you for your question. True risks of DVT following Abdominoplasty. Many practices, mine included, utilize a scoring system to assess the relative risk for individual patient. For the best results seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery will all be board certified in plastic surgery and have demonstrated an interest and special skill in cosmetic plastic surgery as well.
The risk (Caprini Score) of developing a DVT which can lead to a pulmonary embolism is dependent upon a number of factors. Most patients would probably not have a significant decrease in their risk of a DVT from an outpatient operation (such as a tummy tuck) by using a at-home device. The most important prevention aspects are performed before and during surgery.
Getting up as soon as possible (after surgery) and walking is the next most important thing that can be done, especially at home. This does not mean that you have to get up every couple of hours throughout the night. It does mean that while awake you should be up and about on an hourly basis. Your surgeon can asses your risk and work with you on a plan to minimize your risk of developing a DVT.
For the best results seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery will all be board certified in plastic surgery and have demonstrated an interest and special skill in cosmetic plastic surgery as well.
This is not an easy question to answer because there are no valid studies to substantiate whether they help when used after operation AT HOME. There is ample evidence that sequential venous pumps are among the measures that help to lower one's risk of blood clots in the leg veins during or after an operation. Your surgeon should be able to calculate your risk based on the Caprini scoring system that is in place at most ambulatory surgery centers. If your risks of blood clots are low, then current prophylactic measures include sequential pump stocking during the operation and early mobilization (getting up to walk short distances frequently), positioning to promote venous drainage, not wearing excessively tight compression binders/girdles and maintaining good hydration. Your surgeon might also recommend injections of blood thinner if your risks are high enough to warrant it or if you have had blood clots in the past.
Over the past several years, plastic surgeons have come to understand the true risks of DVT following Abdominoplasty. Many practices, mine included, utilize a scoring system to assess the relative risk for individual patient. If the risk is low, we use sequential compression devices during the procedure to limit the patient risk. If the risk is high, anticoagulants may be indicated to help. I've seldom suggested continuing the compression devices at home but would never dissuade a patient from this means of aftercare. There are two important points to remember. Not all compression devices are the same. A cheap unit could conceivably act like a tourniquet and might increase your risk. There is no substitute from early and frequent ambulation (walk). A machine can not be the only answer. The second and more important point is that higher risk patients still need anticoagulation medication. Discuss your risk with your surgeon. They will undoubtedly give you good advice. Best of luck with your upcoming procedure.
Thank you for your question. I think this would be a good idea if you are willing to purchase one. Additionally, ambulating after surgery is the most important therapeutic measure. I don’t see it necessary to get up every two hours throughout the night but I would recommend getting up every hour and walking for at least 15 minutes during the day. At our practice, I also advise patients to take a baby aspirin a day and wear thigh high ted hose (anti-embolus stockings) for the first month post op. I hope this helps.
Best of luck in your recovery!
James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science
That is a GREAT question. In the past the frequency and danger of post-operative deep vein thrombosis (DVT aka clots) has been greatly underestimated. During all surgical procedures, in a hospital or surgery center, patients wear a sequential compression device (calf stocking with balloons in them that pump up and down squeezing the calf) to help prevent these clots. Recent literature has shown that many patients with certain criteria probably develop DVTs post-operatively most of which are asymptomatic. One of the criteria that post-operative compression devices are suggested for is any major operation lasting over 3 hours. Since most tummy tucks take 3+ hours, I place all my patients on take home sequential compression devices (see photo in weblink below). I have them wear the device for two weeks or until they are ambulating normally. In my practice, we loan the device to the patient for this time.Again, thank for your excellent question.
Most DVT forms during surgery and most patients are walking/moving while at home, so most patients don't benefit. Having said that, if you feel it is relatively inexpensive for you and it help you feel better about your recovery risks then by all means buy it. You may well be able to rent it to other patients when you are done! :-)
It is true that dvt is a risk after TT. Studies have shown that many of the clots develop during surgery. That is why we place the sequential compression devices on the legs before the surgery and keep them on during and immediately after the surgery. Another factor to consider is your Caprini score, which takes into consideration your individual risk for forming clots. If it is high, then you may need to be put on a blood thinner after the surgery in addition. While there is nothing wrong with purchasing the machine, if you have a low Caprini score and you are able to walk around during the day, you probably don't need it. Every surgeon differs a little bit in their approach to dvt prophylaxis, so be sure to discuss this important issue with your PS. The type of surgery a person has is important, with orthopedic, pelvic and intra-abdominal surgery carrying highest risk. The exact risk after a TT is not well quantified, which is why there will be variation from one PS to another in their approach. Thank you for this important question.