Do I need clearance from my primary doctor if I get a BBL out of my state?

At my practice clearance is not always needed, but for patients that are over forty or have certain medical conditions clearance is required. For healthy patients under forty only routine blood tests are required. I only use Lovenox on patients at high risk of blood clots. I usually do not require patients to take Lovenox because if a patient is that much of a risk I’d rather not perform elective surgery on them at my practice. The use of Lovenox will vary between surgeons.


Jaime Perez, MD
Brazilian Butt Lift Specialist
Plastic Surgery Center of Tampa

Each patient is different and the pre-op testing will vary. About 50% of my BBL patients come from outside NY and for young healthy patients, I simply require routine bloodwork that canbe done at any walk-in lab in their home area. If they have medical problems or are older than 40 years old, I require formal medical clearnace from  primary doctor which can be sent ot my office.

If you are not overweight, have no medical problems, and are under the age of 40, you will likely not need medical clearance prior to surgery for a Brazilian Butt Lift.  The use of Lovenox, a blood thinner, is surgeon dependant.  I do not routinely use it but some surgeons do.  

Your age and general state of health determines if you will require a pre surgical clearance from your primary. The length and type of your surgery along with your past medical history will determine if you will require a blood thinner like lovenox. For example you would be a increased risk for a blood clot and may require preventative treatment with a blood thinner if you have a history of blood clotting (DVT or Pulmonary embous), are obese, smoke or have a genetic tendency towards clotting. 

Every physician has their protocol on what type of testing would be needed before a patient chooses to have cosmetic surgery. In my practice, usually patients who are healthy without any family history of clotting or bleeding disorders will not require any clearance. Overall you should follow your plastic surgeons recommendations.

               In general, patients above the age of 45 should get medical clearance for any surgery requiring general anesthesia.  In healthy patients under 45, medical clearance is generally not mandatory. 

               Lovenox should only be administered to prevent blood clots in your legs (DVTs) in higher risk patients.  There is a Caprini risk assessment, with which all plastic surgeons are familiar, which helps judge a patient's risk for blood clots.  It is based upon age, length of surgery, BMI, other comorbid factors, etc.  If your risk for clots is so high that you require Lovenox for a Brazilian buttlift, you may want to reconsider if this elective cosmetic procedure should be performed for you.  

                 I have performed hundreds of Brazilian buttlifts, and I have never elected to operate on a patient who would require Lovenox for the procedure.  Healthy patients do not need Lovenox prior to this procedure.

                 Good luck.

The decision to get medical clearance will depend on your age and your overall health.  Lovenox may be necessary depending on your health and the distance you have to travel for surgery.  It is better for you to arrive into town a couple days before surgery, and stay in town for several days afterwards.

I require all of my patients to have some simple bood tests including a blood count, pregnancy test and urinalysis. The remaining tests are individualized.

If you are healthy and less than 45 years of age and with no medical history you should not need medical clearance. Bu every surgeon has his(her)protocol. In our office, where we see many patients from out of town and out of the country, we require blood testing  and a physical examination that can be performed in our office in healthy patients under the age of 45. We do not prescribe Lovenox in healthy patients and without a history of blood clots. For patients who will fly soon after the surgery we suggest getting out of the seat and walking around in the plane as often as possible. Also we suggest using anti-embloic stockings.

 Cardiopulmonary Clearance for Cosmetic surgery is often based upon age and a patients medical history. Patients with no medical problems, no family history of significant medical issues ( such as clots in the legs i.e. DVT/PE ) and are under the age of 40 typically do not require clearance. As a patient age increases or they have medical issues an EKG can be required and even cardiopulmonary clearance for surgery. It never hurts to go to your primary care physician and get cleared for surgery.
 The determination of the utilization of Lovenox in the peri-operative period is often determined by a screening process conducted by your surgeon. Some procedures such as an Abdominoplasty have a higher incidence of DVT/ PE especially, when combined with other cosmetic procedures like Liposuction. In this setting many practitioners do utilize Lovenox in the post-operative period to prevent DVT/ PE occurrence.
Consider calling the surgeon you are considering and request them to address your concerns. Best,

 

Gary R Culbertson, MD, FACS