How Common Are Blood Clots After Tummy Tuck?

Question

Am due for a tummy tuck soon, but am scared of getting a blood clot DVT, my surgeon said they use compression cuffs on the legs, that keep pumping during surgery. After surgery I would be in surgery stockings. Is that normal or should be on blood thinning tablets or some injections? Can I do anything before to prevent DVT.

Kenneth Hughes, MD · Answer

Blood clots after tummy tuck are not common. Blood clots that lead to pulmonary embolus are even more uncommon. However, if you have more than one risk factor for blood clots other than having a tummy tuck surgery, you may need Lovenox or something similar. Your plastic surgeon should be familiar with the Caprini assessment, and he or she should be able to determine if this is indicated. Kenneth Hughes, MD Los Angeles, CA

Robert F. Centeno, MD, FACS · Answer

The exact incidence of blood clots after tummy tuck is not exactly known because many do not cause symptoms.  Having said that, a tummy tuck is probably the highest risk Plastic SUrgery procedure, especially if combined with Gyn procedures.  You need a thorough history and physical to rule out any risk factors. Compression boots and stockings are a good start, but postop blood thiniing injections would further reduce your risk if you are a medium to high risk patient. Discuss this further with your surgeon or a Hematologist.  All the best.

Lawrence Iteld, MD · Answer

It is uncommon for patients to develop a blood clot in the legs (DVT) with cosmetic surgery, but the risk does exist. To reduce the risk, most surgeons use either compression pumps (SCD's) or a blood thinner injection. Patients at a higher risk include: prior history of blood clots, family history of clots or bleeding disorders, obesity, prolonged surgery, and use of hormone replacement or supplements. I suggest that you discuss this with your surgeon and primary care physician prior to surgery.

Marvin F. Shienbaum, MD · Answer

Deep Vein Thrombosis or DVT    can sometimes occur by blood clotting in the deep veins of the body.   This can sometimes occur after a tummy tuck.  Fortunately, the average tummy tuck candidate has a low change of developing DVT.  However, the risk could increase for those who smoke, have a genetic predisposition for hypercoagulation, over the age of 50, use oral contraceptive and/or are undergoing hormone therapy. Precautions should be taken by your surgeon before, during and after surgery to minimize   this type of risk.

Tom J. Pousti, MD · Answer

Thank you for the question. The risk of deep venous thrombosis and/or pulmonary embolism associated with tummy tuck surgery is small, but real. Your surgeon will obtain a careful personal and family history ( and sometimes additional bloodwork if necessary) to ascertain your risk factors and determine the best “prophylaxis”. Avoidance of nicotine products and/or estrogen related products may be indicated.Choosing your plastic surgeon carefully is important. Having the procedure performed in a fully accredited surgical facility is also important.  Routine measures such as compression stockings and early adulation are some of the measures taken. Some patients benefit from use of “blood thinners” around the time of surgery as well.Again, your plastic surgeon will be able to ascertain your own personal risk “profile” when it comes to potential deep venous thrombosis and/or pulmonary embolism.  It is probable that once you have had this communication with your plastic surgeon, your anxiety level will decrease.Best wishes.

Jourdan Gottlieb, MD · Answer

Aliya--if you Google  "Caprini score" you can get a "scorecard" which rates the risk for clotting after surgery. You will get at least one point for a major surgery. Various conditions are scored. One of the higher risks is a family history, so if any parent or siblings have had a clot, that gives you 3 points. Once you add the points to get your score the  recommended treatment will appear at the bottom of the sheet. If you pass the threshold score, some pharmacologic anti-clotting medication will be recommended--usually injections of lovenox. If you feel your score suggests that Lovenox should be used, discuss with your surgeon.

	All the best.

Alberto Di Giuseppe, MBBS · Answer

You are doing already which is the best possible intra op and post op treatment for Dvt prevention.
	Your surgeon is advising you properly.
	Only if you have a pre medical history of Dvt or a strong family history it could be' suggested a pre op subcutaneous heparine injections

Maria Cristina Picon, MD · Answer

It is not common but exist, you need a very good trained surgeon,  a very safe hospital, and to be a healthy people.

	 

	Spanish translation provided by doctor:

	No es comun pero existe, usted necesita un cirujano/a bien entrenado, un hospital seguro, y ser saludable.

Mark A. Schusterman, MD, FACS · Answer

Fortunately the incidence of blood clots (DVT) and pulmonary embolus is low, but if it occurs it is extremely dangerous, and it is certainly higher in tummy tuck than almost any other plastic surgery procedure. There is a specific grading scale that your surgeon should be using to see whether the addition of anticoagulants is indicated after surgery but there is no hard and fast rule. If you are concerned, just ask you surgeon for a prescription and start the anticoagulants after surgery.

Jeffrey Zwiren, MD · Answer

There are many things that you can do to lower your risks for developing a DVT or PE after an abdominoplasty. It is important to know what your risk factors are and how some can be reduced. Risk factors include age over 40, use of birth control pills or hormone replacement medications, previous history of a DVT, family history of DVT, obesity, BMI>30, history of a malignancy and smoking. The only things that you can do is stop smoking and have your BMI below 30. Prior to surgery avoid long airplane or automobile trips, stay well hydrated, consider taking Vitamin B with folic acid and reduce the consumption of red meat for a week prior to surgery. Intraoperatively your physician will usually take full precautions including the use of sequential compression hose. Your risk is very low and in the 2/10,000 level. Safety is an absolute must.

How Common Are Blood Clots After Tummy Tuck?

Answers (12)

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