Lovenox Before Surgery or After? Any Major Bleeding Complication if Before in Your Personal Experience?

Lovenox or heparin have an excellent safety profile and may be indicated for your surgery. However, surgeons are still trying to determine where and how to best use these drugs.

Thank you for your question. Depending on your surgeon and your Caprini score (DVT risk assessment), you may have Lovenox administered before surgery, after surgery, or both.  There is enough evidence that Lovenox does not significantly increase the risk of hematomas or bleeding and may be beneficial in reducing DVT and PE (pulmonary embolism) risks.  Best to check with your surgeon regarding your procedure and risk factors.  

Patients that are at high risk for pulmonary embolism may be placed on Lovenox in the early postoperative period. In my own practice I discourage patients from having abdominoplasty if the risk of pulmonary embolism is inordinately high.

Lovenox increases the risk of bleeding.  Since my cosmetic tummy tuck patients go home the day of surgery, and I use compression boots intraoperatively, I do not give lovenox for tummy tuck patients.  That being said, I always give lovenox prior to a lower body lift.  Best of luck.

I use postoperative Lovenox or heparin, but send my patients home with their own sequential compression devices. I have seen a few significant bleeds with chemical anticoagulation so I prefer mechanical anticoagulants.