I am 31 years old, 5'2 and 150 pounds. Three years ago, I went to the hospital with chest pains and found out I was pregnant. A month later, my DVT was discovered.(Don't know why it took so long) I was on Lovenox throughout the pregnancy, delivered a healthy 8 lb. baby (C-section under general anesthesia, no complications), and had minimal scarring. I'm considering a Mommy Makeover, but my family is worried. Am I still a candidate for elective surgery having had a clot in the past?
Considering Mommy Makeover After a DVT, Am I Still a Candidate?
Doctor Answers 15
Mommy makeover - abdominoplasty
I think your family will be more supportive if they realize that you had a C-section while on low molecular weight heparin so having an abdominoplasty with the same medication should be as safe or possibly safer.
I have performed abdominoplasties on patients with histories of DVT using low molecular weight heparin prophylaxis and those patients' intra and postoperative course was no different than the average patient. The main concern would be to make sure you do not have a genetic bleeding disorder.
Your posted photos show that you could benefit from the surgery but family cooperation and support before hand will make your recovery much smoother.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
MOMMY MAKEOVER AFTER DVT PROBLEMS
Yes all will be well and you risk small but there are steps you must take. First a visit to you internist and a workup to see how you are doing. Studies should be done to see if you have a tendency toward DVT. Clotting and general metabolic workup should be done. A plan needs to be established that may include Lovinox and other drugs. You surgeon and anesthesiologist need to talk and plan. You should do this staged and not all at one time. It is safer to stage into 2 or 3 procedures and not really much more costly. The abdominoplasty comes first, then the breasts, then the liposuction. It is important you get up and walk the night of surgery. During surgery you must be protected with compression anklets that keep blood moving in your legs. You must go home with similar SCDs that squeeze your legs gently and keep blood moving when in bed and sedentary. This will be a safe approach. There are other protective plans that may be appropriate. Do all these things and you will be fine. Dr George Commons
DVT history and TT
For starters, I'd recommend that you see a hematologist - so they can figure out with careful testing if there was a particular reason why you had your first DVT. Some of these causes are worse than others - in that they have have a higher risk of causing major problems this time around.
Then, I'd make a decision to operate depending on what the hematologist told us. If you are considered "high risk", we'd really have to think hard about whether it was a good idea to do this elective procedure....safety first.
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Mommy Makeover After DVT
Mommy Makeover surgery - tummy tuck, breast reduction, and liposuction may be performed after a history of a DVT but only after a thorough workup by your internist. Your surgeon and anesthesiologist must also be in agreement as to type of anesthesia and DVT precautions including the use of low molecular weight heparin prophylaxis.
I have performed tummy tucks on patients with histories of DVT's using the precautions stated above, without any problem.
The components of the "Mommy Makeover" surgery should be performed separately. I would recommend the abdominoplasty first, then the breast reduction, and lastly the liposuction. After each procedure you should ambulate with assistance as soon as possible after surgery and compressive stockings and venodyne boots should be used throughout all surgical procedures.
Good luck! I think the tummy tuck will make you very happy!
one risk factor for dvt (or vte: venous thromboembolism) is history of a dvt. In addition, general anesthesia, immobility, and length of surgery are other risk factors. You would likely benefit from seeing a hematologist (a doctor who specializes in blood disorders) prior to surgery. You may need to be placed on blood thinners during the post-operative period
You are a high risk for deep venous thrombosis and pulmonary emboli with any surgery under general anesthesia.
You will need a hypercoaguability work up, see a hematologist for that.
If surgery is to be done you will need a venous duplex as well.
After surgery, you will need to be on lovenox. Being on lovenox increases your risk of bleeding, especially in the surgical site.
Abdominoplasty has a higher risk of deep venous thrombosis.
In my practice you will not be a candidate for surgery.
One may consider aplacing a filter in the vena cava. But deep venous thrombosis has long term effect on the legs, the so called post phlebitic syndrome.
Surgery after DVT
Deep venous thrombosis and pulmonary emboli can represent life threatening conditions. Several risk factors are associated with the development of DVT’s. These include the length of the surgical procedure, use of hormonal replacements or birth control pills, cigarette smoking, obesity, a history of cancer, family history of hypercoagulability, advanced age and a previous history of blood clots.
Every patient should be evaluated for their DVT risk prior to surgery. The majority of patients are asked to use anti-embolic compression stockings, maintain hydration and ambulate frequently. In patients who have multiple risk factors or have had previous blood clots, anticoagulants such as Lovenox should be used as well. It’s important to remember that every patient’s situation is unique. For this reason, treatment needs to be individualized for every patient.
In your case, an evaluation with a hematologist is appropriate to rule out hypercoagulability states. If you elect to proceed with mommy makeover surgery it’s also appropriate to utilize Lovenox during the procedure. When these steps are taken the potential for blood clots is decreased, but not totally eliminated.
Considering Mommy Makeover After a DVT, Am I Still a Candidate
Pregnancy does increase the chances of a blood clot but some people have a genetic predisposition to it. A full work up by a hematologist should be done to rule out anything that can contribute to it. If there are no other underlying risk factors, then a Mommy Makeover with post-operative DVT prevention with a short course of Lovenox can be done.
Blood clots and tummy tuck risks
Yes, you can still have a tummy tuck provided that you inform your doctor of your past medical condition and all the appropriate precautions are taken to prevent it from happening this time around. You just have to be careful and follow all instructions to a T. This doesn't guarantee that nothing bad will happen but it certainly can do a lot to minimize the risk. Good luck.. I hope it goes well.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.