What Are my Chances of Dying During my Tummy Tuck?

Question

I'm a 32 year old with 4 children I've had 3 c-sections under epidural and had a d and c under anastetic! I dunno what's a matter with me got a terrible fear of dying while under the knife! But I've been wanted this done for 10 years since I had my twins! I need it done my apron hang is making miserable and hinders a lot of my decisions wether it be clothes, holidays, swimming, gym! I'm dieting to get to my ideal weight before surgery!

Richard H. Tholen, MD, FACS · Answer

Published mortality rates associated with tummy tuck range from 0.02% to 0.16%. These include all causes of death for one month after surgery, with the most common one being pulmonary embolism (blood clot from legs to lungs). To put this in perspective, the death rate for elective C-section delivery is about 0.02%, with emergency C-sections having a slightly higher risk. Even a normal vaginal delivery has a death rate of 0.0067%, by some estimates.

	These statistics may be misleading, however, as recognition of these risks and attempting to minimize them can reduce the likelihood of any complication, including death.

	For example, in the 22 years our accredited in-office surgical facility has offered general anesthesia capability, I and one or more partners have performed about 16000 general anesthesia procedures without a single death, heart attack, or stroke. We have experienced a single (proven) blood clot which was not fatal or had any long-term consequence. We now provide active anti-embolism stockings for EVERY patient, not just those with long operations or higher risk factors. I insist on early patient ambulation, which helps keep the blood moving in the patient's extremities, and  I see almost all of my surgical patients the day after surgery (yes, even on weekends), which forces them to get up, get ready, and come to the office for recheck. We take care to keep the patient well-hydrated during and after surgery, minimize blood loss with careful technique during surgery, and in general do as many of the things possible that most plastic surgeons do to keep their patients safe.

	I personally believe that inpatient hospital care after tummy tuck is a "hidden" risk factor that I avoid with outpatient surgery. My patients are not kept (immobile) in recovery for 2-3 or more hours after inhalation anesthesia, and are not put in a hospital bed with side rails and a button to push if they want a pain shot, a bedpan, or a drink of water. At home, the patient must do these things herself, and the movement and activity helps to prevent blood pooling and stasis that occurs when a patient is (un)safely and comfortably asleep (sedated) in the hospital with all of the sick patients and bad bacteria surrounding her!

	So are there risks? Absolutely! Could you be "the one?" Yes. But is it likely? Honestly, in a good place with a good surgeon and staff, not really!

Gary M. Horndeski, MD · Answer

With any general anesthesia there is a risk.  However, it is very low, less than 1/10th of a percent chance of mortality.  From a surgical perspective, the chances of pulmonary embolism are 1 in 1000.  I assume you have had no problems with blood clots in the past, no anesthetic adverse reactions or no history of any family members having anesthetic death.  Your chances of dying during an abdominoplasty are less than 1 in 1000.

	Best of Luck,

	Gary Horndeski, M.D.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question. It is normal to have a healthy level of fear when it comes to getting major surgery, but having an overwhelming terror of dying during surgery is probably keeping you from getting what is normally a safe and effective procedure - tummy tuck.

	In general terms, for young healthy individuals, the risk of death from some type of event during surgery/anesthesia is about 1 in 500,000.

	The risk of death for all individuals undergoing anesthesia is about 1 in 30,000. 

	Things that minimize this risk are having a board-certified plastic surgeon, a board-certified anesthesiologist, and having the surgery performed at an accredited facility.

	I hope this helps. Good luck.

Steve Laverson, MD, FACS · Answer

If you're concerned about safety, then shop for safety. Face up to your fears, and arm yourself with information. If you want a better body, you should have it! Visit the ambulatory surgery center or clinic in advance, speak with anesthesiologists, nurses who work there, and patients who have had the procedure. Ask questions, and listen to the answers. You will likely feel much better, understand what to expect, and be able to select the safest environment for your tummy tuck. You will then proceed with confidence. The most common dangerous complication of tummy tuck is deep venous thrombosis, and pulmonary embolus. Institute preventive measures. Abdominoplasty is a routine, safe procedure when performed by a qualified surgeon in an accredited center.

Jeffrey E. Schreiber, MD, FACS · Answer

General anesthesia is a very safe method of anesthesia. I would make sure that your anesthesiologist is board certified and have your procedure done in a hospital to help with any anxiety that you may have.

Matthew H. Steele, MD · Answer

Thank you for your question. Your concerns are understandable with young children at home.  Rest assured that modern anesthesia is very safe and the risk of death is extremely low, especially in a healthy cosmetic surgery patient.  You should share your medical history and current medications with your surgeon and anesthesiologist to make sure you have no issues that would make your surgery riskier.  Good luck.

Tom J. Pousti, MD · Answer

Thank you for the question. The best published data I can find regarding mortality rates associated with tummy tuck surgery range from 0.02% to 0.16%.   In other words, mortality rates are extremely low. The most common cause of that is related to pulmonary embolism (blood clots that moved to the patient's lungs).

Your best bet: choose your plastic surgeon very carefully; everything else including good judgment/advice/planning, anesthesia provider and safe surgery facility will follow.

This careful selection should give you some peace of mind that you will be safe around the time of surgery.

Best wishes.

Ralph R. Garramone, MD · Answer

In my experience, a tummy tuck is a safe procedure if it is performed on a healthy person who is close to or at their ideal body weight. The plastic surgeon performing the procedure should be certified by the American Board of PLastic Surgery.  The facility where you will having the procedure should be accredited by a national organization such as AAAASF or JACHO.  In addition, your anesthesia provider should be appropriately credentialed.  

	You should investigate all of these issues and most of all you should be comfortable with the idea to have the surgery because there are risks with every procedure.  There are a number of potential complications that can occur death is of course the worst but also the least frequent. You should have several consultations with plastic surgeons in your area and go with the one with whom you are most comfortable.

	Thank you for your question and good luck.  Some of my happiest patients are patients who have had a tummy tuck by the way.

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