My Sister Developed a PE Post-gastric Sleeve. My Caprini Score is 3?

I am hoping to have a TT with lipo of my flanks. My caprini score is 3. The guidelines suggest lovenox 40mg based on my weight. Should I worry? I've had 2 successful C sections. Are my bleeding risk increased? Should I get a d-dimer post-op?

Doctor Answers 3

My Sister Developed a PE

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Although there are a number of scoresheets, I don't see how you have a Caprini score of less than 5, with 3 points for family history of thrombosis, and 2 points for the surgery of over an hour. You can reeavluate  the score yourself by googling "Caprini score." 

Your score is high enough that you should have Lovenox prescribed irrespective of d-dimer results, so those will not be helpful. Bleeding risks are increased, but most hold that the overall health risk is lowered by using the anticoagulant to minimize the chances of abnormal clotting that could present life-threatening complications.

Thanks for your question, all the best. 

Seattle Plastic Surgeon

Bleeding Risk Increased with Lovenox

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   The bleeding risk is increased with Lovenox, but Lovenox would be advisable if you continue ahead with tummy tuck.  Kenneth Hughes, MD Los Angeles, CA

DVT risk with Tummy Tuck

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Given your history, your thoughts about having lovenox post-op are reasonable.  You will need to be very aggressive about getting up and walking the same night as the procedure.  Lovenox does increase the risk of bleeding complications with surgery but in your case it may be warranted.

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