How common is pulmonary embolism in plastic surgery?

Question

Hi i had a question about pulmonary embolism. What are the risks of getting a pulmonary embolism and is it common in plastic surgery? Does it happen often? What should we do in order to prevent this from happening? I am so terrified because of this even though I am very healthy. I am going for a bbl, lipo, tt and breast implants any suggestion doctors? Thanks so much.

Sheila S. Nazarian, MD · Answer

Assuming that your surgeon is board certified, your risks are extremely rare. Make sure to discuss your fears with your surgeon so that the two of you can review your medical and family history and take whatever steps necessary to prevent pe and alleviate your anxiety.My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Steven J. Rottman, MD, FACS · Answer

Thank you for your excellent question. Studies published in the plastic surgery literature show the chance of developing a pulmonary embolism (PE) is extremely low - less than 1%. Patients with a prior history of PE and overweight patients have a slightly higher risk. Hope this helps and good luck.

Vincent N. Zubowicz, MD · Answer

Well trained plastic surgeons are aware of the risks of pulmonary embolism and are well versed in its prevention. In the hands of a board-certified plastic surgeon the risk is very rare.

Nelson Castillo, MD · Answer

Thank you for your excellent questions.  Pulmonary embolism is thankfully an exceedingly rare complication in elective aesthetic surgery due to the good general health of patients pursuing surgery.  There are many steps take to minimize blood clot formation, including optimizing one's medical condition, the use of preoperative blood thinners, sequential compression devices intraoperatively, appropriate patient positioning in the OR, limiting operative time, early post surgery walking, and blood thinners after surgery.  Voice your concerns with your surgeon, they will work with you to minimize any risks, both behavioral and genetic, that may be a risk factor in clot development.

Camille Cash, MD · Answer

Safety is the number one priority in surgery.  The risk of developing a pulmonary embolism as a result of plastic surgery is low for the general population.  However the risk can increase based on the patient's medical history which is why it is very important to have open and honest discussions with your surgeon about your history and medications.  Certain procedures also carry a higher risk. To keep your risk to a minimum you will want to begin by selecting a board certified plastic surgeon for your procedures.  Be sure to closely follow all pre op and post op instructions including avoiding nicotine and certain medications. Walk around early as directed by your surgeon.  Perform deep breathing exercises as directed after surgery.  And report any concerns to your surgeon.

Suzanne M. Quardt, MD · Answer

While pulmonary embolism (PE) is a potential complication after
plastic surgery, the risk is very low for individuals who are healthy and have
no prior history of DVT or PE.Moreover,
your surgeon will provide compression devices and elastic stockings after
surgery to minimize the potential for this complication.I would encourage you to speak with your
surgeon about your concerns, and he or she can conduct a risk assessment and
take additional preventative measures if necessary.

Hisham Seify, MD, PhD, FACS · Answer

Thank you for your question.Fortunately, the incidence of pulmonary embolism (PE) is very low in
someone who is healthy.The best
predictor for this is to have a risk assessment done by your doctor.One of the highest risks is someone who has
had previous DVT or PE.Even if you were
to be at high risk, there would be preventative measures that could be taken
like using anti-coagulants after surgery.However, in most cases, the use of the compression device after surgery
and wearing elastic stockings after surgery is sufficient. I hope this helps and best of luck with your
surgeries.

Samir Shureih, MD · Answer

The incidence of deep venous thrombosis (clots in the veins of the leg and thighs), and pulmonary emboli (Clots in the lungs), in cosmetic patients is unknown. There is no good study of the incidence of blood clots in the cosmetic patient.We can calculate the CAPRINI Score based on history and physical examination and tell if you are a high , medium or low risk.  How ever many other factors are not taken in consideration. similar to your case, you are asking for so many surgeries in one session that alone will increase your risk of blood clots significantly.We know that tummy tucks has higher incidence of blood clots.Length of surgery is very important factor, the amount and different areas of surgeries is a major factor, So one can calculate the CAPRINI SCORE for the patient, Limit the number of surgeries in one session , limit the anesthesia time take a good history and family history. Based on that the doctor will be able to tell you if you are a high, medium  or low risk. each has a recommendation for prophylaxis. Even when patients are put on blood thinners, they can have a blood clot.

Mark Deutsch, MD, FACS · Answer

Fortunately pulmonary embolus after elective cosmetic surgery is uncommon but it can occur. The best prevention is preop screening of high risk patients. Sequential compression devices intraop, Lovenox injections, early ambulation and avoiding lengthy surgery times are other factors in keeping the incidence low.

Vincent D. Lepore, MD (retired) · Answer

Deep venous thrombosis (DVT) with possible pulmonary embolism (PE) is a risk associated with any surgery, including cosmetic plastic surgery procedures.  The risks of these complications can vary significantly depending on a number of factors including the type and extent of the surgery and the health, weight, and genetic makeup of the patient.  Depending on these factors, the risk of a DVT can range from 0.5 to 10% with the risk of a PE being somewhat less.  There are a number of steps a plastic surgeon and patient can take to reduce, but not eliminate, the risk of a DVT or PE.  First let your surgeon know if you, or anyone in your family, has had a history of DVT or PE.  There are genetic factors which can significantly increase a patient's risk.  Second, try to get your weight under good control - a BMI of less than 30 carries a lower risk than above 30.  Be certain to get up and move/walk as soon as possible after the procedure and drink plenty of fluids - bedrest alone, even without a surgery, can increase the risk of a DVT/PE.  Your surgeon may opt to give you intermittent foot/leg compression boots to wear after your procedure - be sure to follow their instructions regarding their use.  Finally, your surgeon may give you anticoagulant medications via injection and/or orally to help decrease the risk.   Discuss your concern with your surgeon, they should be able to formulate a plan which can help reduce the risk of DVT/PE in your case.  Best wishes, Dr. Lepore.

How common is pulmonary embolism in plastic surgery?

Answers (10)

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