I have two blood clotting disorders and I had a breast augmentation 3 months ago. How risky is a tummy tuck or body lift?

Question

I have two blood clotting disorders factor v leiden and factor ll. I had a breast augmentation three months ago and now I am thinking of a tummy tuck or body lift how risky is that for me?

Robert J. Spies, MD · Answer

Hello and thanks for the question.  Factor V Leiden defect is not that uncommon.  It involves the propensity to form blood clots.  Factor II is the opposite and predisposes one to bleeding.  I would definitely want someone with these issues to see a hematologist and get his or her opinion on the safety of elective surgery.  I have performed surgery on patient's with a Factor V Leiden without problems.  Sometimes the use of blood thinners such as Lovenox are indicated to further reduce the risk of clots.  Please discuss this with your plastic surgeon so all precautions will be done to provide you with the safest environment.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  Every surgical procedure carries it's risks and complications. Certainly, blood clots, and the potential for embolization to your lungs (PE's), are some risks during any procedure. Those with clotting disorders are obviously at higher risk of developing these, which may be a devastating consequence.  Sometimes for emergent Surgery, the benefits may outweigh the risks for this. However, for elective procedures, it may not be that way. It is advised to see a hematologist for recommendations and the safety to undergo an elective procedure such as you describe with the length of time for the procedure. It likely will be cleared, and many precautions taken such as proper positioning, use of compression devices, adequate hydration, the use of anticoagulants, as well as early mobility. All if which should be done routinely, but special consideration with those with known clotting disorders.  Best wishes!  Hope that this helps!

James Nachbar, MD · Answer

Neither of these conditions would likely prevent you from having this surgery, but they can increase the risks.  Tummy Tuck has been associated with higher risk of blood clots than a breast augmentation, and is likely to have a greater impact on your ability to get around ("mobilize") quickly after surgery.  Early mobilization after surgery has been found to be one of the most important factors in reducing the risk of blood clots after any surgery.In this setting, the No Drain Tummy Tuck might be especially helpful, since without the drain, my patients tell me that there is less pain when you start moving after surgery (and we want you to start moving even the same day as your surgery).  On the other hand, the No Drain Tummy Tuck is more complex, and does take about 20-30 minutes longer, even in experienced hands.  But I believe that the significant benefits of early mobilization are greater than any increased risk associated with that additional operative time.Since No Drain Tummy Tuck is more complex, if you do decide to go that route, be sure your surgeon has a lot of experience with the No Drain technique.Of course, you should definitely get input from your hematologist before having one of these, larger, procedures.  Likely you have already seen a hematologist.  Having the hematologist write a note for the plastic surgeon is a great way to facilitate that communication and put you in the best position for the best result.Good Luck with whatever you decide!

Mark Deutsch, MD, FACS · Answer

Thank you for your question. Did you consult with a hematologist prior to your breast surgery? If not then I would recommend you do so before a tummy tuck or body lift because those procedures are more prone to causing stasis in your leg veins which could lead to a DVT.  Preop and postop subcut. heparin may be needed and this may slightly increase your chances of bleeding. I would have your hematologist discuss your case with your plastic surgeon prior to surgery to plan what type of measure might be used to prevent any clotting issues.

Tom J. Pousti, MD · Answer

Thank you for the question. Your hematologist will be your best resource when it comes to delineating the risks  of proceeding with tummy tuck surgery.  It is likely that your complete medical/surgical history as well as bloodwork will be taken into consideration when he/she makes recommendations to you. Your hematologist may also have recommendations for your plastic surgeon to help with perioperative management and reduction of risks. Best wishes.

I have two blood clotting disorders and I had a breast augmentation 3 months ago. How risky is a tummy tuck or body lift?

Answers (5)

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