Plavix and tummy tucks - is 6 days safe enough?

I’m surprised the er doc didn’t refer you either back to your primary care doctor or a specialist such as a neurologist.  If you have a primary care doctor you should definitely seek their advice on this.  You may have a serious condition that needs to be evaluated more thoroughly by a specialist.  If you have already seen a specialist you should seek their input on discontinuing plavix.

There are two main issues in your situation: How long do you need to be off Plavix prior to surgery to avoid bleeding problems, and is it safe to have your tummy tuck and be off Plavix given the vertebral artery dissection. Remaining off Plavix for 6 days should be fine in terms of bleeding. I often operate on patients for different types of surgeries who have been off Plavix for shorter times, and have never had any problems. This is pretty common. The bigger issue is whether you need additional evaluation or treatment prior to your tummy tuck, in order to make sure the vertebral artery dissection poses no additional risk, and if it's safe for you to go off Plavix at all right now. That is something that needs to be determined by a neurologist or neurosurgeon, not by an ER doctor. The specialist can evaluate your situation and risk, and determine whether it's safe to stop the Plavix temporarily, and whether it's safe for you to have your surgery, or if you should wait. Best of luck!

I would delay the tummy tuck procedure.  Not sure emergency room doctors know enough about plastic surgery.  It seems you need to see a specialist to figure out why you had a vertebral artery dissection.Plavix and aspirin are blood thinners and would significantly increase the risk of bleeding after surgery.I would agree with your surgeon to be off all blood thinners for a month.Dr Spies

Plavix and aspirin are blood thinning medications which can be problematic when considering surgery. Only your surgeon can answer this question for you as opinions may vary, but it is important that you are upfront and honest even if it means your surgery will be postponed. You also need to let your surgeon know about your new diagnosis. It is for your safety.

I am sorry to hear of your recent health issues.  Vertebral artery dissection is a serious issue and you should be more concerned about with when is it safe to stop Plavix so you don't develop a stroke due to the artery dissection.  You must get cleared by a neurologist before proceeding with elective cosmetic surgery.  When it is safe to stop the Plavix I usually have my patients stop taking it 10 days prior to surgery and restart 3 days after.

With a potential diagnosis of vertebral artery dissection, an elective surgery as a tummy tuck should be put on hold for the time being.A consultation with a neurosurgeon and full work up and treatment plan is needed. There is no safe time to stop the Plavix till seen by a neurosurgeon.

Thank you for your question.  I would recommend 2 weeks for off Plavix prior to surgery, however, you should meet with a vascular doctor or neurologist to discuss the optimal timing based off your condition and to discuss the risk involved.  I would delay your elective surgery until you have better information to reduce your risk for complications. Best Wishes!

I would put a hold on things until everything is worked out. AN emergency room physician may or may not be in the best position to offer advice regarding surgery. I would suggest your plastic surgeon speaks with your neurologist and with you and determine the overall risk and benefit and then make a decision but your situation is not to be taken lightly and you have to balance the risk/benefit. It may be that you just forgo the tummy tuck all together but I would get all of the information first so you can make an informed decision.

I'm sorry to hear about  the recently diagnosed vertebral artery dissection.  Based on the limited information here, my best advice: postpone the tummy tuck operation. Again based on the information here, you have been receiving advice from the emergency room physician,  who is not the ideal source of information/advice.   Best to follow up with your primary care physician who will then refer you to the appropriate specialists (such as a neurologist, for example).Again, I would suggest that you not undergo elective surgery until  you have been seen by the appropriate specialist.  Once you have received "medical clearance" from the specialist you will (hopefully) be able to proceed;  he/she will be able to guide you when it comes to peri operative medication use.  Do not rely on online consultants even when it comes to this type of specific management. Make your decisions very carefully; otherwise you may end up with potentially serious complications. Best wishes.

I strongly agree with the others that your neurologic situation needs to be fully evaluated and stabilized before undergoing an elective plastic surgery.  My guess is that it's too soon to stop your blood thinners but speak to your neurologist about the risks and the proper timing.  Best wishes,Jon A. Perlman, MD FACS