Pulmonary Embolism After Tummy Tuck & Lipo. Is It Possible After 20 Days from Surgery?

Question

Clots in right leg and both lungs. Diagnostic: pulmonary embolism. Symptoms (pain & shortness of breath mostly) on day 20 after surgery.

Richard H. Tholen, MD, FACS · Answer

Surgery and (relative) inactivity during recovery can increase the risk of blood clots forming in the legs, even if precautions are taken in the operating room (such as active anti-embolic pressure boots or leggings). Regardless of when the clots formed, as you resume more normal activity levels, the clots can partially dissolve and can "break off" and then travel in your blood stream to your lungs. (In rare cases of persistent congenital hole in the heart between pumping chambers, clots could also travel to the arterial circulation and cause a heart attack or stroke.) These are risks that any of us undergoing surgery will have, but other risk factors can increase the likelihood of blood clots forming, even in non-surgical settings.

	These include genetic or inherited clotting disorders such as Factor V Leiden (search "Factor V Leiden" on this site for my answer about this topic), obesity, hormone use (birth control), smoking, excessive immobility such as airline flights or long car rides, and a host of possible hematologic abnormalities that can show up in the form of clots and pulmonary emboli.

	Appropriate responses to your diagnosis are Hematology work-up, blood thinners, and possible other recommendations specific to your individual situation. I'm glad you're doing well; this is something that can happen to any of us or any of our patients, even without surgery. Good luck and continued best wishes!

Vivek Bansal, MD · Answer

This is possible if your activity level was too low, and you had other risk factors. You will need to be speaking with an Internist, Pulmonologist, Hematologist, your surgeon, and any others they feel need to be a part of your recovery.

Jeffrey J. Roth, MD, FACS · Answer

Yes, it is possible to have blood clots that can lead to a pulmonary embolism 20 days or more after surgery. Blood clots can occur at any time. They can occur without being proceeded by an operation. They are often associated with inactivity, venous damage, (trauma, smoking), and hypercoaguable states, (hematologic disorder, pregnancy). With your signs and symptoms, please see a doctor immediately. Get treatment, and they will most likely check for causes including hypercoaguable state, etc. Tell your plastic surgeon as well.

Robert Brueck, MD · Answer

Yes this is possible.Post op I try to get my patients walking and ambulatory and NOT sitting around to increase blood flow and circulation in your lower extremities.

David Bogue, MD · Answer

A pulmonary embolism is certainly possible 20 days post liposuction and tummy tuck. The clot may form in the leg(s) early in the postoperative period and dislodge to become a pulmonary embolism far later in the postoperative course.

Darryl J. Blinski, MD · Answer

Yes it can occur! Please seek immediate medical attention and possible in hospital care. If in Miami see your doctor ASAP or I would be happy to help you.

David L. Abramson, MD · Answer

Pulmonary embolus ismampossible complication after an abdominoplasty. If can occur even 20 days postoperatively

Tiffany McCormack, MD · Answer

Yes, this is possible. You probably developed the clot in your leg during or shortly after surgery. It likely dislodged and travelled to the lungs more recently. This is certainly a risk with any surgery- slighly higher with tummy tuck surgery-. Hopefully you are on some type of blood thinner (lovenox or coumadin) and getting a hematology work up to rule out genetic issues that predispose you to developing clots. Other risk factors are listed above in Dr. Aldea's post. Good luck! Dr. McCormack

Peter A. Aldea, MD · Answer

Yes - As hard as it may be to believe a blood clot in the deep veins (Deep Venous Thrombosis) which may become dislodged and travel (embolus) to the lungs (PE) may be seen up to a month after surgery.

	Vein clots may be formed as result of genetics (certain mutations make some people more prone to clotting), taking certain medications (hormones, birth control pills etc), having occult cancer, smoking, obesity, surgery longer than 2 hours among others. At this point you would probably need to be treated with blood thinners to help break the clots up. I would bet your doctors are also working you up for any genetic disease associated with increased clotting.

	Good Luck.

	Dr. Peter A Aldea

John Whitt, MD (retired) · Answer

Thrombo-embolic events following elective plastic surgery are rare but can occur 20 days following tummy tucks or even later. Most surgeons take various precautions to lessen the chances of this occurence but it still can happen. These problems seem to occur at a slightly higher rate in patients undergoing tummy tucks who have previously undergone bariatric surgery.

Pulmonary Embolism After Tummy Tuck & Lipo. Is It Possible After 20 Days from Surgery?

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