Muscle Repair with Pre-existing Conditions - is it possible for me to have a Tummy Tuck?

Hi Steph5678,
The baseline risk for blood clots in the overall tummy tuck population is 0.2%, or 1 patient in 500, based on great data from ~129,000 aesthetic surgery patients in a database called CosmetAssure. However, based on your description, you would be at higher risk than most.
You have a known genetic predisposition for blood clots (Factor V Leiden), and have had a personal history of blood clots. These two risk factors, coupled with the potential of having a surgery under a general anesthetic, elevate your risk for clots.
It will be important for you and your surgeon to discuss your risk for blood clots after surgery. Your surgeon should identify any other risk factors that are modifiable (such as oral contraceptive use, elevated body mass index, varicose veins, and others), and remove those prior to surgery. Other risk factors, like your personal history of clots and genetic hypercoagulability, can unfortunately not be changed. Prior to surgery, you should discuss your risk level with your surgeon, and the two of you should make an informed decision about whether to move forward or not.
If you have surgery, sequential compression devices (leg squeezers) can decrease your risk for clots by physically propelling blood out of your legs during surgery. There is a straight line relationship between time spent under anesthesia and risk for clots, and so you and your surgeon should discuss the appropriateness of concurrent or additional procedures, balancing your goals with your risk level.
You and your surgeon should also discuss the role of blood thinners/anticoagulants, if you elect to move forward with surgery.
The attached video is a talk I gave at the American Society of Plastic Surgeons meeting a few weeks ago on this very topic--it should help you identify potential talking points for you and your surgeon.
Hope this helps,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Dear steph5678,
it is hard to tell for sure without an examination. You will need to get a clearance from your doctor prior to surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Many patients with health conditions are able to safely undergo a tummy tuck with preparation. The first step would be to speak with your specialist about your desire for a tummy tuck. If given clearance you can then meet with a board certified plastic surgeon near you for a consultation. More information is needed to determine this for sure, but extra precautions may be necessary during surgery including but not limited to having the surgery in the hospital.

You have a combination of medical conditions that are less than ideal for having elective cosmetic surgery.

Some plastic surgeons may feel that this makes you a non-candidate while others may be willing to still perform surgery.

You will for sure need to get medical clearance and most likely have an internist or hematologist manage blood thinners.

I suggest scheduling in person consultations to get an accurate assessment and better understanding of what can and cannot be accomplished.

Complex situations require in person thorough discussions.

Best,

Mats Hagstrom MD

Hi and welcome to our forum!
As you have already suffered a DVT following pregnancy, in spite of the heterozygous nature of your factor V anomaly (lifetime risk ~10% in the heterozygous condition), there is concern for another DVT.
By "muscle separation", we must differentiate between diastasis recti (which typically does not cause abdominal pain) and hernia, which may be painful and prone to bowel incarceration.
As the pain interferes with your activities of daily living, surgery should be considered if you are felt to be medically stable. Care to prevent DVT would include the use of anticoagulants, leg compression, and leg elevation in the early postoperative period. An inferior vena cava umbrella filter is often used to prevent recurrent episodes of DVT.
Smaller abdominal hernias can be repaired directly. Larger defects may require a mesh and flap closure.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...