Do you use blood thinners after a tummy tuck with all patients?

Question

Do you use blood thinners as a precautionary measure with every Abdominoplasty patient? If yes or no, why?

Stephen J. Delatte, MD · Answer

We typically inject Lovenox before the procedure, and the next morning before discharging patient from the hospital, but we encourage ambulation following abdominoplasty to prevent blood clots. No blood thinner is prescribed for patient during the recovery period.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Each surgeon will have their own post surgical protocol they wish to follow.  In my practice I do have all my tummy tuck patients on Lovenox for a total of 10 days.  I typically give my patients their first injection day of procedure and follow the next 9 days.  The reason I do this is because I want to decrease the chances of blood clots and since patients aren't up and moving as much as I would necessarily would like them to be.  I would suggest you speak with your surgeon of choice and follow their recommendations for post surgical care.  Best of luck to you.

N. Bill Aydin, MD · Answer

Hi and thank you very much for your question. Each surgeon has different protocols in regard to which medications they prescribe after surgery. Abdominoplasty surgery has a greater incidence of blood clots compared to other cosmetic surgeries therefore many surgeons choose to prescribe blood thinning medications. I recommend you meet with a Board Certified Plastic Surgeon and discuss your concerns further. Hope this helped! Dr. Aydin

Tim Neavin, MD · Answer

Thank you for your question. Each surgeon has different protocols on prescribing blood thinners after a tummy tuck. It is best to discuss with your surgeon.

Joshua Cooper, MD, FACS · Answer

We prescribe a 7 day course of Lovenox (blood thinner) to all of our tummy tuck patients. The Lovenox is administered once daily after the procedure. During a tummy tuck we tighten the abdominal muscles in order to give the abdomen a flatter and more pleasing appearance. The tummy tuck procedure places patients at an increased risk of DVT (deep vein thrombosis) formation in the legs, and a PE (pulmonary embolism) may result. PEs can be fatal. Because of this risk we place of all of our tummy tuck patients on Lovenox. Lovenox is a blood thinner and it may increase the risk of bleeding, but over the past 10 years of using Lovenox for our tummy tuck patients, we have not seen an increased incidence of bleeding or hematomas. Incidentally, we haven't seen any downsides to using Lovenox for our tummy tuck patients.Definitely discuss this question with your board certified (ASPS Member) plastic surgeon.

Jerome Edelstein, MD · Answer

Hello,Thank you for your question.  I don't typically prescribe blood thinners for patients after a tummy tuck.  It elevates the risk for bleeding.  I normally encourage patients to be mobile and not spend all their time laying in bed after surgery.  Being ambulatory will help minimize the risks of developing deep clots in the leg veins.  It's best to speak with your board certified plastic surgeon, as every surgeon has different post-operative protocols.All the best.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. This is a great question. Compared with other cosmetic surgeries, tummy tuck has a higher incidence of DVT. So, you have every right to be cautious. Talk to your surgeon about risks and prevention strategies. Strategies to prevent DVT include early ambulation post op, pharmacological measures (subcutaneous heparin, other blood thinners) or mechanical with the use of SCD machines (intra-op and postop). Plastic surgeons typically determine the DVT risk using standardized formulas (e.g. Caprini score) and decide on the best regimen based on the patient's calculated risk. A discussion about DVT prophylaxis has to be an absolute part of initial consultation with your plastic surgeon. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

W. John Bull, MD · Answer

I routinely use lovenox the day of the procedure after a tummy tuck. After the first day it depends on the patient's own risk factors as to whether this needs to be continued for prevention. During the procedure other methods are used to help prevent a clot as well, which usually don't need to be continued after the procedure as the patients are going to be up and walking the same day which helps prevent blood clots. The use of additional blood thinners has the risk of bleeding and other issues that may not be worth the benefit in most patients. However there is additional research going on now to help decide on the best post procedure treatment plan. This is all based on each patient's own risk factors and sometimes will involve consulting with both your regular doctor and a hematologist if there are medical concerns

Daniel Barrett, MD · Answer

Dear Loveyourself2day,
most plastic surgeons don't use thinner after tummy tuck. But every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Blood clots after TT are not common.  Blood clots that lead to pulmonary embolus are even more uncommon.  However, if you have more than one risk factor for blood clots other than having a TT surgery, you may need Lovenox or something similar.  Your PS should be familiar with the Caprini assessment, and he or she should be able to determine if this is indicated.  The risk for DVT with PE is 5/1000.

Do you use blood thinners after a tummy tuck with all patients?

Answers (14)

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