I have two blood clotting disorders. Will it be safe to have a tummy tuck and breast implants? (Photo)

You are 2 disorders that make it very high risk for you to undergo an elective surgery. I would say that you need a full hematology, cardiology and primary physician work up with anticoagulation recommendations and a very qualified plastic surgeon to take on your case in addition to working with general surgery for your hernia repair. You might consider staging your surgeries with just repairing the hernia then performing a breast augmentation if everything goes well. The number one concern is safety and you want to make sure that you set yourself up to optimize your outcome and results. #PlasticSurgery #MommyMakeover #Tummytuck #clottingdisorders 

Thank you for your question and photos.  You need to be seen in person by a board certified plastic surgeon if and only if you are cleared for surgery.  Please see a board certified hematologist to determine if you can have the surgery performed and to learn of the risks.All the best,Dr. ResultsMiami, FL

Always remember risks and benefits.  A tummy tuck is elective surgery that should carry no health risks or minimal.  With that said, the best person to discuss this with is a hematologist.  Good Luck

Performing cosmetic procedures on patients with systemic conditions that put them at high risk for complications is a judgment call.  If surgery is going to be performed in these situations then migration of risks should be maximized like doing short procedures and getting appropriate medical clearances and management of medications.

Patients with clotting disturbances can have mommy makeover surgery safely. This has to be carefully planned by the surgeon in the hematologist.

Thank you for your question and photographs.  It is possible to have your surgeries, but you should be informed of the much higher risks your medical issues will pose to your health and recovery.  You would need to obtain clearance from your hematologist, with their recommendations for anticoagulation before and after surgery, as well as clearance from your primary care doctor, cardiologist, and anesthesiologist, to ensure that your heart can tolerate a general anesthetic.  Be sure to inform your board certified plastic surgeon of your medical conditions, so that they can help ensure your safety, while providing the necessary post operative care to minimize your risks.  

Having two major factor mutations in the hypercoaguability work up is a major risk factor when considering major surgery under general anesthesia. The question is how did you know you have factor 5 mutation and prothrombin gene mutation? did you have a history of deep venous thrombosis or pulmonary emboli? that is another major risk factors. The other major problem is the amount of hernia content you seem to have. Putting all that hernia content back into the abdomen will increase the intra-abdominal pressure and would increase the risk of deep venous thrombosis and pulmonary emboli.Even on lovenox you are still high risk for thrombosis. Other option is to have a filter put in prior to surgery. But even deep venous thrombosis alone would do harm to the legs on the long run.No combination surgery

One of the biggest risks of any surgical procedure is the development of blood clots in the legs after surgery, known as Deep Vein Thrombosis (DVT).  These blood clots can break off and travel to the lungs and cause Pulmonary Embolus (PE), people can and do die from PE.  So, prevention of DVT is essential in any operation.Part of the pre operative work up is an evaluation for DVT risk.  All patients are given a DVT number, the higher the number, the greater the risk of DVT, so appropriate measures will need to be taken.  Some risk factors are age, obesity, length of the procedure, previous history of autoimmune disease, the presence of cancer and inherited clotting disorders ( Factor V Lieden, prothrombin gene mutation).Because of your clotting disorders, you will be at high risk for developing blood clots after surgery and you will need to take every precaution available including chemical chemoprophylaxis, that means taking blood thinning medication after surgery (heparin, comedian, lovenox, xarellto, etc.)  Of course, this will increase your chance of bleeding after surgery, but we can control bleeding, we can't control blood clots!Good Luck!

It is possible that you will be able to proceed but careful preoperative evaluation of your medical conditions and risk/benefit ratio will be necessary. I would suggest you start with your hematologist and cardiologist and let them know of your plans. These doctors, knowing you best, may suggest that you avoid elective surgery. On the other hand, they may provide "medical clearance" and have suggestions regarding preoperative management of all the issues involved. It will be important that you select your plastic surgeon carefully;  hopefully he/she works with a board-certified anesthesiologists in a fully accredited surgery facility. Best wishes as you work toward your goals.

Yours is a challenging situation and should be addressed with appropriate diligence and caution to optimize your safety. Close consultations with your hematologist, cardiologist, primary care doctor and plastic surgeon are required to minimize risks and to have your team available should any problems arise. Consider having your doctors  consult and communicate with the anesthesiologist, as well.You should plan for the procedure to be done in-hospital with at least one overnight for post-op care and observation.