Tummy tuck and venous insufficiency?

Question

Hello. I am scheduled for tummy tuck with lipo to flanks in 2 weeks. I do suffer from venous insufficiency and varicose veins. I had ultrasound done and was cleared by vascular dr. Does this put me in high risk??

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding tummy tuck and liposuction procedures in the presence of venous insufficiency and varicose veins. Despite your venous concerns, provided your vascular and internal medicine doctors consider you healthy enough for surgery, you should be able to safely proceed with your tummy tuck and liposuction. For future consideration, you may want to look into varicose vein removal to alleviate symptoms and potentially improve your circulation. Post-surgery, blood thinners are typically recommended for at least a week to mitigate the risk of blood clots or deep vein thrombosis (DVT).

Sincerely, Dr. Katzen

Sincerely, Dr. Katzen

Derek Fletcher, MD · Answer

Having a history of varicose veins and venous insufficiency may place you at increased risk of DVT/PE. Discuss VTE prophylaxis (protection against blood clots) with your surgeon prior to your operation.

Daniel Barrett, MD · Answer

Dear Sincere494465,
it is hard to tell for sure without an examination. 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

Camille Cash, MD · Answer

Safety is always the number one priority in surgery.  Your venous insufficiency puts you at an elevated risk for development of blood clots, however there are many things that can be done preventatively.   Use of compression stockings and/or sequential compression devices can be used.  Walking around after surgery and doing deep breathing exercises are also indicated.  If your surgeon feels it is warranted, medications can also be given to help with blood clot prevention.

Douglas Taranow, DO, FACOS · Answer

Varicose veins are not a contraindication for an abdominoplasty procedure, but they do increase your Caprini score (a grading scale for the risks of postoperative blood clot development) by one point (not very significant).
I would suggest wearing medium compression stockings either knee or mid thigh high worn prior to the beginning of surgery, and continued for several days post-op until you are ambulating freely.

Please call your operating surgeon to get his/her approval for these stockings (which may be purchased at any surgical supply store).  You may also look into Amazon to purchase home compressive devices.  We give them to all abdominoplasty cases (Quinear model QN005A seems to be inexpensive and works well with my patients).
Best wishes.
Good luck with your procedure.
Dr. Taranow

Mark A. Schusterman, MD, FACS · Answer

Hello and thank you for your question.  I don't think that the varicose veins are a particular contraindication for a tummy tuck, but a tummy tuck will cause slowing of venous return to your heart from your legs.  This may cause a blood clot in your veins that can go to your heart and lungs.  For that reason I put all my patients on blood thinner (Lovenox) after the surgery.  Consult with your surgeon for more information on the subject.

Mats Hagstrom, MD (license on probation) · Answer

Venus insufficiency is relatively common and does not have a strong correlation with medical complications during elective surgery.
You’ve been cleared by a vascular surgeon so no further precautions should be necessary.
A lot of people put a lot of emphasis on concerned about things that can go wrong during cosmetic surgical procedures.
Well medical and surgical complications do happen and some procedures are higher risk than others what patients should probably be more concerned about is ending up with results that are substantially different than what they anticipated.Location satisfaction is often easily avoidable if patients put in sufficient effort in provider selection.
Finding the best provider for whatever procedure someone is seeking generally requires doing some work and takes time.
Being a board-certified plastic surgeon with overall good reputation and years of experience does not mean somebody has mastered any one single procedure.
There are substantial differences in outcome among different providers. Variation in outcomes differs substantially depending on what procedure is being performed.
Some procedures are technically easier and more standard while others have more complexity and more individual decision making involved.
Most plastic surgeons can competently perform at tummy tuck and get typical results.
The difference between average or typical tummy tuck results and spectacular results is however quite different.
For that reason I suggest patients select providers carefully.
My suggestion he’s doing that by having multiple in person consultations well advance of scheduling surgery.
I suggest patient start by having a minimum of five in person consultations but consider scheduling more if needed.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
Bring pictures of your own body taken the same way plastic surgeon in State Before and after pictures. pictures should include your torso standing in a neutral position cropped including your body from your neck to your knees showing your front, side and back side. Bringing copies of pictures of yourself is an excellent reference when reviewing before and after pictures.
Ask providers to only show you before and after pictures of previous patients with similar body characteristics to your own.
Candidacy has a major impact on the quality of surgical outcomes for most plastic surgery procedures.
The best results are always going to be on individuals who are the best candidates.
To understand it was possible for each individual person requires seeing before and after pictures of previous patients who had a similar candidacy for surgery.
Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped.
Providers may be apprehensive to do this and will generally prefer to show you preselected images representing the best results of their career. this is however insufficient to get a clear understanding of what average results look like or how many of these procedures they’ve actually performed.
The majority of patients in someone’s practice get average results not the best results of the providers career.
For reference and experience surgeon should have no difficulty showing you at least 50 that’s a before and after pictures of commonly performed procedures like a tummy tuck.
Typical hallmarks of quality done tummy tucks surgery Includes a consistantly Natural looking belly button, a very low census car that follows an atomic contours naturally and evenly on both sides leaving the Torah sound like a balanced appropriate and attractive from all angles including from behind.
For individuals scheduled for more than one procedure the vetting process needs to be done for each procedure. If you’re adding liposuction then you need to vet the plastic surgeon not only for tummy tuck outcomes but also for Liposuction outcomes.
Delivering consistent quality liposuction results is more difficult than most people believe. Liposuction results has more variation in outcomes than any other plastic surgery procedure. there is a lot of mediocre liposuction being done and not all plastic surgeons are particularly good at Liposuction.
If you’re paying for liposuction then you should have clear evidence that the surgeon has mastered that procedure as well. This should require looking at similar numbers before and after pictures of Liposuction results also making sure the patients had similar body characteristics to your own and looking very carefully and Liposuction results in detail. this means looking very closely at all areas treated with Liposuction to make sure there are no skin contour irregularities and that the results are consistently impressive.
It’s also very important to have a clear understanding of exactly what areas are going to be treated and what body position you’re going to be placed in while you have liposuction.
Doing liposuction of the love handles and waist is very difficult to do well laying on your back. to get quality results patients generally need to be turned either on their side or laying face down.
Well these are technical aspects most patients probably would never think of asking their critical to understanding if you’re going to get a quality liposuction outcome or not.
There’s no way you can accurately contour the backside of the torso with patients laying on their back.
For that reason you should have a clear understanding of how you’ll be positioned during surgery even though you will be under general anesthesia.
Most liposuction done in conjunction with a tummy tuck tense to be relatively and impressive compared to the work done by plastic surgeons who focus exclusively and mastering Liposuction.
Never say never and never say always.
There are certainly plenty of plastic surgeons who can do both procedures well and the number of plastic surgeons believe people disfigured is probably in the minority.
Considering that the results are permanent and irreversible the decision process when it comes to these procedures is important enough that I believe patients should be far more selective than they ever thought necessary.
You’ll be reminded of the outcome every day for the rest of your life.
This is not to make anybody feel uncomfortable or anxious but in reality the most common problems after cosmetic surgery it’s not having blood clots or tissue necrosis but instead ending up with results that are very different than patients had anticipated.
Patients should not make assumptions regarding skill and competency without seeing clear evidence of a consistent track record which can really only be demonstrated by showing enough before and after pictures to absolutely convince you that each provider can consistently deliver the type of results you’re looking for.
Perhaps a bit more than what was asked for.
I see enough people posting on this website with concerns after surgery to recognize that patients do not always approach the consultation process as well as they could have.
Best,
Mats Hagstrom MD

Tummy tuck and venous insufficiency?

Answers (7)

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