Protein C and S deficient. Can I still get lipo?

The deficiency of Protein C and S puts you at a higher risk of a potentially fatal blood clot, including DVT and pulmonary embolism. As long as your condition is regulated by your hematologist who will have to provide clearance for the liposuction, you should be able to have the surgery. Early ambulation and use of compression devices will help to prevent blood clots.

we have hematology and cardiology clear our clients with this, if they clear you then we plan the pre and post treatment. never had issues before in our practice with these clients. hormonal optimization is very important (see link). Best, Dr. Emer.

Things like inflammation, immobility, and wearing compression garments can raise the risk of blood clots after surgery. Patients like you with blood that naturally clots more readily need special precautions to ensure a safe surgery.

The best way to do this is ask what your surgeon plans on doing (and not doing) very specifically as part of your surgery and aftercare. You will also need to get recommendations from your hematologist and see if anti-coagulants should be used and for how long.

Dear Drhotrod82,
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 a surgery, I would suggest you to 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

I appreciate your concerns, however I do not believe that your coagulation issues would be a contraindication to having liposuction. Lovenox is often used concurrently with different types of cosmetic procedures in patients with issues with previous blood clots. I recommend that you consult with both your medical doctor and board-certified plastic surgeon to formulate a safe plan to allow you to undergo liposuction. Best of luck!

There is some increased risk of doing surgery while on blood thinners and risk of having a blood clot from insufficient blood thinners either during or after the procedure.

I would imagine most plastic surgeons will want you to work with an internist for hematologist to have some type of blood thinner regimen at least for immediately after the procedure.

Personally I do all liposuction and fat chance for procedures without general anesthesia and this significantly lower is the risk for forming blood clots during the procedure itself.

Even awake procedures do have some increased risk of blood clot and this should be taken seriously considering you had a PE already.

It would also be important that you get an honest and accurate assessment to see if you’re a good candidate for the procedure in the first place. It may not make sense to take significant medical risks for someone who isn’t going to benefit much from the procedure but it might make sense to take increased risk for those whose life is going to be significantly improved from having the procedure.

I would say that must plastic surgeons probably still use general anesthesia for most full body contouring procedures.

About mid career I evolved towards relying more on local anesthesia and have now completely abandoned general anesthesia for all liposuction and fat transfer.

My practice has been focused exclusively a liposuction and fact to transfer procedures for the last 10 years.

You can certainly have plastic surgery consultations without having a hematology consultation but it would make sense to start by talking to your hematologist or primary care doctor.

Best,

Mats Hagstrom MD