Mommy makeover and mild-ish varicose vein (Photo)

Question

I’m considering getting a mommy makeover, but I have mild varicose veins. I have been to a vein specialist that ruled out clots. From time to time the veins do cause me pain after lifting weights. Would I even be a good candidate for a mommy makeover with my old varicose vein? With having varicose veins, does it put you more at risk for blood clots?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding varicose veins and the potential for blood clots during a mommy makeover. After reviewing your history and images, here's my assessment:
1. Varicose Veins: Mild varicose veins are noticeable in the images provided. If they cause discomfort, consulting your vein specialist for possible removal via injections, lasers, or surgery is recommended.
2. Blood Clot Precautions: All surgeries carry some clot risk, particularly in higher-risk procedures like tummy tucks. For your mommy makeover, I propose:
Using sequential compression devices during surgery and the subsequent two weeks.
Considering Lovenox injections before and for two weeks post-surgery, in line with the American Society of Plastic Surgery's standard.
In my professional opinion, proceeding with the mommy makeover is reasonable, given the precautions above. This should address your concerns about varicose veins and blood clot risks.
Best regards,
Dr. Katzen

Finny George, MD · Answer

Hi, thank you for sharing your question. History of varicose veins does increase your risk for developing blood clots. After a thorough history and risk assessment for post-op thromboembolism, your surgeon may opt to consult with a hematologist for recommendations or avoid surgery altogether, but I wouldn’t preclude surgery at this stage.

Christopher Pannucci, MD, MS · Answer

Hi SKjar,
Varicose veins represent a potentially modifiable risk factors for blood clots, including deep vein thrombosis and pulmonary embolus. Your surgeon will likely consider your overall risk, considering factors like age, body mass index, planned procedures, varicose veins, and others. You might ask your surgeon if they are using a 2005 Caprini score, or similar risk stratification tool, as suggested by the American Society of Plastic Surgeons.
Ultimately, your surgeon should be able to estimate your approximate risk for blood clots, based on your individual factors, and consider the potential risk reduction of a preemptive procedure to obliterate your varicose veins prior to schedulable aesthetic surgery. You and your surgeon can decide whether the anticipated risk reduction is worthwhile to you (since there is a tradeoff of having an additional procedure for varicose veins), and make the best decision moving forward for surgery (yes/no) and preemptive varicose vein obliteration (yes/no).
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Rafael Arenas, MD · Answer

In patients  with history of varicose vein with symptoms that are looking for a MMO,  an specific protocol is recommended that starts prior to the surgery having an evaluation with an Angiologist who can make and specific assessment with a doppler ultrasound   and visualize vessels, measure blood flow and give you the clearance for surgery.  After the surgery measurements like compressive  stockings and  anticoagulants usually is recommended. You can speak this directly with your board certified plastic surgeon, he will give you the best recommendation according to your case.

John Reilly, MD, FACS · Answer

Hello, varicose veins of the lower extremities do add an extremely small risk for surgery for an otherwise healthy patient. It is one item on a grading scale in regards to the risk of a blood clot after surgery. It would not exclude you from surgery if you are otherwise healthy and it would not elevate your risk to anything that approaches an unacceptable level. Good luck.

Daniel Barrett, MD · Answer

Dear SKjar,
it is hard to tell for sure without an examination. You might need 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

There is no doubt that patient with history of varicose veins is at increased risk for blood cloth in the extremities as well as lungs when under general anesthesia. This is in particular the case when extensive, longer lasting procedures like breasts, abdominoplasty, liposuction are combined, like in MMO surgery. However. good prophilaxis by means of compressive stockings, injections of anticoagulants, and intraoperative compressive devices, would significantly reduce risks of blood clots in patients with increased risk. In person consultation with a board certified plastic surgeon about prevention of blood cloths should be part of your preopearative preparation. Hope this helps.

Salvador Garcia, MD · Answer

Hello Im Dr Salvador Garcia, is importan an assessment for cardiovascular surgeon, if you are controlade and have a appropriate treatment, we can do the surgery safely, before de surgery we put TEP stockings, and during surgery we put on intermittent compression stockings to prevent thrombosis and if you need after surgery if its necessary, leave anticoagulants to prevent thrombosis

Eleonore Zetrenne, MD · Answer

Varicose veins are not a contra indication for mommy makeover. However, it does place you at higher risk for blood clots. But if you take the proper precautions prior to surgery and after surgery, your risk can be a minimized. If you are on oral contraceptives or hormone replacement therapy, your risk for DVT or PE are increased as well. If you were my patient, I would give you subcutaneous heparin just prior to going into surgery and start you on Lovenox the morning after surgery. It would be especially important that you get up and walk the night of surgery and daily afterwards. You must also maintain good hydration. If you follow the instructions, stay well hydrated, ambulate every three hours after surgery, have mechanical compression device on your legs during surgery and take prophylactic subcutaneous anticoagulant just before surgery and 24 hours after surgery your risk should be minimized. Also, you should wear compression stockings during and after surgery.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Although varicose veins can increase your risk of clot formation, a full review of your medical history is necessary in order to provide you the best prophylactic treatments to maintain your safety.   Varicose veins alone should not prevent you from obtaining a mommy makeover.

Mommy makeover and mild-ish varicose vein (Photo)

Answers (15)

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