PE in Mother. Does This Increase my Risk?

I am having a mommy makeover in two weeks. My mother had a PE and luckily she caught it in time. She had another clot in her leg a few months later again it was caught in time. I have had 4 c sections and never any health issues. Does the fact that my mother had a PE increase my risks? I am prone to spider veins but I didn't think this ever meant I had an increases risk. I didn't think to mention the PE in my mother because I don't remember any kind of family history being asked.

Doctor Answers 10

Family History of Pulmonary Embolism and Planned Mommy Takeover Surgery?

Best to raise your family history about concerns with your plastic surgeon. the fact that you have had four C-sections without difficulty is very promising.  Based on your complete history and physical  the plastic surgeon will undoubtedly have recommendations in regards to prevention of thromboembolic phenomenon. If in doubt, a hematology consultation can be very helpful.

 Given that you are about to undergo a major operation which often involves a significant physical and emotional recovery a few additional words of advice (unrelated) may be helpful:

1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.

2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.

3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.

4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.

5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.

6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.

7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.

8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).

9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.

10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.

11. Keep in mind the end results as you go through the tougher emotional times after your surgery.
Best wishes for a safe  and successful mommy makeover procedure.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Blood Clots after surgery

Deep Vein Thrombosis or DVT's is a very hot topic in medicine today. Blood clots in the legs can develop and break off and spread to the lungs, causing a pulmonary embolism (PE). People can and do die from PE's! PE's are commonly seen in people who have a prolonged session of immobility, either from surgery, sickness or just sitting in an airplane for hours.

All patients admitted to hospitals and evaluated before surgery are assigned a Risk Assessment Value number based on multiple risk factors known to increase the risk of developing DVT, (Caprini scale). Prevention of DVT is then based on this number and can range from nothing more than early ambulation with compression stockings to the use of blood thinners post operatively.

Talk with your plastic surgeon and find out what your risk factor number is and what preventative measures will be taken for you. If your mother has had DVT it does not increase your risk, UNLESS there is a an inherited hypercoagulable state that she has passed on to you, then your risk does rise dramatically, and you will probably need blood thinners.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Family history is not an issue except in rare cases

The key risks of developing pulmonary embolus include surgical procedures lasting longer than four hours, weight, history of smoking, history of clotting disorders or bleeding disorders, history of trauma to your lower extremities, and history of taking hormones. During surgical procedures, most surgery centers place compression devices on the legs to decrease the chance of deep vein thrombosis. In addition, most plastic surgeons have their patients walking around the night after surgery. Some patients may be placed on Lovenox in the postoperative period to decrease the chance of developing blood clots in the legs.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 20 reviews

DVT/PE risk from mommy makeover surgery

This is an excellent question.  During my mommy makeover consultations, I routinely review a patient's risk factors for DVT/PE  (blood clots).  The fact that you have undergone 4 C-Sections without any problems is a good sign.  Your mother's history alone does not necessarily mean you are at higher risk for a blood clot.  But the question is:  what is your risk of a DVT or PE after cosmetic plastic surgery?

There have been several studies on this exact topic of DVT risk in plastic surgery procedures.  In fact, the American Society of Plastic Surgeons has a Venous Thromboembolism Task Force that has systematically reviewed this matter in detail.  Multiple studies have shown the risk of a blood clot from a tummy tuck or related procedure is well below 1%.   To help plastic surgeons select patients who may or may not need Lovenox (or some form of blood thinners to help prevent blood clots, there are published guidelines to aide in patient selection (known as the Caprini/Davison risk assessment model (RAM).    Ultimately, your plastic surgeon will determine the need for Lovenox based on 1) your health status and past medical history and risk factors and 2) length of your procedure(s).   Most PS utilize SCDs (massage boots) and early ambulation as the mainstay for their blood clot prophalaxis. Others also opt to add on Lovenox as well.

Overall, combined procedures are VERY safe in healthy patients.   Early ambulation after your procedure is very important too.  Please talk to your board certified plastic surgeon about your concerns.
Best wishes,

Dr. Basu
Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 209 reviews

Deep Venous thrombosis

Once there is a family history of deep venous thrombosis, this should raise questions, mainly why your mother had the DVT. If ther is any question about the family history then you need to see a hematologist and get full workup for hypercoaguability syndromes.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Pulmonary Embolism in the family

Thanks for an excellent question.  First, you need to be discussing this with your plastic surgeon knowing that surgery is coming up soon.  You had 4 c-sections without a clot which is excellent to hear, but a mommy makeover is a much longer procedure.  There are familial clotting disorders that run in families.  There are blood tests that can identify some types of clotting conditions, but others are simply not identifiable.  I often use Lovenox on long cases in high risk patients.  Ask your surgeon.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 197 reviews

Family risk of PE

There are specific risk assessments for PE after surgery, and specific risk reduction measures depending on your risk "score". Family history is less important unless there is a clotting disorder, but do ask your surgeon to go through a risk assessment with you.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Risk for Blood Clots with Cosmetic Surgery

A family history of blood clots that travel to the lung (PE) increses your risk for blood clots after your surgery, but it is only one of several factors to be considered. 

There are also things you can do to decrese your risk after surgery, like pumping your ankles in bed and getting out of bed to move around and promote circulation to name a couple.

Your surgeon can run a risk assessment with you, so be candid about your family history and your concerns, so together you can limit the chance of a complication.

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

Disclose your maternal history of PE

Discuss your mother's experience with your PS.  Do you have any risk factors for PE? Use of oral contraceptives or hormone replacement? Tobacco use? High BMI? Proposed operative time for your mommy makeover?  Most PS will review any risk factors and pair you with the appropriate measures to ensure that your mommy makeover is safe as well as spectacular. At minimum, you will have support hose, sequential compression devices ("squeezers") as well as a program of early ambulation.  If you are deemed "high risk", your PS may recommend a consultation with a Hematologist (blood specialist) and utilize "anti-coagulants) (blood thinners).  

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Pulmonary emboli in cosmetic surgery

can arise from a number of issues (ie: length of surgery, birth control pills, obesity, etc) but heredity is not one of them unless you have an inherent blood disorder that predisposes you to clotting.  You should raise your concerns with your doctor as there is a chart they can review your risks factors with and determine the risk to you and if special measures are needed to prevent PE's.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.