Tummy Tuck and Breast Augmentation Still Possible with Protein S Deficiency?

Abdominoplasty and breast augmentation are both elective procedures and it is important that a prosepective patient be in the best possible health prior to undergoing surgery. I would recommend seeing a hematologist who would be in the best position to evaluate your lab results and help you determine how best to proceed in conjunction with your Plastic Surgeon

I would start with a consultation to a hematologist.  In our surgery center, all clotting disorders get a plan from the hematologist for surgery in writing prior to surgery.  There likely will be some additional testing that will help determine if you are safe to proceed.   

You need to obtain clearance from your hematologist and make sure your plastic surgeon follows the recommendations. This usually requires compression stocking before during and after surgery. Injections of Lovenox an anticoagulant may also be suggested around your procedure.

Make sure you understand all the additional rails with this condition before proceeding! Good luck!

Thank you for the question. I would highly recommend a thorough evaluation by a hematologist who is familiar with your condition. Having said that your condition is a genetic trait that causes you to be predisposed to forming venous clots, as a matter of fact approximately 6 times more likely than patients without the condition. The clots can form anywhere in the body and can lead to tissue death. Typically if you have Protein S deficiency you are told not to sit for prolonged periods of time without getting up an moving about. Patients undergoing surgery may need to be anti-coagulated as prophylaxis (prevention) against developing Deep Venous Thrombosis (DVT) in the lower extremities.  These are clots that can form in the legs and dislodge traveling to the lungs potentially causing death. You are also asking about an abdominoplasty (tummy tuck) which increases your risk of having DVTs in the legs.

If you were coming to see me I'm afraid I would have to advise against a mommy makeover as the risks would seem to outweigh the benefits in your case. However as I first mentioned you would need to consult with a hematologist for a more thorough discussion of your condition and the implications. Lovenox may be useful but I would want to personally discuss your case with your hematologist before I would even consider doing the procedure.

Good luck.

I think you'd be hard pressed to find many plastic surgeons who would address your Protein S deficiency without the consultation of a hematologist. Having a hypercoagulable state does impact the postoperative DVT prophylaxis, particularly if you have a tummy tuck. You will likely require some chemo-prophylaxis, most likely an injection called Lovenox for 3 days until fully ambulatory. This is where the opinion of the hematologist is important. Regardless, it is much better to know this information ahead of time so that the proper precautions can be taken to lessen your risk of a complication from surgery.

Thank you for the question.

You will be best off having a full evaluation by a well experienced hematologist. He/she will evaluate your past medical history ( especially in regards to bleeding/clotting) and laboratory studies. The hematologist would be able to provide a recommendation to you and your plastic surgery in regards to the feasibility/safety of undergoing the planned procedures.  Perioperative medical management may also be recommended by your hematologist.

Best wishes.

The question of interpreting the results of your test are best left to  a discussion with your hematologist, or with whoever ordered these studies.

They do indicate a clotting disorder, which must be considered in balancing the risks and benefits of any surgical procedure. There is no reason that you cannot have these procedures, albeit with some added risks that must be managed. 

You will likely be asked to take a course of blood thinners by injection once daily for a week after your surgery, this to decrease the likelihood of blood clots in veins that can travel to the lungs (pulmonary emboli).

Your personal physician or hematologist should be part of the planning along with your plastic surgeon.

Thanks for your question, best wishes. 

You will need a comprehensive work up and recomendation by a hemotologist and then proceed with surgery. They will likely recommend lovenox injections before and after surgery. This does increase your chances of bruising and likely not increase bleeing tendency. I have performed these procedures in my practice with the before mentioned criteria. Best of luck. 

Thank you for the question. We have operated on women with similar situations before. Please check with your hematologist to determine if any special attention is required in preparation for you surgery.

Individuals with Protein S deficiency may still be candidates for elective surgeries such as tummy tuck and breast augmentation, but it’s crucial to approach these procedures with caution and under the guidance of healthcare professionals familiar with your medical history. Protein S deficiency is a condition that predisposes individuals to an increased risk of blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE). Before undergoing any elective surgery, especially procedures that involve significant tissue manipulation like a tummy tuck and breast augmentation, it’s essential to: 1. Consult with a hematologist: A hematologist, a doctor who specializes in blood disorders, can assess your specific risk profiles based on the severity of your Protein S deficiency, any previous history of blood clots, and other relevant factors. 2. Discuss with your plastic surgeon: Your plastic surgeon should be made aware of your Protein S deficiency during the consultation process. They can work in conjunction with your hematologist to develop a comprehensive surgical plan that minimizes the risk of blood clots during and after the procedure. 3. Implement preventive measures: Depending on your individual risk factors, your healthcare team may recommend various preventive measures to reduce the risk of blood clots, such as preoperative anticoagulant therapy, compression stockings, early ambulation post-surgery, and other interventions. 4. Monitor closely during and after surgery: Close monitoring during and after surgery is essential to promptly detect and address any signs of blood clot formation or other complications. Ultimately, the decision to undergo elective surgery with Protein S deficiency should be made on a case-to-case basis, weighing the potential benefits against the risks and implementing appropriate precautions to mitigate those risks. Your healthcare team will play a crucial role in guiding you through this process and ensuring your safety and well-being throughout the surgical journey.