Is it necessary to take an anti coagulant after a tummy tuck? I am a healthy woman in my 40s, normal weight and active.

Hello!There are criteria many surgery centers follow where there is a scoring system for risk of clot after surgery, related to time of surgery, weight, medications, family history of clotting and more. This score is a guideline with regard to medicating to protect against clot. I almost never provide anticoagulants to my patients. The most important thing is to walk and hydrate well after surgery. Different surgeons will recommend different things and you will likely find another board certified plastic surgeon who will not mandate blood thinners.

The way to avoid DVT and PE is immediate mobilisation. the majority of my patients do not opt for anti coagulants and you need to run through the pros and cons with your PS.

Guidelines set by Surgeons, like Mark Venturi a local (Va.) plastic surgery star, and the American Society of plastic Surgery support using sub-Q heparin in all patients under going this surgery. Exceptions can be made, but the standard of care answer is; yes. These recommendations are based on risk/benefits assessment. Therefore I often prescribe it, but I wouldn't be appalled if you don't use it.

I think that the reason to anticoagulate someone is based upon a lot of criteria.Things such as a patient's medical history, the extent of surgery, and surgeon preference to name a few are included. I would say most do not need anticoagulation.   

Generally in a healthy, active patient who does not have any prior history of clotting (leg blood clots, multiple unexplained miscarriages, etc), post operative anticoagulation is not required/needed.  I do tend to use a preoperative dose of heparin (blood thinner) on the day of surgery and encourage early and frequent ambulation post operatively.  We generally leave compression hose on our patients post operatively as well. Each surgeon has their own preference, so you should discuss with your plastic surgeon.

The simple answer to your question is no,  it is not necessary unless you have a known blood clotting disorder. However, the worst possible outcome from this surgery would be a pulmonary embolism that could result in death. For this reason, many plastic surgeons  including myself, routinely place patients on anticoagulation medication after surgery.  The risk of course is that chances for bleeding go up but compared to the risk of blood clots, that is an acceptable risk for many surgeons.There is no right answer.   Each case may have different indications or contraindications for anticoagulation.  The most important thing is that you are well informed either way. instagram: @dralexmesbahi