Preventing Blood Clots After Tummy Tuck and Body Lift
Tummy tucks and body lifts can be life-changing procedures. The removal of skin and fat excess along with tightening of the abdominal wall can reverse many of the problems that occur following childbirth and/or weight loss. But make no mistake: even though tummy tucks and body lifts are cosmetic surgeries, they are still surgery. And every surgery has risks.
The most serious risk of any excisional body contouring procedure is blood clots. Due to the immobility associated with any major surgery (especially one that temporarily makes it more difficult to walk), there is a risk of blood clots forming in leg veins (deep venous thrombosis). If a clot "breaks off" and travels through the bloodstream to the lungs, it can suddenly and seriously impair oxygen exchange. This life-threatening condition is called a pulmonary embolus. It requires immediate treatment with blood thinners (to dissolve the clot) and oxygen.
Every plastic surgeon and plastic surgery patient should take these risks very seriously. The question: what can we do to prevent blood clots following tummy tuck and circumferential body contouring (body lift)? We have a protocol:
- DO NOT smoke for at least one month before surgery and one month after surgery. Smoking causes constriction of blood vessels, impairing blood flow and oxygenation. Smoking greatly increases your risk of blood clots (even if you are not undergoing surgery).
- DO NOT use contraceptives or hormone replacement therapy for at least one week before surgery and one week after surgery. These substances can increase your risk of blood clots (even if you are not undergoing surgery).
- DO walk regularly after surgery. Every time you want to eat or use the restroom, you must have a family member or friend help you to the kitchen or the bathroom. Regular meals in bed are just a bad idea. Walking helps pump blood through your leg veins, preventing clots from forming.
- DO use SCDs. Sequential compression devices (SCDs) are mechanical pumps that intermittently compress the leg veins, promoting circulation by simulating walking. We place these on all patients undergoing surgery in our nationally-accredited surgical facility, the West Plano Plastic Surgery Center. We send abdominoplasty (tummy tuck) and body lifting patients home with an SCD machine for the first few days to further reduce the risk of blood clots. I do not know of any other surgeon or surgery center that does this routinely, and I sincerely believe that they should.
- DO consider anticoagulants. Anticoagulants (blood thinners) can significantly reduce the risk of blood clots. Unlike #s 1 to 4 above, they do increase the risk of postoperative bleeding, so they must be used with caution. For example, I will not use an anticoagulant in a patient who bleeds excessively during surgery. However, in most patients undergoing excisional body contouring, I begin low dose Lovenox (low molecular weight heparin) in the first 24 hours after surgery and continue its use daily for a week.
With this protocol in place over the past five years, we have not experienced a single clotting-or bleeding-episode in a tummy tuck or body lift patient.
We want you to look great after surgery. But first and foremost, we want you to be safe!
Dr. Friedman, the former Chief of Plastic Surgery at Parkland Memorial Hospital in Dallas, serves the Frisco, Allen, McKinney, and Fairview communities.