American Society of Plastic Surgeons
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Dayna R
one year ago
Answered

Risk

Hello, I’m scheduled to have a TT on February 22nd and I’m extremely nervous but excited all at the same time. My question is how likely is it to have major complications and what can I do to prevent them. I’m not concerned about pain or minor risk. Also, I’m worried about going under. I have a irregular heart beat but I always get cleared and last year he cleared me but I’m getting another.

Procedure: Tummy Tuck
Type: Question

Replies 7

Debra Johnson
ASPS Surgeon
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Biggest risk after a tummy tuck is a blood clot (deep venous thrombosis or DVT). Higher risk factors are obesity, tobacco use, hormone use, personal or family history of DVT. BMI less than 30, nonsmoking status are helpful. Drinking plenty of fluids postoperatively and walking frequently are important. Following all your doctor’s instructions will help you get through the process as successfully as possible.

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Susan Buenaventura
ASPS Surgeon
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Definitely discuss these concerns with your ASPS board certified surgeon before your surgery. The main risk to be concerned about are DVT which can lead to a pulmonary embolus (rare but important to know about) . Having general anesthesia and an anesthesiologist necessary for the surgery and keeps you safe. To minimize your risks, your BMI should be 30 or less, you should be walking 20-30 minutes a day and not smoking. Also stopping any hormones or birth control pills will lessen risk of DVT. Medical and cardiac clearance as indicated is also important. Avoiding travel for several weeks around the surgery is also important.

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Richard Greco
ASPS Surgeon
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Risk - This is the most important question anyone will ask. You should talk with your surgeon to ask his/her risk profile and experience.

One starts with a good history and physical to determine your ability to undergo a general anesthetic and the procedure. Factors such as smoking, obesity, heart disease, pheriphreal vascular disease, diabetes all have certain risk mutlipliers and are taken into account.

How long your operation will take, use of dynamic compression hose, long term local anesthetics, overnight care and early ambulation will reduce your risk. In the best locations and with appropriate care the risks are low - but not zero.

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Gary Culbertson
ASPS Surgeon

Consider starting with your internal medicine or cardiologist to get medically optimized or cleared for surgery. This will assist your surgeon in determining your overall peri-operative risk. There are issues that can be addressed to assist in reducing your risk with an abdominoplasty. We call these critical pathways of care. They are specific for each different plastic surgical procedure but, very important for LipoAbdominoplasty’s. For example Exparel can be given at the time of surgery to assist in reducing your post operative pain, DVT/PE screening is done and meeting/ making sure someone will care for you for a few days after surgery are just a few examples. Consider discussing your concerns with surgeon BEFORE your TT. Best,

Gary R Culbertson, MD, FACS

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James Chappell
ASPS Surgeon

If you are not a diabetic, have a body mass index under 30, are not on hormone replacement, and have a strong heart, lungs and other major organs, your risks are minimal, but definitely get medically cleared (because of that “irregular heartbeat”) and discuss with your surgeon whether they think you need to be on a blood thinner. I tell my patients they should be up and walking around three or four times a day and staying well hydrated. Being a little nervous is normal. I hope you are going to a board-certified plastic surgeon.

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Nelson Castillo

Thank you for your question. It would be quite unnatural to not have some anxiety and feelings of worry about an impending elective surgery, but i applaud you for reaching out for reassurance. Be confidant that you have made the right decision for you and you alone. Entering surgery with a positive mindset will make the recovery that much easier. The majority of patients do quite well with a tummy tuck, and if there were questions about your ability to have the surgery performed, your physician would have discussed these with you, based on any risk factors you may have. Discuss your concerns with your surgeon, they are there to help.

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Jon Ver Halen
ASPS Surgeon
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Hello and thank you for your excellent question. I agree with most of the comments on this thread: the main risk of a tummy tuck is a DVT or PE. Your controllable risk factors include your activity level; obesity; smoking status; nutritional status; hypertension; and diabetes mellitus. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

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