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.
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.
Oh wow, my mother had blood cloths about 5 years ago. Not sure of exactly what DVT but it was definitely that. This scares me now! Is it any way I can check out my blood before my surgery?
I would definitely discuss this with your surgeon. There are some lab evaluations that might be needed. There is a also a method of assessing risk for DVT. If your surgeon feels you are higher risk he/she might recommend use of a blood thinner during the perioperative period. If you are not felt to be higher risk, it wouldn’t be necessary. However all abdominoplasty patients should be up and walking, and drinking plenty of fluids, postoperatively.
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.
Thank you for your reply. It has helped a lot and I’m considering everything that you mentioned.
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.
Thank you for your reply. It has helped a lot and I’m considering everything that you mentioned as well as the other PS. This was very helpful.
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
Thank you for your reply. It has helped a lot and I’m considering everything that you mentioned. I will definitely be discussing concerns prior to the surgery. I just wish he would allow to to stay over night. His patients go home after their surgery. Thank you
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.
Yes sir, he is board certified. I will be visiting again with him next Tuesday. Also, my cardiologist is doing my normal yearly check up before my surgery. Normally the irregular heart be has never been an issue but I’m the most scariest person ever so I do way extra. I also have my primary PCP running additional lab work on me to check to see if I’m high risk for blood clots. I see her Monday @ 8
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.
Yes, I’m visiting my PCP and I will be seeing my PS on next Tuesday to discuss everything. I’m also seeing my cardiologist to have him run additional test to be certain. I see him once a year but I’m letting him know about the surgery when I go in. Thanks for your response.
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!