Abdominoplasty, or tummy tuck surgery, at my Scottsdale-area medical office is a very popular and dramatic surgery I perform frequently. Whether alone or in combination with breast surgery as part of a “mommy makeover,” abdominoplasty is definitely a transformative procedure.
Abdominoplasty is also associated with more possible surgical risks, and as a result, it must be taken very seriously. When the abdominal wall is tightened, this places some pressure on the internal abdominal cavity, which can, in turn, slow down venous blood return from the legs. If the blood flow is sluggish enough, patients can develop blood clots in the deep veins of the legs called DVTs (deep venous thrombosis). These clots, in rare cases, can dislodge and migrate to the blood vessels in the lungs causing a PE (pulmonary embolus).
Thankfully, this is a very uncommon problem, but I take it very seriously and take many precautions to prevent it. First of all, I make sure patients going into surgery are healthy and do not have any medical problems contraindicating elective surgery. If patients have a personal or family history of blood clots, I generally have them see a hematologist for preoperative clearance.
Next, I take precautions during surgery that include compression stockings and pneumatic sequential compression devices (SCDs) that squeeze the lower legs during surgery to assist with blood flow. After abdominoplasty surgery, I have my patients stay overnight at a recovery center to continue the SCDs and for close monitoring. I also usually start a short-term blood thinner to lower the risks of a clot.
One of the most important ways to enhance blood flow in the deep veins is also one of the simplest: walking! Just walking around causes the calf muscles to contract, which forces blood through the veins. This is why early ambulation (walking) after surgery is so important. Resting and avoiding excess exertion is helpful after surgery to prevent bleeding and damage to the surgical sites, but staying in bed all of the time is not the best idea. I encourage my patients to get up frequently (at least 5 times a day) and walk around. Simply getting out of the bed, walking to the bathroom and back multiple times a day can lower the risk of a clot. Walking around helps patients feel less sedentary, and it’s an easy way to make sure your recovery is as safe as possible!
Learn about other ways to lower surgical risks on my blog.