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What are your complication rates? Dvt, PE and death?

Q:

I'm having a mm/mr on January 14th and I can't help but read about procedures, risks, and advice. It seems like dvt, PE are mentioned quit a bit but not many doctors admit to having these complications. In your years of operating how many of your patients have had this complications? Do you use lovenox as preventative with all your mm?

A:

Dear Jamie,

Thank you for your question. A mommy makeover is a major operation, even though most surgeons including myself, do this as outpatient surgery. It is imperative that your surgeon use an anti- DVT method. It is rare to get a DVT and even more rare to get a pulmonary embolus. I do not use chemoprophylaxis like Lovenox, but use sequential compression garment during surgery and have the patient take the device home for 24 hours. After that, I expect that my patients be up and ambulate every two hours during the day. I've been in practice for over 20 years and I can recall only two patients who experienced a PE. One was overweight and the other one had a normally higher coagulable state. She never had surgery before. Both patients did well and recovered without sequelae. Good luck with your urgery.

A:

 

 I must disagree with Dr. Maroson. Yes, patients who undergo prolonged procedures, and/ or combined procedures with an Abdominoplasty can be at increased risk for DVT/ PE. A Mommy Make Over falls into these categories. Your practitioner would normally have a patient screening form most likely filled out at the time of your first consult. This helps to define which patients are at increased risk for DVT/ PE with such procedures. For example a family history of DVT/ PE may necessitate further blood tests or a Hematologist consult BEFORE your surgery. If your practitioner is planing to give you Lovenox post operatively anyway the only blood clotting abnormality/ disorder of great concern would be a Factor V Lyden Deficiency. Yes, peri-operative Lovenox and other agents that prevent DVT/ PE are much more commonly utilized than in the past especially with Mommy Maker Overs.

 As has been recommended by the ASPS/ ASAPS surgical procedures over 5 to 6 hours of anesthesia as well as procedures combines with an abdominoplasty like a Mommy Make Over frequently may require post operative observation to decrease post operative adverse events and unfavorable outcomes. Our facility performs these types of procedures quite regularly so, we screen these patients BEFORE surgery, administer Lovenox 12 hours after surgery & keep them overnight at our surgical facility for post operative observation under the care an RN ( http://www.garyculbertson.com/iris_surgery_center.htm ). Favorable outcomes performed with a focus on patient safety is one of our primary concerns.

 Mommy Maker Overs are not minor procedures. May I suggest you return to your surgeon and address your concerns in person. Hopefully, they are members of the ASAPS . Best,

 

 

Gary R Culbertson, MD, FACS

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