A serious complication after any major surgery is the development of blood clots in the legs (DVT). These blood clots can break off causing serious problems elsewhere in the body (embolus). They may even cause death. This is a known risk of an abdominoplasty.
Fortunately it is uncommon. About 1/100 patients may have some clotting of the veins of the leg after surgery. In about 1/200 a small piece (embolus) may break off causing problems in the lungs.
If the diagnosis is suspected special tests, like doppler studies and venograms, are used to confirm the diagnosis. Often anticoagulants, like heparin, are prescribed.
It is impossible to completely avoid this problem but there are a number of things which may reduce the risk.
Patients who have had blood clots in the past may not be candidates for surgery. In some cases surgery can be performed but the patient needs to be on small amounts of anticoagulants around the time of surgery.
It is important to avoid compression of the leg veins especially behind the knee. Many surgeons like to use elasticated stockings. This may help but there is a danger that unless the patient is watched carefully the stocking can roll up creating a tourniquet. This will increase the risk of clots forming.
The role of birth control pills is controversial but they may increase the risk of blood clots. The patient and surgeon must decide if it is worth stopping the pill and taking the risk of pregnancy.
One of the most important ways to reduce the risk is to encourage the patient to walk early after surgery. Usually the night of surgery the patient can get up to the bathroom. By the next day a walk round the room is valuable.
Long operations also increase the risk so it is important for the surgeon not to waste time and complete the operation as quickly as possible. The risk of blood clots may also be increased if the abdomen is closed very tightly after surgery. Unfortunately a tight abdomen is the purpose of surgery and so it is often difficult to know how tight is dangerous.
Some surgeons feel that it may help to massage the legs both during and after surgery. However there is also a a concern that this may loosen blood clots and increase the risk of embolism.