Risk of Thromboembolism Following Body-Contouring Surgery After Massive Weight Loss.

Background: “Postbariatric” patients are at significant risk for increased postoperative complications. This study aimed to define the risk of venous thromboembolism following body-contouring surgery after massive weight loss. Methods: A retrospective analysis was performed on all patients who had undergone all forms of body-contouring procedures after massive weight loss between January 2005 and August 2012 at St George's Hospital, South West London, United Kingdom. Data were collected on patient demographics, comorbidities, risks factors for thromboembolism, preoperative and postoperative body mass index, and type of surgery. Results: A total of 135 operations were performed on 53 patients (43 females, 10 male), with an average age of 44.8 years (range, 26–56 years). Most had staged procedures including 55 abdominoplasties, 23 brachioplasties, 31 thigh lifts, 14 lower-body lifts, and 12 mastopexies. All patients received venous thromboembolism prophylaxis postoperatively including low-molecular-weight heparin (dalteparin) within an average of 22.5 hours after surgery and the application of intraoperative graduated compression stockings. Patients received dalteparin for an average of 4 days (range, 2–14 days), which correlated to their length of stay. One patient had a deep venous thrombosis 14 days postoperatively and then 2 days later developed a nonfatal pulmonary embolus, giving a venous thromboembolism prevalence of 0.74% (1/135). Conclusions: The clinically apparent venous thromboembolism prevalence was low among patients undergoing body-contouring procedures after massive weight loss in this study. We provide evidence of a successful algorithm to prevent venous thromboembolism for patients undergoing body-contouring procedures after massive weight loss.