Understanding the Potential Danger
Blood clots generally become trapped in either the lung or the brain when they break free from other parts of the body. When the blood clot becomes caught in a blood vessel in the brain, it results in a CVA or stroke. When it becomes trapped in a blood vessel in the lung it is known as a pulmonary embolism or PE. Either condition is life threatening and can carry serious consequences.
While blood clots and strokes are a significant risk for all patients having any type of invasive surgery, plastic surgeons run into a unique scenario that generally makes it a little more difficult for our patients to get treatment and help in a short amount of time. Incidents of blood clots and stroke can happen anywhere between several hours post operatively up to about ten days after surgery. Thus, these incidents rarely occur within a medical environment and usually happen at home. Patients who remain in the hospital or a medical center after a medically necessary procedure are more likely to have these incidents in the hospital.
Patients, who are going to experience a cosmetic procedure, or any type of surgery for that matter, should familiarize themselves with the general symptoms of post surgical pulmonary embolism or stroke. Symptoms that include shortness of breath, chest pain, disorientation, and sometimes even a sense of altered mental status are likely either to be related to a pulmonary embolism or a stroke. Patients and physicians alike should also understand the basic risk factors for these complications and prior to a surgical procedure. While there are still studies being conducted, which will help determine a patient's risk level in the future, there are some pretty basic factors, which point to a likely candidate.
Risk Factors For Patients
Women are more likely to experience these types of complications than men, as are smokers. There are numerous medications, which place patients at a higher risk for postoperative blood clots, including but not limited to hormone replacements and birth control pills. Weight plays a significant factor as does the level of activity the patient generally participates in. Patients who generally lead a sedentary lifestyle are at a higher risk. Obese patients are at an even higher risk. Increased age and a previous history of deep venous thrombosis are more obvious risk factors. Patients who have a current diagnosis of cancer are at a particularly high risk.
Reducing the Risk Factors for Safer Surgery
Whenever a patient is booked for surgery in my practice, I always insist that they have a medical clearance by an internist to help determine their general risk level for elective surgery and the possibility of medical complications, which includes the risk of abnormal blood clotting. I also take into consideration the type of surgery that I am performing on the patient. In general, surgical procedures that have a longer operative time and involve body contouring carry a higher risk than those that are minimally invasive and are performed on the head and neck. The internist will review a list of current and recent medications, as I do myself, and will verify that the patient is physically fit to tolerate the procedure that is desired. There are still no guarantees, but knowing a patient's medical history, their obvious risk factors, and having a second pair of eyes look over the same information that I am presented with, ensures that I am taking all possible precautions.
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