Prevention of Venous Thromboembolism in the Perioperative Period of Abdominoplasty: An Integrative Review
DOI:
https://doi.org/10.62827/fb.v27i9.1311Keywords:
Abdominoplasty; Venous Thromboembolism; Disease Prevention; Physical Therapy; Rehabilitation.Abstract
Introduction: Abdominoplasty is one of the most commonly performed cosmetic procedures worldwide; however, it carries a significant risk of venous thromboembolism (VTE). Objective: To analyse, through a comprehensive review of the literature, the main strategies for preventing VTE in patients undergoing abdominoplasty, in order to focus on risk stratification, mechanical and pharmacological prophylaxis, and the role of early mobilization and perioperative rehabilitation. Methods: Searches were conducted in the PubMed/Medline (Medical Literature Analysis and Retrieval System Online), SciELO (Scientific Electronic Library Online) and LILACS (Latin American and Caribbean Health Sciences Literature) using search terms covering the thematic areas of abdominoplasty, venous thromboembolism and physiotherapy/rehabilitation, with full-text articles available between 2018 and 2026 in Portuguese and English. Five studies were selected for the final sample, comprising three retrospective cohort studies and two systematic reviews. Methodological quality was assessed using the Joanna Briggs Institute (JBI) tool. Results: The findings were analysed descriptively and critically. It was noted that the prevention of VTE should be a multimodal strategy. Mechanical measures (compression stockings, intermittent pneumatic compression and early mobilisation) are highly safe as they do not increase the risk of bleeding. However, the use of routine chemoprophylaxis is controversial; although protocols combining pharmacological measures (such as enoxaparin and rivaroxaban) with mechanical measures have been shown to be effective in reducing VTE in high-risk patients, routine chemoprophylaxis is not universally recommended due to the increased risk of haemorrhagic complications, such as post-operative haematomas. The Caprini score aids in stratification but should not guide decisions in isolation. Conclusion: There is no universal pharmacological prevention protocol. VTE prevention must be individualised and integrated through a multidisciplinary approach, carefully weighing the risk of thromboembolic events against the haemorrhagic potential of each patient.
References
International Society of Aesthetic Plastic Surgery. ISAPS Global Survey 2023. Mount Royal (NJ): ISAPS; 2024.
Swanson E. Abdominal fascial plication and the risk of venous thromboembolism in abdominoplasty patients: a systematic review of the literature. Ann Plast Surg. 2025;94(3):378-383.
Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2020;41(4):543-603.
Justino TA, Varoni ACC, Duz GL. Tromboembolismo venoso (TEV) em abdominoplastias: um protocolo de prevenção. Rev Bras Cir Plást. 2018;33(1):50-57. doi:10.5935/2177-1235.2018RBCP0006.
Rodrigues MA, Ferreira LM, Calvi ENC, Nahas FX. Preoperative Respiratory Physiotherapy in Abdominoplasty Patients. Aesthet Surg J. 2018;38(3):291-299. doi:10.1093/asj/sjx121.
Restifo RJ. An in-depth analysis of 1370 consecutive abdominoplasties… Aesthet Surg J. 2024;44(12):NP870-NP882.
Swanson E. A systematic review of the efficacy of venous thromboembolism prevention protocols in abdominoplasty patients and the risk of bleeding. Ann Plast Surg. 2026;96(2):197-206.
Gasparini LHM, Medeiros AS, Artismo RS, Karsten M, Matte DL. Exploring the use, outcomes, barriers, and facilitators of prehabilitation and rehabilitation in abdominoplasty surgeries: a scoping review. J Plast Reconstr Aesthet Surg. 2024;99:515-525. doi:10.1016/j.bjps.2024.09.039.
Claytor RB, Tolan G, Pettibone T, Fisher A. A comprehensive mechanical and chemoprophylaxis algorithm… Aesthet Surg J Open Forum. 2025.
Bricker J, Ferenz S, Moradian S, Termanini K, Jackson B, Whitney A, et al. Apixaban (Eliquis) for VTE prophylaxis following abdominoplasty: establishing a safety and efficacy profile. Plast Reconstr Surg. Published online July 15, 2025. doi:10.1097/PRS.0000000000012308.
Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546-53.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Márcia Christiane Oliveira Rodrigues, Gabriela Ladeira Tavares, Joana de Carvalho Souza, Laura de Carvalho Girardi, Fernanda Jardim Gripp (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Autores que publicam nesta revista concordam com os seguintes termos:
Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution 4.0 que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
Autores têm autorização para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
