Blood Clots After Surgery: Signs, Risks and Prevention

A blood clot is one of the complications people worry about most after surgery, and for good reason: it is uncommon, but when a clot reaches the lungs it can be life-threatening. The reassuring part is that clots are largely predictable and preventable. This guide explains the signs of a blood clot after surgery, how long the risk lasts, who is at higher risk after cosmetic surgery, and the practical steps that lower it, from planning your operation to your first weeks of recovery.

It applies to most operations, but it pays particular attention to body procedures such as a tummy tuck, liposuction and the combined operations that make up a mummy makeover, which carry more clot risk than face or breast surgery.

What Is a Blood Clot After Surgery?

Doctors group clots in the veins under one name, venous thromboembolism (VTE). It takes two forms:

• Deep vein thrombosis (DVT) is a clot in one of the deep veins, most often in the calf or thigh. It partly or fully blocks blood returning from the leg to the heart, which causes pain and swelling.
• Pulmonary embolism (PE) happens when part of a clot breaks away, travels through the heart and lodges in an artery in the lungs. It stops blood reaching part of the lung and puts strain on the heart.

A DVT can happen on its own and be treated before it moves. A PE often starts as a DVT that was never noticed. That is why recognising leg symptoms early matters so much.

What Are the Signs of a Blood Clot After Surgery?

The signs depend on where the clot is. Some people have very mild symptoms, and a few have none until a PE occurs, so treat any of the following seriously, even if they seem small.

Blood Clot in the Leg After Surgery: DVT Symptoms

The NHS lists the main symptoms of DVT ↗ as:

• Throbbing or cramping pain in one leg, usually in the calf or thigh
• Swelling in one leg, rarely both
• Red, blue or darker skin around the painful area, and the area may feel warm
• Swollen veins that are hard or sore when you touch them

The pain is often worse when you walk or bend your foot upwards. Rarely, a clot forms in an arm, or in the pelvic veins, where lower tummy pain may be the only clue.

Blood Clot in the Lung After Surgery: Pulmonary Embolism Symptoms

The NHS describes the symptoms of a pulmonary embolism ↗ as:

• Difficulty breathing that comes on suddenly
• Chest pain, or pain in the upper back, that is worse when you breathe in
• A very fast heartbeat
• Coughing up blood
• Feeling faint, dizzy or collapsing

Shortness of breath or chest pain after surgery can have other causes, such as a chest infection, but neither should be put down to normal recovery without being checked.

Leg Swelling After Surgery: Is It Normal or a Blood Clot?

Swelling is expected after body surgery, which can make a DVT harder to spot. A few differences help:

• Normal post-operative swelling is usually around the operated area, affects both sides fairly evenly, and improves gradually with rest, elevation and time.
• A clot usually affects one leg more than the other, especially the calf, and comes with pain, tenderness, warmth or a change in skin colour. It tends to get worse rather than better.

If you are not sure, do not wait to see if it settles. A swollen leg after surgery that is worse on one side, especially with calf pain, needs checking the same day.

When Should You Call 999 or NHS 111 After Surgery?

• Call 999 or go to A&E if you have sudden difficulty breathing, chest or upper back pain, a very fast heartbeat, you cough up blood, or someone collapses. Do the same if you have leg pain and swelling together with breathlessness or chest pain. Do not drive yourself.
• Get urgent advice the same day if you think you have a DVT without breathing problems: call your surgical team, or NHS 111 or your GP if you cannot reach them.

After surgery at Centre for Surgery, you have your surgeon’s direct number for the first 24 hours, then the clinic phone line during opening hours. Out of hours, use NHS 111, or 999 in an emergency, and let your surgical team know afterwards. A suspected clot is diagnosed with an ultrasound scan of the leg or a scan of the lungs, and it is treated with anticoagulant (blood-thinning) medicine, so getting seen quickly makes a real difference.

How Common Are Blood Clots After Surgery?

Clots after cosmetic surgery are uncommon, but the risk varies a great deal by operation. The largest study on this, a 2017 analysis of 129,007 cosmetic surgery patients in the Aesthetic Surgery Journal ↗, found a confirmed clot within 30 days in 0.09% of patients, or roughly 1 in 1,100^[1]. The pattern inside that figure is what matters:

• Face and breast procedures each had a clot rate of about 0.01%, or around 1 in 10,000.
• Body procedures had a rate of 0.21%, and combined body and breast procedures 0.28%.
• Combined procedures overall had a clot rate of 0.20%, compared with 0.04% for single procedures.
• Body procedures, combined procedures, a higher body mass index (BMI) and older age were each independent risk factors.

Plastic surgery patients with more risk factors carry a much higher risk. In a multicentre study of 1,126 plastic and reconstructive surgery patients who were admitted after surgery and did not receive blood-thinning injections, 1.69% developed a clot overall, rising to about 1 in 9 (11.3%) among those with the highest risk scores^[3]. Those patients were often having larger or reconstructive operations, so the figures are not typical of a healthy person having a single cosmetic procedure, but they show how strongly personal risk factors add up.

How Long After Surgery Can You Get a Blood Clot?

Most clots happen in the first few weeks, but the risk does not end when you go home. A 2009 UK cohort study of nearly 950,000 middle-aged women in the BMJ ↗ found that the risk of being admitted with a clot was highest in the first six weeks after surgery and remained clearly raised from seven to twelve weeks^[2]. Over the 12 weeks after an operation, about 1 in 815 women having day-case surgery and 1 in 140 having inpatient surgery were admitted with a clot, compared with 1 in 6,200 women in a 12-week period without surgery.

That study covered all kinds of surgery, not just cosmetic procedures, but the timing lesson applies to everyone. In the plastic surgery study above, more than half the clots in the highest-risk patients were diagnosed between 15 and 60 days after surgery^[3]. So a painful, swollen calf or sudden breathlessness three, six or even ten weeks after your operation still needs urgent attention.

What Causes Blood Clots After Surgery?

Three things make blood more likely to clot, and surgery affects all of them:

• Slow blood flow. Lying still during the operation and moving less afterwards means the calf muscles are not squeezing blood back towards the heart.
• Blood that clots more easily. The body responds to any surgical wound by making the blood stickier for a while, which helps healing but raises clot risk.
• Changes in the veins. Operating on the trunk and limbs, and the swelling that follows, can affect the veins that drain the legs.

Who Is at Risk of DVT After Surgery?

Your risk of DVT after surgery depends on a mix of personal and surgical factors:

• A previous DVT or PE, or a close relative who has had one
• A known clotting disorder (thrombophilia)
• Taking oestrogen, including the combined contraceptive pill, hormone replacement therapy (HRT) or gender-affirming oestrogen
• Pregnancy or having given birth in the last few months
• A higher BMI and older age
• Longer operations and combined procedures
• Body surgery such as an abdominoplasty, body lift or extensive liposuction
• A long-haul flight or long car journey shortly before or after surgery
• Some medical conditions, such as active cancer, heart failure or inflammatory bowel disease

Plastic surgeons commonly use the Caprini score to add these factors up. The American Society of Plastic Surgeons’ venous thromboembolism task force recommends scoring every patient this way and matching prevention to the result^[4]. In the UK, NICE guidance on reducing clot risk in hospital ↗ also says every surgical patient should have their clot risk and bleeding risk assessed.

Can You Get a Blood Clot After a Tummy Tuck, Liposuction or Breast Surgery?

Yes, but how likely it is depends on the operation. Body surgery carries more clot risk than face or breast surgery, and combining procedures adds to it. Some useful figures from the research:

• Tummy tuck. A 2026 systematic review of 24 studies and 9,502 abdominoplasty patients found an overall clot rate of 0.3% to 0.5%^[7]. A separate pooled analysis of 1,596 abdominoplasty patients found 0.56%^[8]. In plain terms, roughly 1 in 200 to 1 in 330.
• Liposuction on its own. In 31,010 liposuction procedures, the confirmed clot rate for liposuction alone was 0.06%. When other operations were done at the same time, the risk of a confirmed clot was more than five times higher than for those operations done alone^[6].
• Breast surgery. A blood clot after breast surgery, including breast augmentation, is rare when the operation is done on its own, at about 1 in 10,000 in the large cosmetic study^[1].
• BBL. The main lung risk after a Brazilian butt lift is fat embolism rather than a blood clot, as our BBL death rate guide explains, although the usual clot precautions still apply.
• Combined operations. A mummy makeover joins a tummy tuck with breast surgery and sometimes liposuction, so it sits in the higher-risk group. The extra risk comes mainly from a longer operation and the body component, which is why careful planning matters.

Our guides to tummy tuck risks, liposuction risks and combining cosmetic surgery procedures cover the other complications of each. Some combinations are better staged as two operations, and that decision is made with your surgeon at consultation.

How to Prevent Blood Clots After Surgery

DVT prevention starts weeks before the operation and continues for several weeks after it. Most of it is simple, and much of it is in your hands.

Before surgery

• Tell your surgical team everything relevant: any previous clot, a family history of clots, a clotting disorder, recent pregnancy, recent long journeys and every medicine or hormone you take.
• Discuss the pill or HRT. NICE advises people to consider stopping oestrogen-containing contraceptive pills or HRT four weeks before planned surgery. Do not stop anything without advice, and arrange other contraception if you do. If you take gender-affirming oestrogen, our guide to hormone therapy before surgery explains how this is usually planned.
• Reach a stable, healthy weight where you can. A higher BMI is an independent clot risk factor^[1], and our guides to BMI and cosmetic surgery and losing weight before surgery can help.
• Stop smoking and vaping at least four weeks before and four weeks after surgery. Smoking mainly harms wound healing, as our guide to smoking and cosmetic surgery explains, and stopping makes recovery safer overall.
• Avoid a long-haul flight shortly before surgery, and do not book one for the first weeks afterwards.

On the day of surgery

Your surgical and anaesthetic team will use measures matched to your risk, which can include anti-embolism stockings, devices that gently squeeze the calves during the operation, and keeping the operation to a sensible length. Arrive well hydrated, following your fasting instructions, and wear the stockings you are given.

After surgery

• Get up and walk early. NICE advises encouraging people to move about as soon as possible after surgery. Most people are walking a few steps on the day of surgery or the next morning.
• Walk little and often. A short walk around your home every hour or two while you are awake does more than one long walk a day.
• Do ankle exercises when sitting or lying. Point your toes up towards you, then down, 10 times, and circle each ankle, several times an hour. These “ankle pumps” squeeze the calf veins.
• Drink plenty of fluids, mainly water, unless you have been told otherwise.
• Wear stockings or garments as instructed, and take any prescribed injections for the full course.
• Avoid long periods of sitting still, crossing your legs for long spells, and long journeys in the early weeks.
• Know the warning signs and act on them. NICE says everyone should be told the signs of DVT and PE when they leave hospital.

Good pain control helps you move. At Centre for Surgery, our post-operative pain audits show that combining TIVA with local anaesthetic keeps the need for strong opioid painkillers low, even after larger operations, which makes it easier to get up and walk soon after surgery. Our guide to reducing complications after plastic surgery covers the wider recovery plan.

How Long Should You Wear Compression Stockings After Surgery?

Anti-embolism stockings, often called TED stockings, are the white, graduated stockings that are tightest at the ankle. They support the veins and help blood flow out of the legs while you are less mobile. NICE advises that people who are given them wear them day and night until their mobility is no longer significantly reduced, and know when to stop wearing them. That is often the first week or two after a day-case procedure and longer after bigger body surgery, so follow the exact period your surgical team gives you.

They are different from the compression garments worn over the operated area after a tummy tuck or liposuction, which control swelling and support the tissues. You may be asked to wear both. A few practical points:

• Stockings should fit well, without rolling down or digging in, as a tight band can restrict blood flow.
• Check your skin each day, especially over the heels, for redness or sores.
• Stockings are not suitable for everyone, for example people with some types of circulation problems in the legs, which is part of your assessment.

Do You Need Blood-Thinning Injections After Surgery?

Blood-thinning injections, usually a low-molecular-weight heparin such as enoxaparin (Clexane) given once a day under the skin of the tummy or thigh, lower clot risk in people at higher risk. They also raise the risk of bleeding, and in cosmetic surgery a collection of blood under the skin (haematoma) can mean a return to theatre. So DVT prophylaxis with injections is a balance, decided for each person.

The evidence supports that individual approach:

• A 2017 meta-analysis of risk-scored surgical patients in the Annals of Surgery ↗ found that blood-thinning medicine significantly cut clots in patients with high Caprini scores (7 or more), but not in the three-quarters of patients with lower scores^[5].
• In the 2026 review of abdominoplasty, clot rates were 0.3% with routine blood thinners and 0.5% without, a difference that was not statistically significant, while haematomas were far more common with them (4.7% against 0.6%)^[7]. All the studies were retrospective, so the quality of evidence is limited.
• A 2021 pooled analysis of abdominoplasty patients found no clear difference in clots or bleeding with or without blood thinners, but noted that patients had not been risk-scored, which limits firm conclusions^[8].
• A review of 5,617 women having breast surgery found more bleeding with blood-thinning medicine and no significant fall in clots compared with mechanical measures alone^[9].

In practice, most people having a single, shorter cosmetic procedure with few risk factors rely on early walking and mechanical measures, while people with a higher personal risk, or having longer body surgery, may be prescribed injections for a set number of days. If you are given injections, complete the course and do not stop early because you feel well.

How Soon Can You Fly After Surgery?

Flying after surgery adds to clot risk, as you sit still for hours in a cramped seat. A cohort study of 8,755 employees of international organisations found about one clot for every 4,656 flights lasting four hours or more, with the risk highest in the first two weeks after the flight and back to normal by about eight weeks^[10]. The risk was higher in women taking oral contraceptives and in people who were overweight.

On top of the clot risk that surgery already brings, that adds up. Most surgeons advise against flying in the first couple of weeks, and longer before a long-haul flight, with the exact timing agreed with your surgeon. Our guide to travelling after cosmetic surgery gives procedure-by-procedure advice. It is also one of the main reasons that having surgery abroad and flying home a few days later carries extra risk. When you do travel, walk around regularly, do ankle exercises in your seat, drink water, avoid alcohol and sleeping tablets, and wear stockings if advised.

How Is Your Risk of DVT Assessed Before Surgery?

At Centre for Surgery, clot planning is part of preparing for surgery at our Baker Street hospital. In practice that means:

• A full medical history at consultation and at your pre-operative assessment, including clot history, hormones and travel plans
• Prevention matched to your personal risk, rather than one approach for everyone
• Advice on whether combined procedures are sensible for you, or whether staging is safer
• Anaesthesia with TIVA, sedation or local anaesthetic, which helps you wake comfortably and get moving
• Clear written aftercare instructions, including the warning signs of a clot and who to call

Our guides to preparing for cosmetic surgery and whether cosmetic surgery is safe cover the rest of the safety picture.

Frequently Asked Questions

References

1. Winocour J, Gupta V, Kaoutzanis C, et al. Venous thromboembolism in the cosmetic patient: analysis of 129,007 patients. Aesthet Surg J. 2017;37(3):337-349. doi:10.1093/asj/sjw173 ↗
2. Sweetland S, Green J, Liu B, et al. Duration and magnitude of the postoperative risk of venous thromboembolism in middle aged women: prospective cohort study. BMJ. 2009;339:b4583. doi:10.1136/bmj.b4583 ↗
3. Pannucci CJ, Bailey SH, Dreszer G, et al. Validation of the Caprini risk assessment model in plastic and reconstructive surgery patients. J Am Coll Surg. 2011;212(1):105-112. doi:10.1016/j.jamcollsurg.2010.08.018 ↗
4. Murphy RX, Alderman A, Gutowski K, et al. Evidence-based practices for thromboembolism prevention: summary of the ASPS Venous Thromboembolism Task Force Report. Plast Reconstr Surg. 2012;130(1):168e-175e. doi:10.1097/PRS.0b013e318254b4ee ↗
5. Pannucci CJ, Swistun L, MacDonald JK, et al. Individualized venous thromboembolism risk stratification using the 2005 Caprini score to identify the benefits and harms of chemoprophylaxis in surgical patients: a meta-analysis. Ann Surg. 2017;265(6):1094-1103. doi:10.1097/SLA.0000000000002126 ↗
6. Kaoutzanis C, Gupta V, Winocour J, et al. Cosmetic liposuction: preoperative risk factors, major complication rates, and safety of combined procedures. Aesthet Surg J. 2017;37(6):680-694. doi:10.1093/asj/sjw243 ↗
7. 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. doi:10.1097/SAP.0000000000004626 ↗
8. Perzia BM, Marquez J, Mellia JA, et al. Venous thromboembolism and bleeding events with chemoprophylaxis in abdominoplasty: a systematic review and pooled analysis of 1596 patients. Aesthet Surg J. 2021;41(11):1279-1289. doi:10.1093/asj/sjab090 ↗
9. Klifto KM, Gurno CF, Major M, et al. Pre-, intra-, and/or postoperative arterial and venous thromboembolism prophylaxis for breast surgery: systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2020;73(1):1-18. doi:10.1016/j.bjps.2019.09.038 ↗
10. Kuipers S, Cannegieter SC, Middeldorp S, et al. The absolute risk of venous thrombosis after air travel: a cohort study of 8,755 employees of international organisations. PLoS Med. 2007;4(9):e290. doi:10.1371/journal.pmed.0040290 ↗

Talk to a Surgeon About Your Surgery Safety Plan

If you are planning surgery and want to understand your own clot risk, you can book a consultation at our Baker Street clinic by calling 020 7993 4849 or using the form below. A patient coordinator will be your point of contact throughout.