Last week, the Washington Post had an article describing new research about sitting. Who knew that sitting can be deadly. It turns out that people who sit for more than three hours a day have an 18% greater risk of premature death, as well as increased incidences of diabetes, hypertension and obesity. Famous examples of people who stand to work, including the previous Secretary of Defense, Donald Rumsfeld, were mentioned.

I have been telling my patients for some time to always stand to answer the phone as it burns up more calories. It’s just a way of making people lose more weight. However, I was not aware of this new research.
For years I have also told my cosmetic surgery and abdominoplasty (tummy tuck) patients in particular not to sit after surgery. They are encouraged to walk or stand, and if they get tired to lie down—but not to sit.

One of the greatest risks of an abdominoplasty is the risk of thromboembolism in the leg veins (blood clots). These clots occur naturally in the legs during surgery due to the decrease in the muscle movements of the legs as a result of anesthesia. The blood stagnates in the vessels of the legs and then readily clots. Of course, as in all other situations to do with the body, there are external factors that influence this process. Aspirin, for example, decreases the rate of clotting and in fact makes you bleed during surgery! Cancer patients, on the other hand, often have a higher rate of blood clots. The clots form while the patient is immobilized, and when the patient wakes up and starts to move around, the clot dislodges from its attachment within the blood vessel and travels to the heart and lungs, causing problems—sometimes fatal ones. That alone is a good reason to find a surgeon who is efficient in his/her surgery and can minimize your time in the operating room to decrease your risk of thromboembolism. Surgeons should take other precautions to decrease your risk of clots as well, but using automatic pneumatic leg massagers and, in some cases, giving injections of Heparin before surgery can thin your blood.

In plastic surgery, due to the nature of the procedures I perform, and in tummy tucks in particular, Heparin cannot be used. I do use leg compressors on all patients and encourage early ambulation. For years I have not kept a patient in the hospital after this surgery and prefer to do all my tummy tucks as an outpatient procedure, forcing the patient to get up and go to the bathroom at home that night, just for this reason. Imagine: when I first started my practice nearly 20 years ago, I would keep my patients in the hospital, in bed, for five days after surgery. That was what the norm was then.

I also tell patients not to sit and explain this by using the analogy of a garden hose. Imagine your blood vessels are a garden hose. When you sit, the hose (blood vessels) develops kinks, first at the junction of your abdomen and your legs, and then at your knee. Two kinks that will diminish blood flow and lead to more blood clots. Also, sitting allows all the swelling of the abdomen to come down and get caught just above the pubic area, causing extra pain.

Walking and standing are good; sitting can be deadly—whether you have had a tummy tuck or not!

Washington DC, Northern Virginia, Maryland