Background <p>The use of chemoprophylaxis in the prevention of venous thromboembolism in abdominoplasty patients is controversial. Although the use of anticoagulation is common in the perioperative period in the general surgical population, its use in aesthetic plastic surgery patients is questioned, especially in relation to the risk of postoperative bleeding.</p> Methods <p>The present systematic review and meta-analysis aim to evaluate the efficacy and safety of chemoprophylaxis in abdominoplasty patients. All studies comparing the outcomes in patients with or without chemoprophylaxis were included in the present study. The duration of chemoprophylaxis was classified according to the definitions used in the individual studies.</p> Results <p>Overall, chemoprophylaxis did not show a statistically significant reduction in the risk of VTE. Various studies reported bleeding complications, with some showing an increase in the incidence of hematomas in anticoagulated patients.</p> Conclusions <p>Overall, the evidence does not show a statistically significant reduction in the risk of VTE with the use of chemoprophylaxis. However, the low incidence of VTE, coupled with the heterogeneity of the studies, suggests that prospective studies are needed to determine the risk-benefit analysis of the use of anticoagulants in the prevention of VTE in abdominoplasty. </p> <p>Level of Evidence: not gradable.</p>