I'm almost 6 weeks post-Tummy Tuck. I had a spot on the scar that was healed, but 2 days ago, it started bleeding a little when I removed the Epi-Derm Scar Sheet strip. Prior to this, my doctor had recommended just placing a band aid over any spots that were not healed and continue using the strips, so that is what I did. When I took the strip off again tonight, it was bleeding a lot, and a portion of remaining scar looked like there was blood close to the surface. I've been taking Advil the past couple of days because of the discomfort and tightness. Could Advil have caused this bleeding? Should I also stop using the scar strips?
Can Post-op Bleeding Occur from Use of Advil?
Doctor Answers (18)
Advil probably not the cause of post-op bleeding
Generally, we tell our patients to avoid aspirin or aspirin-containing products, such as Excedrin, for at least 10 days prior to surgical procedure. Other NSAIDs, such as Advil, Motrin, Ibuprofen, and Naproxen, are less dangerous, although these also can be associated with excessive bruising and bleeding.
Therefore, unless there is reason to rush to surgery, we would like patients to stay away from these for at least one week. They can restart Advil 24 hrs after surgery. The bleeding you experienced is probably associated with splitting sutures that need to be removed.
Postoperative bleeding from Advil in a tummy tuck
Tummy tucks are a popular and effective way to contour the abdomen. After any such surgery, your surgeon should provide you with the list of medications that you should avoid. In our practice, we recommend that patients use Tylenol for mild to moderate pain. Although you used Advil, it is unlikely that this cause excessive bleeding. Your skin change is most likely from a mild trauma or found a small amount of blood that worked its way to the surface of the skin. During your healing process, be sure you avoid aspirin and aspirin containing medications. If this discoloration does not go away in a few days, return to your plastic surgeon and notify him or her of your concerns.
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Advil not likely the cause of the bleeding
Bleeding at this stage in the recuperation is more likely related to the scar strips. But it will go away on its own as time progresses.
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At 6 weeks, your skin should be healed, no breaks in it at all. Not uncommonly however, sutures that should dissolve, can become infected or irritated and work theselves to the surface causing "stitch abcesses".
If a stitch abcess forms, it can drain with fluid that has some blood, some pus, some tissue fluid. Another possible cause is a seroma, which is tissue fluid with a little bit of blood.
In any event, your wound is not healing normally. Don't panic, but you should see your doctor. Most of the time, the problems are easily solved without much fuss, but you don't want to sit on an easy problem until it becomes a big one. Your surgeon should be glad you called.
Advil not the culprit
Advil is probably not the culprit. Advil inhibits platelet function, but should only be an issue immediately before or after the surgery.
More likely is a suture "spitting"; a quick visit to your doctor should sort that out. Usually the errant stitch is removed and that solves the problem.
Bleeding from incision
I concur. The bleeding is probably due to trauma from removal of the streri-strip. Allow it to heal without further taping. Be patient and it should heal well. If not, see your plastic surgeon.
Blood thinners, Advil, Ibuprofen, Aspirin, and Motrin before surgery: Not a good idea
There are several classes of blood thinners that should be avoided before and immediately after surgery. These include:
- Coumadin, Plavix
These medications are not immediately metabolized in the body, so that they may last up to one month after you take them. It is advisable that you do not take blood thinners as listed above one month before surgery but this should be individualized by your physician himself. Our office in Santa Monica routinely gives a list of over 200 medications that cannot be taken before surgery. Check to see if your surgeon has a similar list.
A combination of factors
From your description is sounds like there was either a small separation at the incision or you are having a small reaction to the sutures. Either way that area of your body is undergoing some inflammatory changes. This can cause a temporary increase in circulation and delicacy of the tissue.
When you removed the dressing some of the superficial blood vessels bled. Advil may be contributing to how long it takes those small vessels to stop but typically at 6 weeks Advil should not cause significant post-operative problems in normal patients with straight-forward post-op courses.
I hope this helps!
You sounds like a suture is "spitting" out
You are right at the point postop when dissolvable sutures can sometimes "spit" out the incision. These can look like a pimple and can bleed a bit also. The Advil didn't cause the bleeding but might have made it a little bit worse. The suture issue will either resolve as the material comes out or is removed by your doctor.
Ibuprofen should be ok at 6 weeks
Many plastic surgeons advise against the use of anticoagulant medications such as aspirin and ibuprofen (Advil) before and after surgery so as to minimize the risk of bleeding complications. However, by a week or two after surgery, it is not usually a problem. It sounds like you have some healing issues but I wouldn't balme the medications.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.