Abdominal Hematoma Scar Tissue Healing?

Question

I had a Tummy Tuck in February 2012. In April, a large hematoma formed in my abdomen. After having it drain over the course of a month or so, it is clear that there is internal scar tissue that presents itself as a "ridge". This scar tissue is creating an abnormal contour, as it is elevated, bulging almost. My surgeon recommended that I apply heat and massage to help it break down and heal. It has been almost 5 months and it doesn't seem to be improving. Will surgery be needed to address this?

Jeffrey E. Schreiber, MD, FACS · Answer

Scar tissue will continue to soften and improve over 12-18 months. However, if things have settled down after about 6-8 months and the healing has plateaued, you might want to consider scar revision. This is usually easier than a regular tummy tuck and can be done under local anesthesia a lot of times. Thanks for your question! Dr. Schreiber...Baltimore Plastic Surgeon

Stephen M. Chen, MD · Answer

This is a very interesting question.  Hematomas after they occur will congeal (clot) and after many weeks will then liquefy and either reabsorb or they will drain out of the incision.  When it is in the solid phase, external modalities as you have been instructed will help it to break up and liquefy.  At five months, all of this should be gone.  Occasionally, a hematoma can become encapsulated and remain as a ridge.  I have seen this occur in somebody who took a large spill and landed on her bottom against a stairwell.  I resected this mass and it was just an old organized hematoma.  You can have this evaluated by Ultrasound and if it is not solid, they may be able to drain it.  Unfortunately, if this is the case, they often reaccumulate with fluid.  You need to go back to your surgeon to have this evaluated.

	 

	Where is this bulge located?  Is it in the midline, off to the side above the incision line, or is it on the incision line?  Bulges in these areas have different explanations, all of which your surgeon can address.  Please keep us posted of  your progress.

Robert L. Kraft, MD, FACS · Answer

The thickened scarred area may resolve gradually over the course of a year.  If it does not, a scar revision should be considered.  Continue to follow up with your plastic surgeon.

Jourdan Gottlieb, MD · Answer

If this has not changed in five months, a surgical approach is most likely going to be needed to resolve this for you. If it is small sometimes these can improve with kenalog or ultrasound, but this seems to be a larger amount of scar tissue. Discuss with your surgeon.

	Best wishes

Abdominal Hematoma Scar Tissue Healing?

Answers (4)