How should a Hematoma be treated 4 weeks Post-op? (photos)

Question

I had a mommy makeover on 2/19/2016 and immediately noticed the swelling in one area. I mentioned it two weeks post-op appt, and she said we would watch it. Today at my appt. I am 4 1/2 weeks into my recovery, and she tried to drain the fluid, but only blood came out. She said it was a Hematoma and I would need to be seen in two more weeks to see if my body would absorb it. Does this sound like the right treatment for a Hematoma?

Rigo J. Mendoza, MD · Answer

Thank you for your question and pictures.  That is pretty much what I do. The hematoma takes several weeks to liquidfy.  As it does, it can be absorbed by the body or your doctor can drain it with a needle. initially, it is solid or too thick to go through the needle, that why she suggested returning in a couple of weeks.

Nelson Castillo, MD · Answer

Thank you for your question and I am sorry to hear of your hematoma issue.  It sounds as if your surgeon is treating you appropriately.  Small hematomas have the ability to resolve spontaneously while large, growing hematomas need to be surgically washed-out and any continuing bleeding controlled.  Those hematomas that are found on examination that are not growing in size can be drained but usually over a 2 week delay as the body will liquefy the blood allowing for removal - before this it may have congealed too much that it can not be drained by a needle and syringe.  Hope this helps.

Gregory Mesna, MD, FACS · Answer

This sounds like a very reasonable approach to take. A hematoma is a collection of blood so the fact that blood is all that came out (especially if it was dark blood) is a good sign that a hematoma is what you are dealing with. Time will help decide whether or not your body will absorb the fluid or if your doctor may want to remove some more with a needle. Time and patience are a virtue so keep in touch with your doctor and she should be able to get you through this.

Daniel Krochmal, MD, FACS · Answer

Thank you very much for your question.An attempt at draining this far out is reasonable, as much of the blood clot has probably liquified.  Waiting a couple weeks is fine, as your body will probably reabsorb much of it.  Best of luck!

Scott Thellman, MD · Answer

I would agree that your doctor is using a wise approach.  Hematomas tend to break down and liquify with time which allows the body to reabsorb them or permit removal with a needle.  I doubt surgical removal will be necessary.

How should a Hematoma be treated 4 weeks Post-op? (photos)

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