My PS tried to aspirate, but when he pressed on my tummy, dark red blood came out of the needle hole. Is this a seroma? (Photo)

Question

I had a tummy tuck with muscle repair on November 13. I did not have lipo. My drain was removed on day 7. I have been swollen on the right side since day 2. Should I worry that after draining, the right side was swollen 3 hours later? Would you call this a hematoma or seroma?

Gary Lawton, MD, FACS · Answer

If after the drainage procedure you reaccelerated the fluid within three hours, then a more definitive procedure may be required than in-office aspiration.  Dark blood indicates that this is an old hematoma.  If clear straw colored fluid is removed this is a seroma.

Vincent N. Zubowicz, MD · Answer

Dark red drainage is probably a hematoma that is starting to break up. It is important that it is drained so as to prevent prolong convalescence and more scarring.

Elias G. Gikas, MD · Answer

From your description and photos, it appears that the dark red blood is from a liquified hematoma.  Sometimes when these form after surgery they clog up the drains and don't come out.  At this stage, the hematoma has started to liquify and should be easy to drain by serial aspiration or by placement of a small drain.  Your outcome should be good.  Discuss it with your surgeon as to which way to proceed.

Don W. Griffin, MD · Answer

Hematomas are initially too thick to aspirate with a needle. They will liquefy over time and can be aspirated later. Some can become infected and require opening the incision to evacuate. In almost all instances, this is a minor problem that is easily correctable and won't affect your long term results.

Erik Miles, MD, FACS · Answer

The dark red color indicates that there was an accumulation of blood (hematoma) in the surgical space below the skin. The dark red color means that it is likely old blood that is now "organizing," or collecting in one area. Sometimes the blood is initially clotted and difficult to aspirate with a needle. A brighter red color would indicate possible ongoing bleeding.  Your surgeon will monitor that area closely. Sometimes repeated aspiration is necessary. If properly manage, it should not cause you any long-term problems or affect your overall results.

Edwin C. Pound, III, MD · Answer

Seromas are usually straw colored.  Hematomas are like you described - dark red blood.  It is not uncommon to have either after a tummy tuck.  They usually resolve after draining them in the office like your doctor did.

Jourdan Gottlieb, MD · Answer

A seroma is a collection of serum, and a hematoma a collection of blood. Sometimes, it is both, and a small amount of blood will stain a seroma red. From your description, this sounds like a hematoma. Based only upon the photo, it looks like there is enough to consider placing a drain, which can be done in the office with local anesthesia.This should not compromise what looks like a nice result.  All the best.

Eric A. Weiss, MD, FACS · Answer

It sounds like you have a hematoma. Early on it is difficult to drain these as the blood is clotted. With time it will liquify and swell. At this time it will be easier to drain. You early results look good and this should not turn into any significant issue. I don't think a scan is indicated as it is obvious what it is and how to treat it.Eric Weiss MD

Darryl J. Blinski, MD · Answer

If bright red than recent hematoma. If dark red than old hematoma. If yellow to clear than seroma. Obtain a scn of area to see if fluid collections is seen...

My PS tried to aspirate, but when he pressed on my tummy, dark red blood came out of the needle hole. Is this a seroma? (Photo)

Answers (9)

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