Can Post-op Bleeding Occur from Use of Advil?

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.

Hello beaches2961 in Dover, DE. Thank you for your question regarding the recent bleeding you've experienced at your tummy tuck scar site and the potential role of Advil in this situation.

It's not uncommon to have some minor issues with scar healing within the first few months after a tummy tuck. However, the bleeding you describe, particularly if it seems to be increasing, deserves attention.

Role of Advil (Ibuprofen) in Bleeding:
Advil, which is a brand of ibuprofen, belongs to a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). One of the known effects of NSAIDs is their tendency to thin the blood, which can increase the risk of bleeding. This is particularly relevant in the postoperative period, as it can exacerbate any bleeding tendencies at the surgical site.

Regarding the Use of Epi-Derm Scar Sheets:
The scar sheets you are using are generally beneficial for scar management, but if removing them causes trauma to the scar site, it may be wise to pause their use temporarily. The adhesive on the strips might be pulling at the delicate new tissue, contributing to the bleeding.

Steps to Take:

Consult Your Surgeon: It’s crucial to report this increased bleeding to your plastic surgeon. They can assess whether the bleeding is within normal post-operative expectations or if it indicates a complication such as an infection or an issue with internal stitches.

Modify Pain Management: Discuss alternative pain management strategies with your surgeon. They may recommend switching from Advil to another pain reliever that does not have the same blood-thinning effects, such as acetaminophen (Tylenol).

Care for the Scar: Based on your surgeon’s advice, you might need to modify how you apply and remove the scar sheets to avoid further irritation or use a different type of wound dressing that does not adhere as strongly to the scar area.

Monitor the Scar: Keep an eye on the scar for other signs of complications, such as increased redness, warmth, swelling, or discharge, which could indicate an infection.

It’s important to follow up closely with your healthcare provider to ensure proper healing and manage any complications early. Stopping the use of Advil and temporarily ceasing the application of scar strips might be necessary until you speak with your plastic surgeon.

I hope this guidance helps you address the bleeding issue effectively and that your recovery smooths out moving forward.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Advil, Motrin, Aleve, Ibuprofen, and Aspirin can all
potentially cause bleeding in the perioperative period. When patients are six weeks post-op, other
causes are more likely.The
post-operative bleeding that you’ve experienced is more likely related to your
wound strips.The removal of these
strips can sometimes peel away immature epithelium and expose suture
abscesses.Both situation can result in
bleeding.

There are several classes of blood thinners that should be avoided before and immediately after surgery. These include:

Aspirin
Ibuprofen
NSAIDS
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.

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!

Stitches are foreign bodies that your body tries to get rid of by absorbing them or raising them to the surface. This is similar to what happens when you get a splinter that works its way to the surface of your skin.
Given the timing (6 weeks) it is likely that your body is in the process of absorbing your sutures which are usually gone completely by 3 months. Sometimes the stitches don't get completely absorbed and the partially decayed suture opens up on the surface of your skin causing the bleeding you are observing.
Although the Advil is not causing the bleeding, it can make it a little more difficult to stop once it occurs which it will. This is similar to nicking your face or legs while shaving on Advil. The bleeding may be slightly prolonged.
One exception to this is the use of permanent sutures, they can pop up on the surface many years later.
I have also recommended that patients who use silicone skin strips to stop for a week or two to let the skin dry and thicken. Occasionally when skin is kept moist under the strip it becomes fragile and easily breaks down causing bleeding with the slightest of trauma.
Hope this helps!

Hi there
I agree--you're too far out from your surgery for it to be likely that the Advil caused your problem. It's much more likely that you have a suture that hasn't dissolved or some other (usually minor) healing problem. The important thing is to notify your surgeon and go in for an evaluation to be sure that nothing needs to be done, and get his/her recommendations on what to do, given their better understanding of how your surgery was performed.

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.

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.

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.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below: