I had a hematoma removed 2 days ago and it looks like swelling is coming back again on same side. What can be done?

Based on your user name, I assume you are a male patient who underwent rhytidectomy.  It is well known that male patients have higher rate of hematoma following rhytidectomy for several reasons.  Likely the most pertinent reason is that male patients have facial hair follicle with rich vascular supply compared to females.As many of us have recommended, hematoma after rhytidectomy should be evaluated urgently by the surgeon. It is not uncommon for hematoma to reaccumulate (to be more precise, I feel that re-accumulation tends to be seroma more than hematoma).  Seroma can be drained simply with syringe in the clinic, however if it continues to re-accumulate, your surgeon may consider placing a small drain as it can take a few sessions of drainage in the worst case.In most case, this is just a detour and should not affect the overall outcome.  But you should be followed more closely first to ensure there is no further re-accumulation and second, post-seroma can result in fibrosis which should be treated timely with steroid injection.  

Recurrence of a hematoma after evacuation falling the facelift is extremely uncommon. More likely there may be a collection of serum occupying the space where the hematoma was previously. This will require drainage as well.

You should see your doctor immediately.  If you're bleeding again you might need to return to the operating room to fix the problem.

Thank you for your question.  Since you had an evacuation already and you are concerned it is coming back, I would recommend seeing your plastic surgeon.  They may likely want to see you sooner to make sure the fluid is not reforming.  All the best,

While it is uncommon for hematoma to reaccumulate, it is not impossible. After a complication like this, you should be in close contact with your plastic surgeon. You cannot take any chances that the hematoma is reaccumulating. You must contact your plastic surgeon immediately to get his/her advice on being seen sooner rather than later. Don't wait this one out for another two days.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Hematoma after facelift- although uncommon- can occur. Without pre-op photos and sequential photos of the area- it is difficult to comment. However, generally speaking hematoma evaluation and treatment is best performed by the Operating Surgeon. I suggest you take it up with him/her as soon as possible.

Any surgical procedure has risk including the risk of hematoma formation. Swelling post hematoma drainage could happen.Patients concerned about developing swelling after hematoma drainage (post facelift) should ask the surgeon that performed the plastic surgery procedure (facelift) what to do to prevent/improve that developing symptoms. Nobody better than him/her will know better that do do since he/she was the one that did the operation and very likely the hematoma drainage too

In my opinion, you should contact your surgeon for advice. Additionally, it is probably best to be seen by your surgeon as well so that if additional treatment is needed then it can be performed immediately. Best wishes.

 Thank you for your question and for sharing your experience with concerns with us. Ultimately a physical exam would be needed to assess whether your hematoma has recurred and whether any intervention is needed. It is very common for the hematoma side to develop additional swelling, as some of the bleeding may have gone into the tissues, and therefore attract more water.   If the swelling is rapidly growing, then I would visit with your plastic surgeon sooner than two days. If it is fairly stable, then waiting until your visit should be adequate.  Hope this helps.

Your best step is to advise your surgeon ASAP.  It could be swelling or another collection of fluid/haematoma that requires further drainage.  You need an in person review with your surgeon to determine what is occurring.