Hypotension and other complications after tummy tuck (photo)

Complications after a tummy tuck. What do you think might have happened? I'm a nurse & also the patient.

I had a tummy tuck & breast augmentation. I was in the OR 5 & 1/2 hours. I reviewed 5 lt of fluid bc I was very hypotensive. Minimal blood loss during surgery. After recovery I was d/ced home. Approx 3 hours after being d/ced I was I. The ER I had had a syncopal episode & Bp was 60's/ 40's . Labs were drawn hemoglobin was 7.2 I was swollen & 3rd spacing. I received a total of 4 units of blood bf my hemoglobin stabilized to 10.4 What do you think caused all of this?

Doctor Answers 4

Hypotension post tummy tuck

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it is obvious from oyur labs and your post op hemoglobin that you lost quite a bit of blood.I would ask your surtgeon why htis happened.It is unusual to lose this much blood.Hope you like liver and onions.

Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Blood loss after surgery

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Thanks for the question.  I am sure your operating surgeon has discussed this with you since the surgery, and I would imagine the conversation mentioned the possibility that you were very anemic after the surgery, thus causing hypotension and a syncopal episode.  The diagnosis seems accurate, and the treatment very appropriate( blood replacement with transfusions)..I don't believe that you necessarily would have needed to be admitted to a hospital after  five and a half hours, provided you were stable and had little suspicion for bleeding from the surgery, but you clearly did the right thing by following up with the ER for evaluation later that first night, with subsequent admission and blood transfusion.

I would assume you are doing better at this time.

Good luck to you.  The photo seems to indicate that you will have a nice result from the surgery once you are fully healed.

Frank Rieger M.D.  Tampa Plastic Surgeon

Hypotension and other complications after tummy tuck

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First the results appear good. Second - obviously the surgeon and his staff DID NOT calcuate your blood loss correctly. Third -  that long of office surgery of 5+ hours needs an admission for observation in my over the internet opinion. All your symptoms and signs indicated large blood loss during surgery... 

Blood loss during abdominoplasty is minimal.

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If you required for units of blood to restore a normal hemoglobin than the amount of blood loss during surgery would have been significant. The dilution of the blood by IV fluids would not explain the situation you just described.

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