Should Anything Be Done for a Large Hematoma After Abdominal Lipo and Mini Tummy Tuck Procedure? (photo)

  If the hematoma is clinically significant and can be drained, it is usually prudent to do so.  Without the benefit of an exam, I would not be able to advise any more clearly than that.  Your doctor may have felt that this was a diffuse bruise that could not be effectively drained, but this is speculation.  Kenneth Hughes, MD Los Angeles, CA

No one can speak for your surgeon.  If there truly was a significant hematoma then removal of the drain is questionable. Why he did not aspirate is questionable.  If significant then this could get infected.  Many reasons to the cause but it is all in the recognition and treatment where additional problems can be avoided.

Dr. ES

The photograph demonstrates a lot of bruising it is not conclusive for the presence of hematoma. In general and less there is a contraindication to do so hematomas should be drained.

Something does not sound right. If you have/had a "large hematoma" than I doubt any PS would remove the drainage system. In fact you are correct in wondering why no aspirator treatment was not done. Best to return to your chosen PS (was the surgeon a PS?) for care or find another boarded PS in DFW to render appropriate post operative treatment. This could mean a re operation/exploratory to remove the "large hematoma"! 

If you have a large hematoma, then it is best to remove it with an open procedure and clean the pocket.  If it is small it may resolve on its own.  Best to follow closely with your surgeon.

In general, large hematomas are drained with an open procedure.  Smaller ones can usually be managed with less aggressive methods like needle aspiration or tincture of time.  Difficult to say from your post op photos. 

Bruises cannot be drained and should resolve over time.  True hematomas will eventually liquify. Since you still have a drain in place, I would NOT remove it and see if drainage of dark fluid increases demonstrating some decompression of the hematoma spontaneously.   Best to stay in close contact with your plastic surgeon for followup with this problem.

"Hematoma" means "collection of blood" and it occurs, to some extent, after nearly every surgical procedure.  The question is how significant it is; and that's a combination of how big it is and what the procedure is (a small hematoma around a breast implant is more of a concern than a larger hematoma after a mini-tummy tuck).  In your case, you'll need your PS to distinguish how significant it is and, of course, to make sure it's not ongoing (expanding).  Assuming it's stable it can be treated by letting it resorb on its own or inserting a drain, whether now or as it starts to liquify, which should be about now.  Either way, you'll need to be under the care of your PS.  If there are any concerns with this, seek a second opinion.

I hope that this helps and good luck,

Dr. E