Blood Under Skin After Tummy Tuck

Question

i had a full tummy tuck almost 3 weeks ago a im still swelling on my upper muscle i went to get my linphatic massage and when the girl massage my upper muscle she can see blood under my skin and hert me a lot. is this normal?

Joseph Mele, MD · Answer

Dear Kissimmee:

	If you have questions about your specific surgery, you should call your plastic surgeon. Asking in this kind of forum is great for general information, but specific advice requires specific information. Swelling is common after a tummy tuck, and will take months to resolve. If the massage is hurting, you may want to wait until it doesn't hurt, and you should contact your plastic surgeon to be certain that there is not a problem. That is part of our job, so your plastic surgeon should be willing and able to provide you assistance if there is a problem, and peace of mind if everything is ok.

	Fluid collections, usually serum, are not unusual under the skin at three weeks after a tummy tuck. This is why drains are left in place after the surgery. Serum is the liquid part of the blood. Serum is clear, like the fluid found in a blister, but can be blood tinged after surgery. These types of fluid collections are normally found in the lower abdomen, not in the upper part. If small they can be ignored. If large and uncomfortable they can be drained. Frequently they recur until the abdomen has healed sufficiently.

	Whole blood under the skin is not common at three weeks. This is a sign of frank bleeding, and may require additional care. It usually presents as increasing pain and a fluid collection under the skin, and is most common within a few days of surgery. Since skin is opaque, the only blood you can see, is seen as a bruise.

	With any plastic surgery procedure, if you have specific questions about your surgery, or how to take care of yourself, your board certified plastic surgeon is your best resource. They know you. They know the surgery, and they are best informed to take care of you.

Hayley Brown, MD, FACS · Answer

It you have blood or a fluid collection under your skin 3 weeks after abdominoplasty, it needs to be evaluated and potentially treated by your plastic surgeon. I would not recommend or continue lymphatic massage so soon after surgery.

Otto Joseph Placik, MD · Answer

It is normal for a small amount of blood to collect under the skin after a tummy tuck. If it is an excessive amount it can cause problems and is called a hematoma and may need to be drained.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Blood beneath your skin may represent a bruise or a hematoma.  It is hard to say without a picture.  It is best to visit with your PS for an exam.  Sooner rather than later.

	Dr. ES

Carmen Kavali, MD · Answer

Close follow up with your own surgeon is critical. Blood under the skin may be just a bruise, or it could be something that your surgeon actually needs to treat. Please contact your surgeon ASAP to be evaluated.

Peter A. Aldea, MD · Answer

Regarding: "Blood Under Skin After Tummy Tuck
	i had a full tummy tuck almost 3 weeks ago a im still swelling on my upper muscle i went to get my linphatic massage and when the girl massage my upper muscle she can see blood under my skin and hert me a lot. is this normal?"

	I completely agree with Dr. Beraka's comment. Unless you had a complication, you should not be having "blood under the skin" at three weeks after a Tummy Tuck and if such a complication existed it should not be diagnosed, much less treated, by a massage therapist. You have a Plastic surgeon.  Unless you decided to no longer see your Plastic surgeon (not a wise idea), he/she should be involved and supervise your post-operative care.

	Dr. Peter Aldea

Amy K. Alderman, MD, FACS, MPH · Answer

I would recommend you check with your surgeon that performed your tummy tuck. While I am sure you have some post op swelling and increased blood flow (helps heals wounds-incision), dependant on the type of tummy tuck procedure performed and your body type this may be part of your recuperation. As always, check with the surgeon that performed the surgeon as he/she will advise you what is normal in your case in particular. Keep Healing and taking it easy!

George J. Beraka, MD (retired) · Answer

Where is your plastic surgeon?  Something certainly seems to be wrong, and you should see him or her right away.

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