Persistent Hematomas After Tummy Tuck and Lipo

Question

How common are persistent (2 months) abdominal hematomas after tummy tuck with liposuction, and how do they affect recovery in terms of swelling and appearance?

Otto Joseph Placik, MD · Answer

It is very unusual to have a hematoma 2 months after a tummy tuck. Once they are evacuated,. it is generally rare for it to recur.

Martin Jugenburg, MD · Answer

It takes about 3 months to really see the final results of your surgery, and if you did have a hematoma it can take a little longer for your body to fully resorb the blood clot and all the associated swelling.  Massage can help in the mean time.  At 2 months after surgery, I would reassure you that you are still healing and need to be patient,  it will resolve.

	Sincerely,

	Martin Jugenburg, MD

Lohith Bose, MD · Answer

What you think is a hematoma is most likely a seroma.  Seromas can be drained percutaneously in the office.  You may have to do it several times before it resolves.  If it's still persistent, you will have to surgically have the seroma capsule excised.

Mokhtar Asaadi, MD, FACS · Answer

Thank you for your question. You have to be sure that you are not taking medications that cause hematoma formation. Usually you develop Seroma rather than hematoma. In that case, I always recommend a medication called "Tranxemic" acid pills for patients with bleeding, but that should be prescribed by your physician.

Pablo Prichard, MD · Answer

Thank you for your post.  Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak.  The whole point of drains is to keep a seroma from happening in the first place.  If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent.  If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening.  If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat.  An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel.  Occasionally, a seroma can also become infected, especially if a permanent braided suture was used.  This will have a hot, red appearance, and will eventually open up.  I have never seen an infection from sterile aspiration of fluid.  If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma.  Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.Best wishes,Pablo Prichard, MD

Kamran Khoobehi, MD · Answer

Did you have the hematoma evacuated?  You should see the final result of the tummy tuck and lipo after 3 months. If your hematoma still not resolved after  2 months,you need surgical evacuation.

Adrian Richards, MBBS, MSc · Answer

Thank you for your enquiry, I'm not quite sure what you mean by abdominal hematomas after a tummy tuck with liposuction.

	Hematomas are collections of blood which can occur in the tissue above the muscles or within the abdominal muscles.

	In either case they normally would have disappeared within two months of surgery and in most cases.

	Generally, you will still have some swelling at this stage but I would expect to settle over the next couple of months and this is only really this time that you can assess your final result of surgery once the swelling has settled.

	I think it would be best to wait until this time before considering any further treatment to these areas.

Steven Wallach, MD · Answer

I am not sure of the question because I do not know the outcome. DId you have your hematoma evacuated surgically, was it actually a seroma instead? An evacuated hematoma should not impact your final result if it was removed early on.

Persistent Hematomas After Tummy Tuck and Lipo

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