Hematoma evacuation for gynecomastia surgery - likelihood from experience that another is needed?

Hello Jason,Thank you for your question.  Bruising is a very likely possibility no matter what procedure is done and since our bodies are so unique, bruising can occur on one side and not the other.   Typically, bruising lasts anywhere from 1-4 weeks, depending on the person. With regards to your hematoma- if the fluid is completely removed and you wear your binder religiously, that part should heal and you shouldn't need another surgery.  Hope this helps.All the best,Carlos Mata MD, MBA, FACSBoard-Certified Plastic Surgeon

Thank you for your question regarding hematoma evacuation surgery after gynecomastia surgery.  Unfortunately, hematomas can develop after any surgery.  Certainly, hematomas can develop after gynecomastia surgery. When there is bleeding, blood collects and forms a clot. The collection of blood is called a hematoma.  Hematoma surgery involves the removal this collection of blood. Typically, it involves going through the prior incision, the old blood collection is removed, and the pocket is washed out with sterile normal saline. Sometimes, antibiotics are used in the irrigation.  Sometimes, a drain is placed.  Hematoma evacuation surgery is highly successful.  The bruising from gynecomastia surgery and hematoma removal is like any other surgery. Bruising made take 10 to 14 days to resolve. Arnica may decrease your bruising time. However, please consult with your plastic surgeon before taking Arnica or any other medication. If you have any other questions regarding gynecomastia surgery, hematoma surgery, or recovery after gynecomastia surgery, please contact my office. Sincerely, Dr. Katzen.  

I am sorry to hear about your complication. Hematomas can occur and if a return to the OR is warranted, likely means that the amount of blood is significant. Unfortunately, finding the cause of the hematoma can be difficult. Whether it was a missed bleeding vessel or one not bleeding at the time, it is unlikely that an actively bleeding vessel will be found during your reoperation. Depending on the extent of the bleeding, the bruising may take some time to completely disappear. Arnica supplements may help. However, this process ultimately depends on how fast your body's immune system clears the bruising. 

In over 25 years I have had 3 hematomas after gynecomastia surgery. One was immediately after surgery so I returned to the operating room. the other two developed more than one week after surgery when the patients did too uch too soon. One of these was minor and one was medium. I treated both conservatively with repeated aspiration and thereafter vigorous massage. Both patients ended up having smooth results. There are obviously several ways to treat this. Good luck.

Thank you for sharing your question and I am sorry to hear of your hematoma.  Because hematomas often are thick immediately after formation it is difficult to remove by needle and syringe alone.  Oftentimes it takes 10-14 days to liquefy sufficiently for removal.  Your bruising will worsen based on the amount of blood already present but should quickly improve with time.  Hang in there.

While, yes, you can certainly expect some more bruising following the removal of your hematoma, the good news is that the hematoma, if removed properly, should not return. Sorry that you are experiencing this but hang tough. This may add a couple of weeks to your recovery, but you will recover and look great.

It is very possible that you will experience more bruising on your right side due to the hematoma.   This is a healing set back, so treat with ice bags and wearing the compression garment for a nice recovery.  Your surgeon is your best resource for your questions .