How likely is hematoma to come back after being treated?

Question

I developed a hematoma 9 days after surgery, for no obvious reason at that. I'm very concerned that it will come back. I had the drainage and vessel closed up early Friday morning and an at work today which is Monday. While I'm trying to take it easy, my job requires me to sit and stand and move rom to room. Looking for any reassurance.

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

If you had the appropriate surgery for a hematoma and your surgeon was satisfied that there was no more bleeding.  You should be fine. Too much strenuous activity can reinstitute the bleeding. Please follow your surgeon's instructions carefully as well as keep you follow appointments.

William Albright, MD · Answer

Hello Gnaz8,
It sounds like the hematoma was appropriately reexplored operatively and the bleeding stopped.  In this setting it would be very unusual to recur.  If you have signs or symptoms similar to your previous episode, you should contact your plastic surgeon right away.  But otherwise, you should be good to go.  Good luck!
Dr. William Albright
ABPS board certified plastic surgeon

Mitchell F. Grasseschi, MD · Answer

It would be useful to know the type of
surgery and location of the hematoma. If
not evacuated small hematomas last about three months. Some can become chronic and need surgical
removal. If it was evacuated surgically
and the bleeding controlled, it would rarely come back later. Some fluid collections could be lymph rather
than blood and could be more complicated, again, it depends on the location to
determine this.

Steven Wallach, MD · Answer

The cause of your hematoma or treatment is not clear. Best to follow the instructions of your surgeon. Good luck.

Gustavo E. Galante, MD · Answer

It is not clear what procedure you had done from your post, but in general, if a hematoma is adequately evacuated and the source of bleeding stopped, it is unlikely another one will develop. This assumes there are no no underlying bleeding disorders and you are not taking medications that delay clotting such as aspirin or ibuprofin. Heavy activity or exertion should be avoided for 3 weeks after surgery.

Peter E. Johnson, MD · Answer

Once a hematoma is properly drained and the bleeding issue resolved very few will recur. Ask your doctor for a list of medications to avoid and get clear activity limits based on how you are doing in your recovery. Capsular contracture is a future concern as bleeding will increase the capsule rate.

Jason Mussman, MD · Answer

Thank you for the question.  As your surgeon probably mention, hematoma after 72 hours is unusual.  Make sure you have stopped all fish oil, asprin, ibuprofen, and other anticoagulants that your physician has deemed appropriate to stop.  Try not to do anything to raise your blood pressure or cardiac output like straining or vigorous exercise.  If your physician was able to stop a specific bleed, it is possible that this was just an unusual occurence.  Best of luck.--Dr. Mussman

Scott R. Brundage, MD · Answer

Bleeding after a breast augmentation is an uncommon occurance but it can happen. Once a hematoma has been drained and any bleeding controlled it is highly unusual to bleed again if you have normal clotting, which I am sure you do. I would not worry. As rare as it is, I have not seen a second bleed after a hematoma evacuation in over 28 years of practice.

Jourdan Gottlieb, MD · Answer

Sorry to read about your course. At nine days, this is a bit unusual. It is not uncommon to not find an obvious cause. Often, you don't even identify the bleeding vessel during surgery to deal with the clot. Avoid lifting anything over 10 pounds, avoid medicines that interfere with blood clotting ( aspirin, NSAID's like motrin, and others)  Tylenol is ok.  For other meds check with your surgeon. Can this recur? Yes.  Is it likely? No. Chances are this is an isolated event. But if you have had problems with abnormal bleeding, or if a family member has such a problem, you should discuss this with your primiary doctor.All the best.

Erika Sato, MD, FACS · Answer

There are a few things that contribute to developing a hematoma after surgery. - bleeding disorder- medications that cause bleeding such as aspirin or ibuprofen or even alcohol consumption- trauma or over-activity- significant increase in blood pressureMake sure you speak with your plastic surgeon and follow all of his/her recommendations very closely.

How likely is hematoma to come back after being treated?

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