Recurring Hematoma 2 Weeks After Tummy Tuck

Question

i had a tummy tuck 12 days ago, drains was taken out 7 days post op, 2 days later, fluid started to build up, on day 10, it became extremely uncomfortable and the drain site started to ooze lots of blood..approx 500ml oozed out. this gave me some relief, now 2 days later, its starting to swell again, i can see that its a hematoma accumulating again.. approx 150ml already, whats the best way to treat this, aspiration or surgical intervention to identify the source of the bleed?

S. Larry Schlesinger, MD, FACS · Answer

Rarely would one expect a bleed 9 days after a tummy tuck, and 2 days after the drain was removed.  More than likely, you had a collection of blood which lysed (dissolved) giving you usually old coffee-grind-like material which is a dissolving blood clot.  Your second occurrence of a swelling which appears to be the same material is actually a second round of lysis of the old clot.  This process may go on for awhile, and unfortunately, it may lead to a seroma cavity (once the old blood is removed, the pocket in which it was held then starts producing a clear liquid and the swelling changes from a dissolving hematoma to a seroma).  

	Recurrent drainage of this type of lysing blood clot is rarely sufficient.  A percutaneous (through the skin) in office draining system such as a Seromacath can drain the dissolving hematoma and help shut the cavity.  Obviously, this requires a plastic surgeon's intervention.  Please contact your plastic surgeon as soon as possible.  It is not clear if you are draining the lysed hematoma by yourself or if there is a physician involved.  At any rate, recurrent draining increases your chance of infection which can then decrease the aesthetic results of a good tummy tuck.

Vivek Bansal, MD · Answer

Talk to your surgeon about the cause of the bleed.  This is not common and very unlikely.  Be certain to keep your activity intensity at a low level.

Jeffrey Zwiren, MD · Answer

If you are continuing to ooze blood then your surgeon may have not choice but to reoperate.  This could have occurred if you were placed on a blood thinning agent after surgery.

Jourdan Gottlieb, MD · Answer

Hopefully  your have or will address this matter with your surgeon. As to possible treatments, they include

	
		aspiration, using a syringe and needle
	
		insertion of a drain, through the skin under local anesthesia
	
		open surgical drainage.


	Usually one of the first two options will suffice. Do see your surgeon. Thanks for the question, best wishes.

Hugh McLean, MD · Answer

This is not a problem you should ignore. You need to contact your surgeon urgently to determine the nature of the fluid, and that will determine what treatment you need to have. Don't delay getting hands-on evaluation of this problem!

Recurring Hematoma 2 Weeks After Tummy Tuck

Answers (5)