Hospitalized to treat infection after heavy bleeding at 6 days post op. CT scan revealed hematoma measures 15cm. PS was only able to drained 100cc after reopening 4inc of incision and then closing it up. I am waiting to resolve on its own. Is this realistic given the size of it? I had already seen another PS for 2nd opinion, however he says that at this point only time will tell and bleed should have taken care right when it happened. What are my options? lymphatic massages? my back is in pain!
TT, BA and Lipo- Hematoma Complication? (photo)
Doctor Answers 6
Hematoma after TT
Hematoma formation following abdominoplasty surgery can occur for a variety of reasons, but is fortunately rare. When post-operative hematomas are small, they often resolve spontaneously. Larger hematomas often require treatment to avoid secondary complications. Treatment may require repetitive needle aspirations, CT guided drain placement or occasionally open surgical drainage.
When large hematomas aren’t evacuated there’s an increased potential for wound breakdown, infection and scarring. These problems can ultimately impact the aesthetic results from abdominoplasty surgery.
Since your abdominal hematoma had a diameter of 15 cm treatment was definitely indicated. Under these circumstances, your overall healing may be slightly slowed, but with appropriate care you should still reach the same end point. It’s important that you maintain close contact with your plastic surgeon. Your surgeon should be able to monitor your progress and give you appropriate direction.
Mommy Makeover Complication
Thank you for the question. It sounds as if your surgeon appropriately drained your hematoma. I am skeptical that your surgeon would have closed your wound while you were actively bleeding. It is not uncommon that small vessels will constrict (clamp down) when cut. This can be tight enough that vessel does not bleed during the operation so they go unseen by the surgeon. Once in the recovery room or even later as the patient's level of circulating adrenaline goes down and they begin to warm up, the free edge of the blood vessel will open up and bleed forming a hematoma.
He was most likely not able to completely drain it at that time as the blood had solidified and therefore not completely amenable to drainage. Also the blood can dissect into the tissues which means that you can not remove it without removing or damaging the surrounding soft tissues.
Massaging and wearing of your compression garment will help minimize your swelling. Continue to follow up with your plastic surgeon so that they may continue to monitor and help manage your post operative course.
I hope this helps. Good luck.
Hematoma after Mommy Makeover...
I'm sorry to hear about the complication you have experienced after the tummy tuck operation. It does sound like you have been treated appropriately; I don't see anything in the pictures that would suggest any further problems. Hopefully, the remainder of your recovery course will be uneventful and you will be pleased with the results of the procedure.
At this point, there are no specific interventions to expedite the process; often any residual blood will liquefy and absorb. Sometimes, aspiration by your plastic surgeon will be necessary as the old blood liquefies.
Unfortunately, some back pain is quite common after tummy tuck surgery. You may find that the situation improves as you are able to lie on your side ( fetal position); best to check timing of this position change with your plastic surgeon. Otherwise, massage and anti-inflammatories (again after approval of your plastic surgeon) may be helpful.
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TT, BA and Lipo- Hematoma Complication? (photo)
Sorry for your postoperative complications. But the attention and reoperation was done in an expedient manner in my opinion. Allow healing to now proceed over the next few months before considering additional options
Getting a hematoma post-surgery is normal for a big tummy tuck surgery. It is easily removed by draining it with a needle; it might have to be done a few times before its starts to subside. Wearing a compression garment nice and tight should minimize that as well. Make sure you follow your PS instructions.
The presence of a hematoma can cause quite a large amount of swelling beyond what is normal after a tummy tuck. From what I can see in the photos, I see no reason why this can't be expected to resolve. From my understanding of the second opinion, I would expect that this was taken care of when it was recognized. It is unlikely that your surgeon closed your incision while there was active bleeding.
Lymphatic massage is often helpful in speeding up resolution of swelling.
Thanks for your question and for the attached photos. Best wishes for an uneventful rest of your recovery.