Bleeding after Tummy Tuck

What is a tummy tuck? A tummy tuck is surgery that removes excess skin and fat from your abdominal area, leaving you with a tighter stomach that looks much more toned. The procedure can be performed on women or men, and it’s a great option for those who are seeking an alternative to liposuction—or if they’re ready to move beyond liposuction but aren’t quite ready for full body contouring yet.

How long does it take? The surgery itself takes about an hour, but recovery time varies depending on what type of anesthesia is used during your procedure. If general anesthesia is used (as it usually is), recovery will take 2-3 weeks before you’re able to go back to work or school or resume normal activities. If local anesthesia or conscious sedation were used instead (which would make sense if you intended to have someone drive you home after surgery), then the recovery time would be shorter.

Surgical Risks and Potential Complications of Tummy Tuck Surgery

All surgical procedures, including the tummy tuck, have potential risks associated with their performance. The decision to have abdominoplasty or other body contouring surgeries is extremely personal, and you’ll have to decide if the procedure will achieve your goals and whether or not the risks and potential complications are acceptable.

In this section, you will find further information regarding the potential risks associated with various abdominoplasty procedures.

Possible risks of abdominoplasty include:

Surgical Anesthesia: On the day of surgery, your anesthesiologist will discuss the risks of both local and general anesthesia.

Unfavorable Scarring: If the sutured area doesn’t heal properly or takes too long to heal, the scars that are a result of the abdominoplasty may be thicker than normal. If the patient heals relatively quickly, minimal scarring will result. Scars will take years to fade, but they are long-lasting. Despite Dr.Agha’s best efforts, scar appearance and healing are not fully predictable. The scars may be uneven, excessively wide, and/or asymmetrical. Scars may be unattractive and of a different color than the surrounding skin. Excessive, hypertrophic, and keloid scarring are uncommon. Additional treatments, including surgery, may be necessary to treat abnormal scarring.

Bleeding/Hematoma: Bleeding may result if the sutured areas do not heal correctly or if there is improper coagulation after the tummy tuck procedure. A hematoma is a blood collection that can form under the skin and enlarges as a tender bulge. If a patient notices any unusual bleeding after an abdominoplasty, contact Orange County plastic surgeon Dr. Agha immediately. Do not take any aspirin or anti-inflammatory medications for ten days before surgery, as this will increase the risk of bleeding. Non-prescription “herbs” and dietary supplements can also increase the risk of surgical bleeding.

Infection: Major infection with fever and large areas of red skin (cellulitis) is unusual after this type of surgery. Should a serious infection occur, treatment, including intravenous antibiotics or additional surgery to remove dead tissue and drain abscesses, may be necessary. Minor wound infections, accompanied by exposed and “spitting” sutures, can occur and are usually easily dealt with by limited debridement, antibiotics, and dressing care. There is a greater risk of infection in smokers, those with diabetes, and those with multiple procedures.

Fluid Accumulation (Seroma): Drains are often placed at the surgical site at the end of the operation to collect seepage of fluid. After their removal in about five to seven days, body fluids (serum) occasionally accumulate underneath the skin. Should this occur, it may require aspirations. If that fails to cure the seroma, then the patient will need to be seen either in the office or the operating room for the insertion of new drainage tubes and the removal of seroma cavities. This is very rarely necessary.

Poor Wound Healing: Individuals that have a slower than average healing rate or smokers may find that they do not heal properly, that the sutured areas reopen easily, or that they are more prone to infection. Patients should avoid smoking three weeks prior to and after the procedure so that their body’s natural healing process is not hindered.

Wound Dehiscence: In general, your skin closure is in multiple layers. Separation of the superficial, deep, and/or both layers may occur any time during your first postoperative month. Suture breakage, knots untying, sutures tearing through an excessively tight closure, too much movement or bending, and skin necrosis (death) are some of the recognized causes of dehiscence. Breakage of sutures in the superficial layer of skin may be sutured closed or allowed to heal secondarily at the judgment of Orange County plastic surgeon Dr. Agha.

Deep dehiscence may require a return trip to the operating room for closure under anesthesia. These healing problems may require frequent dressing changes, extra office visits and further surgery to remove the non-healed tissue. Open wounds may take weeks to heal or a secondary closure may be appropriate. Wounds allowed to heal on their own usually benefit from secondary scar revision. Smokers have a high risk of skin loss and wound-healing complications. Do not smoke for three weeks before and after your surgery.

Suture Granuloma: Some surgical techniques use deep sutures. These items may be noticed by the patient following surgery. Sutures may spontaneously poke through the skin, be visible, or produce irritation that requires removal.

Numbness in Skin Sensation: Post-operative diminished (or loss of) skin sensation (numbness, pins and needles sensation, burning or itching), and/or pain in the lower torso may be temporary or, very rarely, long-lasting.

Contour Irregularities: Contour irregularities and depressions may occur after these procedures. Visible and palpable looseness and wrinkling of skin can also occur. On occasion, asymmetrical fullness, bulges, and depressions may be present.

Asymmetry in Scar Placement or Contour: On occasion, asymmetry may occur after a tummy tuck. Although this is not typical, it is a risk associated with the abdominoplasty procedure. Every body and every patient is different.

Pain that Persists: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after surgery.

Nerve Damage: If improper healing occurs, the patient may have some nerve damage. The possibility of nerve damage should be discussed with the physician before the procedure. Nerve damage can result in oversensitivity, or it can result in a lack of sensitivity in certain areas where the abdominoplasty was performed.

Allergic Reactions: In rare cases, local allergies to tape, suture material, or topical preparations have been reported. More serious systemic reactions may occur in response to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.

Loss of Umbilicus: Malposition, scarring, unacceptable appearance, or loss of the umbilicus (navel) may occur.

Residual Deformity—Despite the best efforts to obtain a tight abdominal contour, a small degree of residual deformity may persist or develop months after the surgery.

Need for Revisional Surgery: The practice of medicine and surgery is not an exact science. Should complications occur or some aesthetic expectations remain unmet, additional procedures or other treatments may be necessary. Other complications and risks can occur but are even more uncommon.

Suboptimal Aesthetic Result: You may be disappointed with the results of surgery. Under-treatment with residual laxity and looseness or over-treatment with excessive tightness of the skin can occur with the flattening of regional contours and the widening or thickening of scars. Considerable care is used to achieve the optimum shape, but for a variety of reasons, the ultimate results may be suboptimal. At times, it is desirable to perform additional procedures to improve your results.

Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is a rare but worrisome complication of plastic surgery. It represents the formation of blood clots in the deep veins of the legs during anesthesia and surgery. Despite the use of a sequential compression device to mitigate risks, some patients may still experience DVTs. Pulmonary problems can happen if blood clots from the veins move to the lungs (pulmonary emboli) or if the lungs partially collapse after general anesthesia. Should either of these complications occur, you may require hospitalization and additional treatment. Pulmonary emboli can be life-threatening or fatal in some circumstances. Dr. Agha is a board-certified surgeon.

Long-Term Effects: Subsequent alterations in body contour may occur as the result of aging, weight loss or gain, pregnancy, or other circumstances unrelated to the above procedures. Click Here to read more information on a Full Tummy Tuck and Click Here for more information on The Recovery Process.

Contraindications for Abdominoplasty Plastic Surgery

• Severe comorbid conditions (heart disease, diabetes, morbid obesity, cigarette smoking, etc.)
• We are anticipating future procedures.
• thromboembolic disease (blood clotting disorders)
• Morbid obesity (BMI > 40)
• Unrealistic patient expectations
• Upper abdominal scars
• Patients who tend to form keloids or hypertrophic scars

Tummy tuck binder vs compression garment

Part of a successful recovery is wearing your tummy tuck compression garment, also known as a binder. Wear the item as directed for an easier and faster recovery.

A tummy tuck compression garment is a heavily elasticized cloth that stretches around your midsection, much like a girdle. It fits quite snugly, applying even and constant pressure on the encased area. The garment typically covers the area below your breasts down to the hips or pelvis — everywhere that was treated during your tummy tuck, including the immediate surrounding area.

Why do I need to wear a compression garment after my tummy tuck? This is a question we often receive from patients. Because it fits so snugly, some patients find it rather uncomfortable to wear. However, you should know that you should wear it as advised. A compression garment can help a great deal in your recovery after abdominoplasty. Here are the top four reasons:

1. A reduced risk of seroma

Excess serous fluid collection filling a pocket under the skin is technically referred to as a seroma (when it is blood, it is known as a hematoma). Seromas are considered to be the most common complication associated with abdominoplasty, according to several studies, including one from 2002 published in the Annals of Plastic Surgery. The constant, even pressure applied by your compression garment is designed to push down on tissues that were rearranged during your surgery so that pockets where fluid could collect are minimized or eliminated. The garment also promotes circulation. These two reasons are believed to be how the incidence of seromas can be decreased.

2. Better circulation

And since we’re on the topic of circulation, we all know that keeping your blood going during your recovery is key to getting better, since it’s how beneficial nutrients are delivered to the treated areas to promote healing. This also reduces swelling, bruising and the risk of blood clots, which can be serious or even fatal.

3. More comfort

Your compression garment helps keep tissues in place while you move around. Damaged tissues and incision lines are protected from being pulled or strained. That means you’ll feel more comfortable. In fact, some patients like to wear their garment for weeks after it’s okay for them to stop because they feel more comfortable with it on.

4. Better contouring

While great care is taken to tighten your midsection and minimize any contour irregularities, there may still be a chance that uneven contours may appear. Many contour irregularities can become permanent if they’re not corrected early on in your recovery. A compression garment helps to flatten out any lumps and bumps that appear.

However, sometimes an ill-fitting compression garment may leave permanent indentations. For example, seams can leave long lines in your skin. That’s why it’s important to make sure that your garment fits properly.

What causes postoperative bleeding?

In most cases, this is residual blood from normal bleeding during your procedure (i.e., when tiny blood vessels are cut during the operation).

When this blood finds its way out through an incision or drain (for example, after abdominoplasty), it can actually be a good thing, because it means the blood won’t remain in your body, causing firm, persistent bruising or a hematoma.

If the blood is dark red, the hue usually indicates old blood—that is, not bleeding that is currently occurring.

If the blood is bright red, it indicates fresh blood and bleeding that is currently occurring or has recently happened. Losing large amounts of fresh blood after surgery can be an indication that your blood vessels aren’t clotting as we’d normally expect.

Other times it can be due to the fragile operative site being bumped or injured while dressing or sleeping/rolling over or sutures being pulled due to sudden movements or stretching before your body’s incisions have a chance to form a strong enough seal to hold themselves together.

Compression garments are an important part of preventing postoperative bleeding because they restrict movement somewhat and also apply pressure and support to the wound site.

Conclusion

A tummy tuck flattens the stomach and gives it a better tone by removing excess skin. However, this operation carries some risks and side effects, such as infection, scarring, seroma, hematoma, change in skin sensation, pain, fat necrosis, and excessive bleeding.