A hematoma after tummy tuck is a rare occurrence, but it can happen. Being aware of the symptoms and knowing what to do if you experience them will help you navigate through this time.
Hematomas are collections of blood that form in tissue or under the skin. They are usually caused by a ruptured blood vessel. Hematomas can occur anywhere on the body, but they are more common in areas that have been injured, such as the scalp and lower leg. In this guide, we review the Picture Of Hematoma After Tummy Tuck, seroma vs hematoma, tummy tuck hematoma treatment, and signs of hematoma after tummy tuck.
Many patients want to change the way something about the way that the body looks, whether it bothers them for medical or cosmetic reasons. Plastic surgery is one way that patients can accomplish this goal. Although plastic surgery requires some planning and recovery time, these procedures are generally safe and associated with minimal side effects. Of course, as with any surgical treatment, there is the potential for complications, and it’s important to discuss the measures patients can take to avoid these risks. One risk of plastic surgery, especially a breast augmentation, is getting a hematoma. Here are some ways to identify a hematoma and some advice on how to reduce the risk of a hematoma after plastic surgery.
WHAT IS A HEMATOMA?
A hematoma is a collection of blood that develops outside of the blood vessels, usually near the incision site, after surgery. Patients that notice any discoloration around the incision that looks similar to severe bruising or a collection of blood under the skin may be developing a hematoma. Other symptoms of hematoma after plastic surgery include severe, uneven, and sudden swelling, as well as pain in the affected area. Hematomas usually develop within 48 hours of surgery.
DISCUSS MEDICATION HISTORY
While the risk of getting a hematoma is relatively low for most patients, it is still a real risk. This risk is increased for patients that are taking certain medications. Prior to scheduling a surgical appointment, patients should inform their doctors of the medications they are taking and the existence of any type of coagulant disorder or issues with the blood.
WHAT TO AVOID BEFORE SURGERY
There are a few precautions patients can take before surgery to reduce the risk of a hematoma. Patients should avoid any blood thinning medications, including aspirin and anti-inflammatory drugs. Patients should avoid these drugs before, during, and after surgery, until they are cleared to start using them again. Additionally, it is important to avoid alcohol a few weeks before the surgery, as this will help minimize inflammation after surgery.
WHAT TO AVOID AFTER SURGERY
Dr. Mark Deuber will discuss with patients in detail ways to reduce the risk of developing a hematoma. He will let patients know how long they should continue to avoid certain drugs, vitamins, and alcohol.
Additionally, patients should avoid excessive heat after the surgery. Being exposed to heat – including the sun, hot tubs, and heating pads – can increase the chance of a hematoma.
For patients that experience post-operative nausea, the act of vomiting can increase the risk of hematoma. Patients are urged to rest until all nausea passes.
Finally, patients should suppress the temptation to exercise or engage in activity that could raise blood pressure. This will keep inflammation and swelling to a minimum. One of the best things patients can do to heal and avoid any complications is to simply take it easy for a while.
Signs Of Hematoma After Tummy Tuck
Bruising is one of the most common side effects of cosmetic surgery. In most cases, a bruise will heal in a week or two and require no more treatment than ice and standard over-the-counter painkillers. However, hematomas are a condition similar to bruising that may be much more dangerous and require immediate attention. In fact, it may require additional care to correct the problem. Find out how to tell the difference between a bruise and a hematoma, what may increase your risk for hematomas, and what should be done to reduce your chance of getting a hematoma.
What’s the Difference between a Bruise and a Hematoma?
A bruise develops as the result of any blunt contact injury between an object and the skin. This damages tissue and capillaries, causing blood to leak outside of the vessels and under the skin. While most bruises are not serious, a severe bruise may lead to hemorrhaging, in which the blood will pool and start to clot under the skin. The easiest way to tell the difference between a bruise and a hematoma is that the latter will actually feel hard to the touch. If this is the case for you, contact your doctor immediately to schedule a follow-up consultation.
Risk Factors for Hematomas
Hematomas are most likely to form following a cosmetic surgical procedure involving the face or neck. They will usually occur within 24 hours following surgery, but may also not appear until later. Men are more likely to develop hematomas than women. Other risk factors include:
- Hypertension, or high blood pressure
- Blood thinners, including herbal medications, ibuprofen, aspirin, or other similar medications
- Smoking
- Nausea or vomiting following surgery, which can put pressure on the incision site
How Can I Reduce My Chances of Developing a Hematoma?
The best advice is to strictly follow your after-care instructions. Small hematomas can be treated at home by alternating hot and cold compresses. Some other tips to reduce your chances of developing a hematoma include:
- Wear the compressive dressing and elastic strap provided by your doctor
- Take Arnica montana tablets before and after surgery to reduce bruising
- Take your medication as directed and rest to prevent nausea and vomiting
- Avoid smoking before and after surgery
- Avoid blood thinners, both before and after surgery
- Avoid strenuous movement or lifting immediately following surgery
If you have developed a hematoma, call your doctor right away. You may need to come in to have excess fluid and blood drained from the hematoma. The sooner you call, the lower the risk of severe complications. If a hematoma is left untreated, it can lead to scarring, infections, or even necrosis (tissue death).
seroma vs hematoma
A hematoma is generally defined as a collection of blood outside of blood vessels. It occurs because the wall of a blood vessel (artery, vein, or capillary) has been damaged, and blood has leaked into tissues where it does not belong. Hematoma is the term used to describe bleeding which has more or less clotted, different from hemorrhage which signifies active, ongoing bleeding. A bruise, for example, is actually a hematoma. During surgery, hematomas are caused by an injury to the wall of a blood vessel, prompting blood to seep into the surrounding tissues. Your surgeon will seal blood vessels as they are cut and will double-check those seals before closing the incision.
Who is at risk of developing a seroma or hematoma?
The risk of a hematoma is much higher in patients who have been taking blood thinners and in those with some preexisting diseases or bleeding disorders. Vigorous coughing or marked elevation in blood pressure immediately after surgery may also contribute to the formation of a surgical site hematoma. Other risk factors include vigorous exercise, straining, vomiting, stress, and alcohol consumption. This is part of the reason it is so important to follow your doctor’s instructions.
What are some characteristics of a hematoma?
A hematoma produces elevation and discoloration of the surgical wound edges, discomfort, and swelling. Blood sometimes leaks between skin sutures. There may be pain and a feeling of fullness in the affected area. Depending on the site, there may even be visible bruising. Hematoma formation following operations on the thyroid, parathyroid, or carotid artery can be particularly dangerous because the hematoma may expand rapidly and compromise the airway.
How do you treat a hematoma?
Treatment of a hematoma depends on its severity. Small hematomas may resorb after a few days. More severe hematomas that continue to enlarge may require surgery to drain the accumulated blood and/or control any bleeding vessels and reclose the surgical site. A common complication of all hematomas is the risk of infection. Since there is no blood supply to a hematoma (it is a collection of old blood), there is a risk of bacteria colonizing the site. Surgical incision separation and delayed healing may also occur if the hematoma is large enough to compress tissues and prevent oxygen from reaching the surrounding tissue.
What is a seroma?
A seroma is a sterile collection of fluid under the skin, usually at the site of a surgical incision. Fluid builds up under the skin where tissue was removed. The formation of seromas is the body’s response to dead space within tissue that was attached to something before surgery. It may form soon after your surgery or up to 1 to 2 weeks after your procedure. It may appear as a swollen lump and feel tender or sore.
What are common treatments for a seroma?
A small seroma is not dangerous. Depending on its size and your symptoms, it may not need to be treated. The seroma may go away on its own within a few weeks or months. Your body slowly absorbs the fluid. No medicine will make it go away faster. But if you have a large seroma or if it’s causing pain, your healthcare provider may drain it. This is done with a syringe and needle. Or the provider may put in a drain. Seromas can return and may need to be drained multiple times. In some cases, it can become infected or turn into an abscess. Rarely, you may need a minor procedure to remove the seroma. Long-term problems from a seroma are rare.
What are some complications that can arise from a post-surgical hematoma or seroma?
Hematomas and seromas may increase the length of hospitalization and cause delayed healing, surgical site infection, and abnormalities in scarring. Therefore, following your healthcare provider’s instructions is very important.
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tummy tuck hematoma treatment
Bruising is one of the most common side effects of cosmetic surgery. In most cases, a bruise will heal in a week or two and require no more treatment than ice and standard over-the-counter painkillers. However, hematomas are a condition similar to bruising that may be much more dangerous and require immediate attention. In fact, it may require additional care to correct the problem. Find out how to tell the difference between a bruise and a hematoma, what may increase your risk for hematomas, and what should be done to reduce your chance of getting a hematoma.
What’s the Difference between a Bruise and a Hematoma?
A bruise develops as the result of any blunt contact injury between an object and the skin. This damages tissue and capillaries, causing blood to leak outside of the vessels and under the skin. While most bruises are not serious, a severe bruise may lead to hemorrhaging, in which the blood will pool and start to clot under the skin. The easiest way to tell the difference between a bruise and a hematoma is that the latter will actually feel hard to the touch. If this is the case for you, contact your doctor immediately to schedule a follow-up consultation.
Risk Factors for Hematomas
Hematomas are most likely to form following a cosmetic surgical procedure involving the face or neck. They will usually occur within 24 hours following surgery, but may also not appear until later. Men are more likely to develop hematomas than women. Other risk factors include:
How Can I Reduce My Chances of Developing a Hematoma?
The best advice is to strictly follow your after-care instructions. Small hematomas can be treated at home by alternating hot and cold compresses. Some other tips to reduce your chances of developing a hematoma include:
If you have developed a hematoma, call your doctor right away. You may need to come in to have excess fluid and blood drained from the hematoma. The sooner you call, the lower the risk of severe complications. If a hematoma is left untreated, it can lead to scarring, infections, or even necrosis (tissue death).
Although severe complications following cosmetic surgery are rare, it is important for patients to be aware of the possibility so they take precautions before and after surgery. If you are uncertain if you have developed a bruise or an actual hematoma, contact our office to schedule a consultation right away.
signs of hematoma after tummy tuck
There have been several comments recently on one of my previous blog posts about swelling after a Tummy tuck. Swelling is only one of the possible complications that can occur following a Tummy tuck procedure. Other post-op Abdominoplasty complications can be subdivided into a few major classifications: Infection, Wound Separation, and Fluid Collections (Hematoma and Seromas).
Infection after a Tummy tuck
Most surgeons give patients pre-operative antibiotics so wound infection is not as big a problem as it used to be. Ask your surgeon if he will be giving you preoperative antibiotics and make sure you are not allergic!
Infections can be minor, such as a suture abscess. However, they can also be life threatening, like those of MRSA.
A suture abscess is typically not dangerous, and it’s caused by the body trying to dissolve away some of the absorbable sutures that are placed in the deep layers of tissue to hold the tissue together. It is easily taken care of by lancing the area under a local anesthetic, and packing the small puncture with a medicated gauze. Usually additional antibiotics are not needed unless the patient has fever and redness over an extended area.
With respect to MRSA, as a precaution I routinely ask patients if they, or anyone in their family, has had an episode of MRSA (Methcillin Resistant Staph Aureus). This can be a very dangerous infection after surgery. If the patient has a history of MRSA or exposure, we will do a swab culture of the nose (where MRSA frequently resides), and will give specific antibiotics against MRSA at the time of surgery.
Remedy: Taking active steps to prevent infection is the best remedy.
Wound separation after a Tummy tuck
This looks dramatic to the patient, because the patient thinks that the separation is very deep.
However, it is not, as the separation only goes to the muscle wall. Wounds can separate for the following reasons:
The Lockwood technique that I use for the Tummy tuck dissection is excellent because it does less undermining and preserves most of the blood supply.
Remedy: Small wound separations are easily taken care of by packing the wound with medicated gauze. Slightly larger wound separations, or those caused by tension, can be taken care of by a suction device called a “Vac Dressing” manufactured by KCI. Large wound separations caused by poor blood supply may need revision and re-approximation of the wound edges in a procedure room.
Fluid collections after a Tummy tuck
Fluid collections are more common when there is a lot of space created between the abdominal skin and the underlying muscle. Fluid can easily accumulate in this space and complicate the healing process. For more detailed information, see my blog post about post operative Tummy tuck swelling and seromas, Tummy tucks and how to reduce swelling and eliminate fluid collections.
In summary, the different type of fluid collections associated with Tummy tucks are seroma and hematoma.
Seroma
A Seroma is a collection of wound fluid. It is mostly seen when the patient has a lot of activity in the post operative period or there is inadequate compression, and rarely happens when the Lockwood technique is used. It can easily be treated with a needle aspiration, but it is not unusual to have to do a series of aspirations spaced over a few days to take care of the problem.
Hematoma
A Hematoma is a collection of blood in the dead space. It usually needs to be evacuated because it can be painful, can lead to infection or cause excessive scarring. It is usually caused by a small blood vessel that opens up in the recovery period, and can happen up to a few days after surgery. Most of the time it can be evacuated with a needle, but sometimes it may need a small intervention in a procedure room.
Remedy: The best remedy against fluid collections is prevention. I am a firm believer in the right kind of compression garment with shoulder straps to keep the garment well placed. In addition, foam pads (Topifoam pads) over areas of potential fluid accumulation also help a lot.
Discuss possible complications before your surgery
All in all, the Tummy tuck is a very safe operation. However, you need to be aware of the risks and potential complications prior to any surgery. When you go into your pre-operative Tummy tuck consultation be sure to ask your plastic surgeon about these possible complications and how he or she handles them when they occur. Most importantly, get a commitment that the surgeon will be available after surgery within a short time period should you experience any problems. I give all of my post op patients my cell phone number so I can communicate immediately if any problems or concerns arise. Be sure you know how to get answers to post op questions prior to your surgery.