Question About Tummy Tuck Post-Op Complications

Sometimes the Atlantic Coast Aesthetics Question of the Week we get is much more specific than usual. While the advice our founder and Chief Medical Officer, Dr. Thomas A. Pane, gives in his weekly Google Hangout is not intended to replace an in-person direct examination of the patient by medical professionals, questions like this are particularly interesting because they address things that can and sometimes do happen in the aftermath of surgery, even when aftercare protocols are followed precisely. This week’s question came in via email to ACA’s website: “I had a tummy tuck in mid-December [roughly six weeks prior to the question] and I’ve noticed severe abdominal swelling. Is it possible that I have a seroma or hematoma, and what do I do about it?”

Dr. Pane says that the first question is whether or not the patient’s surgeon seems unduly concerned about the swelling. He notes that some post-operative swelling is normal and to be expected in the flap area, which is the portion of the abdominal skin that is brought down and stretched into place as part of the procedure. He said this is typical and not cause for alarm by itself.

A seroma is a fluid buildup that can occur beneath the flap area. This differs from a hematoma in that the fluid is largely benign and has low or no blood content, while a hematoma is essentially a runaway bruise or pooling of blood in a given area that may indicate a serious breach of the integrity of the blood vessels surrounding the area. While to the untrained eye these can look very similar, a seroma is the kind of problem that drains are placed during a tummy tuck to prevent, while a hematoma is a problem that may require surgical intervention to correct.

Dr. Pane observes that the way he does tummy tuck procedures, there is nearly no incidence of seroma due to drain placement and other factors. However, he is familiar with them from helping patients who have had procedures like tummy tucks elsewhere and ended up with seromas.  The first order of business, he says, is to get a clinical examination to ensure that the problem is accurately diagnosed and treated. The wrong kind of treatment in these cases can sometimes be worse than no treatment at all, so getting the problem looked into promptly must always be the first step. If the first doctor’s opinion and/or method of treatment does not satisfy the patient, it is always a good idea to seek a second opinion as to the type and severity of the problem.

It is usually possible to tell what is happening beneath the flap with a routine clinical examination. Seroma and hematoma look and feel different, and the treatment for them is likewise different. In this particular case, Dr. Pane says the most optimistic and hopeful outcome is that the patient is only experiencing routine swelling that can and does often happen after cosmetic surgical procedures. Given that the patient is only about six weeks post-op, he says that swelling at this stage, while not common, is also not unheard-of. He observes that he would be much more concerned if this was occurring at three months or more after the procedure, but that for the patient’s own safety and peace of mind it is a good idea to have the area examined. He also points out that the navel area is particularly prone to internal and external swelling, so the results can be difficult to gauge so soon after the procedure is done.

Following appropriate aftercare procedures in accordance with the instructions given by medical staff can help reduce the incidence of seroma and other post-operative complications, but every patient’s body is a little different and will react to the procedure differently. For this reason, following up with the surgeon at regular intervals is usually strongly recommended to ensure that problems such as seroma can be identified and treated early, before they have the opportunity to become something potentially far more serious.

If you’ve been considering cosmetic surgery or have questions regarding different procedures or surgical aftercare and maintenance, ACA and Dr. Pane welcome the opportunity to discuss your questions and concerns! You may email us at https://acplasticsurg.com, call us at 561-422-4116 or send us your questions on our Facebook page. Your question may just be ACA’s next Question of the Week, and if it is will be answered live on the air by Dr. Pane personally during an upcoming Google Hangout!