Postoperative Bleeding (Hematoma)

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Postoperative Bleeding (Hematoma)
Testimonials from Two Patients

By Peter T. Pacik, MD, FACS

Any surgical procedure carries with it certain risks and complications such as infection, postoperative bleeding, and undesirable results. Though uncommon, and usually not life threatening, they are an inconvenience requiring additional treatment.

Postoperative bleeding, also known as hematoma, is a collection of blood in the surgical site which often requires re-opening the wounds, evacuating blood clot, and identifying the bleeding  vessel(s) if one can be found. (Sometimes the active bleeding has stopped by the time of surgical exploration.)

There are a number of different reasons that can cause postoperative bleeding, and sometimes the causative factor is unknown. During the surgery, and before the incision is closed, surgeons are careful to control any bleeding vessels. Bleeding vessels are normally cauterized with an electrical current which forms a clot. This clot may fall off postoperatively allowing the vessel to start bleeding again. Another factor that can cause bleeding are certain drugs such as aspirin, and a variety of over-the-counter medications and herbs which thin the blood. It is for this reason that surgeons ask patients to be off certain drugs and herbs for at least two weeks before the surgery, though 3-4 weeks is even better. In addition, patients may have certain bleeding disorders, with reduced ability to clot, and these may be known or unknown. One such patient was identified prior to augmentation mammaplasty, and with proper supporting medication was able to have her breast enlargement without complications.¹

If you have a history of easy bruising, postoperative bleeding, heavy periods, or a family history of bleeding disorders, please bring this to our attention at the time of your consultation.

In conclusion, it is unusual to have postoperative bleeding. Everything will be done to help avoid this. You too can help by following the pre-op instructions and letting us know if you have any problems in this regard.

Reference:

1    Pacik PT. Augmentation Mammaplasty and Von Willebrand's Disease. Pl Reconstr Surg 2005; 115:1440.

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