Post-Surgery Concerns for Chin Hemangioma: What to Expect

Postoperative issues related to hemangioma on the chin?

Hello Dr.
Lee, about a week ago, I discovered a lump about 1.5 cm on my jaw.
Initially, I thought it was a sebaceous cyst, but after visiting an otolaryngology clinic, the doctor diagnosed it as a hemangioma.
After taking medication for a week, there was no significant change, so I returned for a follow-up and scheduled surgery for excision with a head and neck surgeon at the same clinic.
The surgery was performed under local anesthesia, but during the procedure, the surgeon accidentally cut a blood vessel (which caused significant bleeding all over my neck).
I was quite startled, but afterward, the doctor assured me that the blood vessel was sutured and that all the fibrous tissue had been removed.
Now, three days post-surgery, I have some questions for you, Dr.
Lee:
If a blood vessel is cut during neck surgery and then sutured, will it function like a normal blood vessel afterward? Could there be any complications after the vessel is sutured, such as the risk of rupture if my blood pressure becomes elevated? Additionally, I prefer to sleep on my side; will putting pressure on the surgical site cause any issues? Will this type of hemangioma grow back in the future? Do I need to undergo any additional detailed examinations, and if so, what kind of tests would be most appropriate? Thank you.

Niming, 20~29 year old female. Ask Date: 2024/06/17

Dr. Li Zhonghuai reply Surgery

Hello! Hemangiomas arise from blood vessels and are highly vascularized.
When surgical removal is necessary, the blood vessels need to be isolated and clamped; it is not simply a matter of cutting into the vessels.
The vessels must be excised to allow for proper anastomosis.
Will there be any issues after vascular suturing? For instance, could high blood pressure cause a rupture? Unless the condition of your blood vessels is very poor, there should be no problems after the anastomosis heals.
In cases of high blood pressure, it is typically the intracranial vessels that are at risk of rupture first.
Will hemangiomas grow back in the future? A pathological examination will be performed, and if the tumor is completely excised, there should be no issues.
Wishing you well! Changhua Hospital cares about you!

Reply Date: 2024/06/17

More Info

Post-surgery concerns regarding a chin hemangioma, especially after an incident involving accidental vascular injury during the procedure, are valid and important to address. Here’s a comprehensive overview of what you can expect and the considerations you should keep in mind following your surgery.

Healing and Recovery
1. Vascular Repair: When a blood vessel is cut during surgery and subsequently sutured, the healing process begins immediately. The body works to repair the vessel, and in most cases, if the surgeon has successfully sutured it, the blood flow should return to normal. However, the newly repaired vessel may be more fragile initially. Over time, with proper healing, it can regain strength, but it may not be identical to the original vessel.
2. Monitoring for Complications: After surgery, it’s crucial to monitor for any signs of complications. These may include unusual swelling, persistent pain, or changes in color around the surgical site. If you experience any of these symptoms, it’s essential to contact your healthcare provider promptly.

3. Blood Pressure Concerns: Regarding your concern about high blood pressure potentially causing the repaired vessel to rupture, it’s important to manage your blood pressure effectively. Elevated blood pressure can indeed pose risks to vascular integrity, especially in the early stages of healing. Regular monitoring and maintaining a healthy lifestyle can help mitigate these risks.

Lifestyle Adjustments
1. Sleeping Position: You mentioned a preference for side sleeping. While it’s generally advisable to avoid putting pressure on the surgical site during the initial healing phase, you can gradually return to your preferred sleeping position as you heal. Consider using a supportive pillow to avoid direct pressure on the area.

2. Activity Restrictions: It’s advisable to avoid strenuous activities or heavy lifting for a few weeks post-surgery. This will help prevent undue stress on the surgical site and allow for optimal healing.

Future Considerations
1. Recurrence of Hemangioma: Hemangiomas can recur, although this is not guaranteed. The likelihood of recurrence can depend on various factors, including the type of hemangioma and individual healing responses. Regular follow-up appointments with your healthcare provider can help monitor for any signs of recurrence.

2. Additional Testing: If you have concerns about the integrity of the repaired vessel or the potential for recurrence, discussing further imaging studies with your doctor may be beneficial. Options may include ultrasound or MRI, which can provide detailed information about blood flow and the condition of the surrounding tissues.

3. Follow-Up Care: Ensure you attend all follow-up appointments as scheduled. These visits are crucial for assessing your recovery and addressing any concerns that may arise.

Conclusion
In summary, while the accidental cutting of a blood vessel during your chin hemangioma surgery can be concerning, with proper care and monitoring, the risks can be managed effectively. Focus on maintaining a healthy lifestyle, managing your blood pressure, and keeping an open line of communication with your healthcare provider. Should you have any persistent concerns or symptoms, do not hesitate to seek medical advice. Your health and peace of mind are paramount during your recovery process.

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