Right Breast Harder, Higher and Bruised 8 Days After Surgery

I am post op 8 days after having my 9 year old saline implants replaced as the DR felt that the right implant had ruptured. Original implants were approximately 360cc. The new implants are 530cc on left and 600 on right. The left is totally soft, loose and low (feels like a water balloon), almost like no surgery had taken place. The right implant is hard, tight,sore, bruised heavily at base and very high. As such, they look very different. Is this normal?

Doctor Answers (14)

Breast Augmentation Complication

+2

Based on your description, you have a hematoma (collection of blood in the implant pocket) until proven otherwise. You need to see your plastic surgeon ASAP. Unless this diagnosis can be eliminated by getting an ultrasound, you need to have an exploration and drainage of blood in the implant pocket. The risk of neglecting a hematoma is the early formation of a capsular contracture (a hardening of the scar tissue capsule that surrounds the implant).


Indianapolis Plastic Surgeon
5.0 out of 5 stars 57 reviews

Asymmetries/Bruising 8 days after surgery?

+1

Significant asymmetry in size/swelling/bruising is not necessarily “normal”;  in person evaluation by your plastic surgeon is necessary to rule out a complication. Best to be seen as soon as possible.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 751 reviews

Hard, sore and bruised

+1

Yikes, it sounds like you might have a postoperative hematoma.  Get thee to your surgeon ASAP and him/her check you out.  If you have had bleeding around the implant, the blood and clot needs to come out, not only to improve your comfort and speed your healing but to prevent the formation of a capsular contracture. 

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 45 reviews

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One breast harder after surgery

+1

If one breast is hard, high, and severely bruised, it may be that you have a hematoma in that breast and should be evaluated by your surgeon ASAP.  Call the office and see the doctor.  Good luck!

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Rt. breast harder

+1

you should probably see your doctor to rule out a hematoma. he may have performed a capsulotomy to place the implant and sometimes they can bleed a little more than we would like

Jonathan Saunders, MD
Newark Plastic Surgeon
5.0 out of 5 stars 30 reviews

This is a breast hematoma that needs surgery promptly!

+1

By your description (of course, personal exam is better) this is almost certainly a hematoma. Blood in the breast pocket can turn into capsular contracture, and a hard, asymmetric, and often painful breast requires an even bigger re-operation than hematoma evacuation.

How long has this been present? The longer the blood remains in the pocket, the higher the likelihood of a capsular contracture. Even evacuation now may not prevent this, but leaving it in place is not an appropriate option at all. No one likes the idea of re-operation and the attendant costs (your surgeon will likely not charge a surgeon's fee, but the facility and anesthesia providers will charge their fees), but truly, a capsular contracture is more difficult, costly, and less likely to "work." I have the luxury of an on-site accredited surgical facility, and my partner and I have never charged for bleeding re-operation (for any cosmetic procedure), but our policy is an exception rather than the rule.

See your surgeon ASAP, and good luck. If this indeed is a hematoma, you should ask about steroid use in the pocket (pros and cons merit discussion), as well as post-op Singulair or Accolate and Vitamin E therapy (also controversial, but low-risk and perhaps helpful.)

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 126 reviews

Bruising of Breast after Implant Exchange

+1

Without photos or seeing you in person, it is impossible to give you specific advice.  However, since you are recently post op and you have asymmetry associated with pain, tightness, displacement of the implant and significant bruising, then you really need to see your surgeon ASAP to make sure you do not have a hematoma.  If you do, you will likely need to have it drained soon.

 

Good Luck. 

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 58 reviews

Hard bruising after augmentation

+1

You have a hematoma and should see your surgeon immediately.  Blood in the pocket needs to be removed as soon as possible: irritation from blood is uncomfortable and contributes significantly to inflammation which in turn causes capsular contracture.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 12 reviews

Right Breast Harder, Higher and Bruised 8 Days After Surgery

+1

Seems like you may have an hematoma on that side. If that is the case. If not treated properly capsule contracture is inevitable.

S. Ozan Sozer, MD
El Paso Plastic Surgeon
5.0 out of 5 stars 20 reviews

Hard, tight implant 8 days after surgery

+1

Hard, tight implants that sit higher and are associated with more bruising in the early post-operative period may represent a hematoma (internal bleeding in the pocket around the implant), and should be evaluated by your surgeon right away.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.