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Capsular Contracture After Hematoma and Infection

asked 1 year ago by Ashley in Ohio in Grove City, OH
Latest answer by Steve Laverson, MD
Question viewed 824 times
Tags: capsular contracture, hematoma, infection, swelling

Two weeks ago I had augmentation. Within 36 hours I had a fever, a hematoma and an infection. At this point the infection and hematoma have cleared. The hematoma was not drained however fluid was drained from incision site of right breast.(all complication were in the right breast) R breast is still more swollen. I am afraid of capsular contracture. There is a hard spot where the hematoma was. What questions should I make sure to ask my surgeon at our follow up?

13 answers to Capsular Contracture After Hematoma and Infection

Capsular contracture risk after bleeding and infection

The number one concern with a breast implant infection is recurring inflammation and infection in the breast when antibiotics are withdrawn. The body has a significantly harder time clearing infection when the implant is in place. The sure bet is removing the implant, treating the infection, and replacing the implant at a later time, though is is possible to save the day with antibiotics alone, though temper expectations and work closely with your surgeon. The risk of a capsular contracture... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Prevention of Capsular Contracture

You want to be sure the firm spot is softening with the passage of time, not becoming more firm. Ask your surgeon if he or she believes leukotriene inhibition with zafirlukast or montelukast may be indicated to diminish the chance of capsular contracture. As an aside, true infections after augmentation rarely resolve with antibiotics alone, and nearly always require explantation.

Steve Laverson, MD
San Diego Plastic Surgeon

Undrained hematoma and capsular contracture risk.

The series of events you describe indicates a hematoma, but not an infection. Likely, the redness was related to the increased pressure of fluid which was relieved after it drained from the incision. If you have a substantial hematoma, this can take a long time to resolve. The old blood is broken down by the body via an inflammatory reaction. This will prolong the inflammatory phase within the capsule itself and can lead to capsular contracture. I recommend reoperation and evacuation of a... more

David Bogue, MD
Boca Raton Plastic Surgeon

I do not believe you had an infection but the hematoma does increase your risk of capsular contracture.

The good news is that I do not believe you had an infection given that they do not usually appear that early. It is more likely that the fever was a result of a problem called atelectasis caused by inadequate expansion of your lungs following the anesthesia used in surgery.. In addition, breast implant infections do not resolve as quickly as yours did especially with the minimal treatment you described. The bad news is that you probably sustained a hematoma and this alone will increase your... more

David A. Ross, MD
Chicago Plastic Surgeon

www.thecosmeticsurgeryinstitute.com

Continue Conservative Management

If your hematoma and infection are resolved I would wait and see how things progress. As others have stated, bleeding or infection in the implant pocket can result in a high incidence of capsular contracture. Whether you need to drain an accumulation of blood after surgery really depends on the extent of the problem. It appears your surgeon treated you conservatively and things improved. The best thing for you to do now is wait and see how your healing progresses.

Scott R. Brundage, M.D.
Grand Rapids Plastic Surgeon

Hematome/infection post aug

Since you are only two weeks out I would do massage and warm compresses to try to eliminate the bumps and keep the implants soft.the incidence of hard encapsulation after hematome/infection is much higher so you need to be diligent.

Robert Brueck, MD
Fort Myers Plastic Surgeon

Capsular Contracture after Breast Augmentation: Decreasing the risk

Breast implants are foreign bodies that in general are inert and have minimal reactivity when placed properly in the body. Your body will form a thin capsule around them, however things like bacteria, blood and leaked silicone can lead to a vigorous reaction that likely predisposes to scarring around the implant and capsular contracture. An undrained hematoma or infection can predispose you to a predictable capsular contracture. Medications, like Singulair have shown to maybe decrease and or... more

Andrew P. Trussler, MD
Dallas Plastic Surgeon

Capsular Contracture After Hematoma and Infection

I will not be to 50/50. I believe you "will" have a capsule fibrosis. So you need to discuss in person with your chosen surgeon your options. In my practice if you truly had a bleed with infection, I would have removed the imp[lant to allow treatment of the bleed and infection. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Concerns about capsular contracture following a hematoma and breast infection

Capsular contracture seems to be precipitated by inflammation such as infection and to a lesser extent, hematoma. Though you did state there was an infection, it is not clear that this involved the implant and pocket as opposed to an isolated area on the skin. It would be highly unusual for a significant infection around the implant to resolve without its removal and even more remarkable, in the presence of a hematoma. You need to discuss the occurrences, present findings and your... more

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Capsular contracture likely after hematoma and infection.

Ashley, I am sorry to hear of your early post-op right breast hematoma and infection. Drainage through the incision may have evacuated some of the blood collection; however, it is unlikely (particularly with your description of residual localized firmness) that all of the hematoma was eliminated without re-operation. If indeed the hematoma was also infected (which I am doubtful of, since infection around an implant rarely if ever is successfully treated by antibiotic therapy--the implant... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Complication after breast augmenation

Complications are always devastating to both the patient and the surgeon. You should sit and discuss your concerns with your PS and trust in his/her training. At this early stage it is very difficult to tell if you have or will have a CC. Unfortunately, only time will tell. You should continue to allow the swelling and internal induration (firmness) to subside, give it a few weeks to months.

Delio Ortegon, MD
San Antonio Plastic Surgeon

Capsular Contracture After Breast Hematoma

Capsular contracture can occur without warning in any patient, but some surgeons feel that a hematoma significantly increases the risk of this occurring. Some surgeons advocate returning to the OR to actually rinse out all of the old blood that could be a stimulus for the contraction to occur. No real scientific evidence to guide us exists - so much of this is a surgeon's personal experience. Also, some physicians feel Singulair, an asthma medication can be prescribed early... more

Vincent P. Marin, MD
San Diego Plastic Surgeon

www.marinaesthetics.com

Hematoma of breast

You should definitely sit down with your surgeon and express your concerns. Unfortunately, it is difficult to predict when a capsular contracture will occur, but you may be set up for one given your initial problems.