Hematoma After Breast Reduction

I am 2 months PO. Starting a few days PO I could hear sloshing in one breast, no bruising, the dr said it was fluid and it would be absorbed. Over time (not sure when) has hardened and is the size of my fist. dr evals the area @ every appt but his answer is still heat/massage/time. The areola/nipple is numb (part of hematoma is felt under the areola. I'm worried about feeling never coming back due to pressure (I get slight reaction to the nipple w/stimulation now but no feeling). Thoughts? TY!

Doctor Answers (8)

Seroma vs. Hematoma after a breast reduction

+1

Hematomas can occur after any surgery including breast reduction.  If the hematoma is small it will liquify on its own and eventually it can be needle aspirated.  This could also be a seroma.  Some surgeons place drains other do not.  A significant hematoma can occur even when drains are used, so a drain will not prevent this from occurring.  If your breast is twice as large as the other side then this is a hematoma that may need to be surgically drained as it can have a detrimental effect on healing causing more pain, stiffness of the soft tissue and generally delaying an otherwise uneventful recovery.


Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast reduction recovery

+1

At this point in your recovery, I would continue to do what you are doing. The differential diagnosis include a hematoma that will liquefy over the course of several weeks (and be absorbed) versus fat  necrosis which may also liquefy (but more slowly).  If the latter is the case excision may or may not be necessary in the future. Continue close follow-up with your plastic surgeon. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 680 reviews

Questions about fluid in breast 2 months after breast reduction

+1

Unfortunately, more information is needed at minimum to provide you with an intelligent conjecture. You noted sloshing soon after surgery. Is it still there? Is that breast significantly larger than the other side? Was there considerably more bruising on that side versus the other side? Is your areola dark in color? Is the overall breast (not just the localized area that you mentioned) much firmer compared to the other side?

There are a few possibilities depending on these answers: hematoma; seroma (fluid collection); fat necrosis.

If the breast is much firmer diffusely and significanly larger, then strong consideration need to be given to attempting to aspirate possible fluid. If nothing is aspirated despite the much larger size, then an ultrasound of the breast would be prudent choice. If fluid or an old hematoma are seen, then an evacuation of the fluid would be in order.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Hematoma After Breast Reduction

+1

Though very rare postoperative fluid collections whether hematomae or seromae can be of concern not only to the patient but the surgeon as well. If you are 2 months postop and the size is fist size, I recommend an ultrasound or sonogram to determine the exact location and size. Also if there is fluid or scar consistency. If fluid than in interventional radiology these physician can expertly drain the fluid under radiographic techniques. As for the decreased sensory responses, sound like you will have some recovery over time. Please discuss these option with your surgeon. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Hematoma after breast reduction

+1

Fluid sloshing is common, as are small hematomas.  If it has been more than a few weeks it might be worthwhile trying to aspirate the hard area to see if any fluid (serum or liquified hematoma) can be drawn out. 

An ultrasound is an easy way to determine whether or not the firm area is due to fluid build-up.  Another cause of hardness is fat necrosis.  Fat necrrosis presents as a firm area that usually improves over time, but very slowly.  Heat and massage are good for any of the above.

Daniel Greenwald, MD
Tampa Plastic Surgeon
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Hematoma after breast reduction

+1

A hematoma can occur after breast reduction, though not frequently, and we prefer to place a drain for a few days as patients feel better and seem to heal faster. It is hard to say if the hematoma and nipple sensation are related, and many after breast reduction will have numbness in the nipple to a varying degree though most recover after six to nine months. Your doctor could aspirate the area and see if there is still a collection to be drained, a simple step which might reassure.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Areola sensation

+1

It is hard to say but most patients have sensation improve over time after breast reduction.  About 85% have normal sensation within a year after surgery according to the literature I have read.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

There are several possibilities

+1

You may have develpoed a hematoma, but you may also have developed fat necrosis. In either case, your surgeon is correct in saying to use heat/massage and time. Your body will resolve most of this by virtue of natural healing. If there is any residual hard area, a small revision can take care of it. Try to be patient for a few more months.

William H. Gorman, MD
Austin Plastic Surgeon
4.0 out of 5 stars 15 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.