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Another Hematoma- After Revision of Peri-areolar Lift

2 wks ago, I had a revision Peri-areolar bl after having a peri-areolar with aug 6 months ago. On day 11 I developed a Hematoma, my Doc aspirated the area taking out 70ccs of blood. Today I went back & he again aspirated what he said was old blood (so no new bleeding). I also had a hematoma my first procedure (same breast). Any ideas on why I am getting hematomas? I'm heathy, 42yo, following post op instructions. I am worried this will effect my ultimate results. Thanks for your input.

Doctor Answers (7)

Recurrent Hematoma

+1

Although unusual recurrent hematomas can occur. I would want to know if you have had bleeding problems in the past and do you bruise easily. Perhaps you have a bleeding disorder which could be clarified by some lab tests. Massage and ultrasound are certainly helpful to help resolve residual hardness following a hematoma. With time this area should settle down and no permanent deformity should result. Express your concerns with your surgeon. 


Indianapolis Plastic Surgeon
5.0 out of 5 stars 7 reviews

W/hy am I getting hematomas after breast surgery?

+1

Certainly there are medications, supplements, and activities that can lead to bleeding and hematomas if taken within the first couple of weeks before or couple of weeks following surgery.  There is a long list, including aspirin, non-steroidal anti-inflammatories (NSAID's) such as ibuprofen, advil, etc, certain vitamins such as vitamin E and Niacin, and a variety of herbal preparations and naturopathic remedies.  Also, heavy lifting, straining, and exercise within the first couple of weeks can lead to bleeding.  Other than that, there are patients who have an unrecognized blood clotting disorder that only becomes known after it is discovered that they bled after surgery. If none of these apply, it may be coincidental, since everyone has some risk, perhaps 1% of patients may have a hematoma after a surgery.  Twice in a row would be rare in the absence of any of the above factors...possible, but rare.

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

2 hematomas after breast lift

+1

Dear Perkster,

2 hematomas after breast lifts are unfortunate but possible.

First, ask your surgeon to prescribe therapeutic Ultrasound treatments 3 times a week for 2 weeks or more. This is performed by Physical Therapists in their office, and they usually require a prescription. These treatments may be covered by your health insurance.

these treatments will help the hematoma to resolve faster, and keep the tissues soft, hopefully avoiding the dreaded capsular contracture which may develop after such.

Second, check all the meds( aspirin ), supplements, vitamins, anything you may have ingested which can affect clotting.

Third, check with your family physician to see if you need additional blood tests to search for any abnormalities.

good luck,

F. Mussat, MD

Florence Mussat, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Hematoma after breast surgery

+1

Hematomas may occur after any breast surgery.  It is somewhat unusual to have this occur twice.  You may want to have your MD check for any bleeding disorders.  It may also be related to any anti-inflammatories medications or herbal supplements you may have taken.  Donald R. Nunn MD Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast Hematomas

+1

Hematomas after breast surgery are rare, on the order of 1% of all cases. You can increase the risk by taking aspirin and other NSAID drugs as well as many herbal supplements. This is why a complete medical history is important. Basic lab work, like a blood count, will show anemia and low platelets; however, it will not reveal if a patient is more likely to bleed after surgery.

Most hematomas occur within 24-48 hours of surgery. While one can certainly occur at 11 days after surgery, this a little less common. Couple this with previous bleeding problems, and it may be worthwhile looking into how your body forms clots.

If you have never had other problems and do not bruise easily, this may just be bad luck. If you do bruise easily, you may consider seeing a hematologist. Special testing can be done to check your bleeding time, coagulation, platelet function and clotting cofactors, but it is best to get the advice of a specialist for guidance.

Many people have mild abnormalities in their clotting or platelet function that do not cause problems, until they have a significant injury or surgery. If the problem can be identified, often something can be done to compensate for it before elective surgery to decrease the risk of hematomas in the future.

With the information given, I can't say if more than bad luck is involved; however, if you do have a clotting problem it is likely mild since you have made it 42 years.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
5.0 out of 5 stars 6 reviews

Second hematoma after breast revision

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There can be many causes of bleeding after surgery, and a second hematoma does raise a red flag. We commonly look at aspirin and other anti-inflammatory medication and have a long list of medications that can be overlooked. You should also consider nutritionals and supplementals such as garlic and gingko, ginseng, and even high doses of vitamin E. If you find you have a history of bruising you should discuss it with your family physician. A hematoma does increase the risk of capsular contracture to 25%. Aspiration may risk damage to your implant and a drain may be safer in some hands.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 27 reviews

Hematoma after Lift

+1

Sorry to hear about your hematomas.  Hematomas are a known risk of almost any surgery.  It is unfortunate you have had 2 but don't blame yourself or the surgeon.  Its probably nothing either of you did.  It sounds like your surgeon is taking good care of you.  Continue with your visits and follow instructions.  Rarely do hematomas cause any long term problems.  With time it will go away.

Albert Dabbah, MD
Boca Raton Plastic Surgeon

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.