Does Having a Hematoma Post-op Increase Your Risk of Capsular Contracture?

I was one of the unlucky few to develop a hematoma above the right breast one day after surgery. The doctor put me back under, suctioned everything out, and is having me wear a drain the next three days. Even though the hematoma is now gone, does it increase my chances of developing capsular contracture later on? If so, by how much? What can I do to prevent CC? Thank You.

Doctor Answers (19)

Bleeding and Capsule Contracture after Breast Implant

+4

Yes, bleeding does increase you chance of a capsule contracture.  I tell patients not to worry and just do everything right.   Taking 10 mg of the advised  allergy prep is now considered a great idea for 3 months.   Use a compression band on the upper pole for one month.  After 2 weeks take 400U vit E a day, massage, and likely you will not get the contracture.   Followly closely with you doctor.  Do not worry the increased risk is small...possibly 5%.  Good luck.


Palo Alto Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast augmentation and hematoma

+3

An untreated hematoma would increase your chances of capular contracture significantly. However, in my experience once a hematoma is cleaned out the chance for capsular contracture is about the same. And for other patients reading this a drain may or may not be necessary after evacuation of a hematoma. So if you've had a hematoma and received no drain this isn't necessarily a bad thing.

David E. Kim, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 46 reviews

Post op hematoma

+2

Unfortunately a few patients do develop a post op hematome. Your surgeon did the right thing by irrigating the area and draining it. The hematoma was dealt with in a timely, and therefore has minimized the risk of you developing a capsular contracture. In my experience, I do not find that there is an increased risk of development of a contracture, provided you massage the breast area daily for 2-3 months

Wilfred Brown, MD
Fairfield Plastic Surgeon
4.5 out of 5 stars 8 reviews

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Hematoma and Capsular Contracture

+2

The presence of untreaated hematoma is linked to the development of capsular contracture. Your surgeon performed the absolutely correct actions of evacuating the hematoma, washing the implant and placeing a drain. Early massage will be very important for you to keep your capsule loose. If there is some tightening, I have found topical Castor Oil, applied twice daily, to be helpful.

Karen Vaniver, MD
Seattle Plastic Surgeon
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Hematoma after Breast Augmentation

+2

Sorry to hear of your hematoma.   I think your surgeon handled everything well by recognizing the problem quickly and addressing it.    

Capsular contracture has been found to have an association with hematoma, seroma, and infection.    By leaving a drain, your surgeon is minimizing fluid collection around your implant, which can be a nidus for infection or scar formation.  Steps that can be taken to minimize subsequent capsular contracture are massage and vitamin E, once your plastic surgeon deems appropriate.

I wish you a safe and healthy recovery.

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Postoperative hematoma after Breast Augmentation

+2

A hematoma after breast augmentation increases your risk of capsular contraction. It sound like your doctor is treating you well. We know that capsular contraction rates are about 10% after six years in women with silicone gel implants. Capsular contraction rates with saline implants are much lower about 1-3% for some reason. We do not know exactly what causes capsular contraction. I do not know of any data about the exact incidence of capsular contracture rates after a hematoma but I think they are higher than someone without a hematoma. There are chemical mediators in scar tissue that cause the capsular contracture and your scar tissue is definitely increased with a hematoma. Massage after th wound is healed in probably the only thing you can do.

Follow up with a board certified plastic surgeon.

Leo Lapuerta, MD
Houston Plastic Surgeon
4.5 out of 5 stars 23 reviews

Hematoma after breast augmentation

+2

Developing a hematoma following breast augmentation surgery is a small but real risk.  Unfortunately it is associated with a higher risk of capsular contracture.  I recommend massage and careful followup exams.

Sanjiv Kayastha, MD
Albany Plastic Surgeon
5.0 out of 5 stars 25 reviews

Hematoma after breast augmentation.

+2

Early diagnosis and treatment in the form of re-operation is never regrettable.  If a bleeding point is found and stopped, a drain is not needed.  In my experience, the ultimate result is equable to the side that bled.  Massage is always helpful.  Oral medications do not work well, and are elective. 

H. Michael Roark, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 6 reviews

Capsular Contracture are you at risk

+2

Capsular contracture has been researched and studied for years now.  Truth be told there are several associations that have been linked to contracture and one of those unfortunately is a hematoma.  It is difficult to quantify by how much your risk is increased, so try not to worry to much about it. Other things that have been linked to CC are talc on surgical gloves, seroma formation and bacteria.  Interestingly people who have none of these risk factors may get a CC while others that have all the risk factors may never get a contracture. The key is to have open communication with your surgeon and if you notice anything different with your breasts notify him immediately. Hope this helps. Good luck

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Capsular Contracture and Hematoma

+2

Dear Wooten3955,

Sorry to hear you had a hematoma.  It sounds like your doctor did the best thing for you by not ignoring it, cleaning it out, and placing a drain.  You are probably at a slightly higher risk, but not necessarily.  I wouldn't worry regardless, that doesn't help. 

As for being proactive in trying to prevent a possible capsular contracture, there is nothing that has shown to be effective in preventing it.  This includes medications like Accolate, Singulair, and high doses of vitamin E, as well as post operative activities like implant massage.  Perhaps the most important thing you can do is to take your antibiotics while your drain is in.

Another medication I give my patients after surgery is a coritcosteroid for the first week; this is to reduce inflammation.  There is no data that this will decrease the risk of CC, but it definitely decreases post operative discomfort and makes the patient feel back to normal.  Coriticosteroids do not come without risk, and your doctor might find that those risks are unacceptable for you.

Best of luck, and it sounds like you are in good hands.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 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.