One of the complications we warn our patients about is a hematoma. Hematoma is bleeding in a breast. If this is happening you will feel a sudden increase in massive pain and swelling of the breast right before your eyes. This can be avoided in several ways. One way is to avoid blood thinners such as advil, aleve, ibuprofen, fish oil, green tea and several other culprits. These products thin the blood and increase your chances for bleeding. Avoiding pushing, pulling, lifting or strenuous activity is another way to avoid this complication. On the rare occasion that a patient has a hematoma that has been confirmed, compression to the breast area with a tight wrap is the first step followed by emergency surgery to evacuate the blood. Very rarely does the implant get damaged. You can still end up with a beautiful result however, the surgery is expensive and the breast with the hematoma will take much longer to heal.
Fortunately breast hematomas are very uncommon after breast augmentation. When they occur it is usually only 1 to 2 days after the surgery, however it could occur 2 weeks later. A relatively sudden change with one side becoming suddenly larger and more painful would suggest a hematoma or other fluid collection. Other than a physical exam, sonography of the breast could help with the diagnosis. Certainly the treatment for a breast hematoma would be exploration of the implant pocket, evacuation of the blood and control of any ongoing bleeding. The outcome of not treating a hematoma is not good.
The symptoms that would suggest a hematoma would be persistent bruising, localized or asymmetric swelling, and tenderness. The ways to diagnose for certain would be with an ultrasound or needle aspiration. If the hematoma is small, it might resolve on its own with just time, massage, and application of warm compresses. But if it is more significant, it should be evacuated and washed out.
Luckily a hematoma two weeks after surgery is very rare. It typically presents as significant pain and swelling which occurs suddenly on only one side. The treatment is surgery to stop the bleeding and remove the blood from around the implant. Not treating the problem can lead to capsular contracture in some patients.