What Are Signs of a Hematoma After Breast Augmentation?

I had breast augmentation a little over a wk ago, the implants were placed submuscular, my left breast seems to be slightly more swollen then my right, and causes me much more discomfort than my right breast, especially when i wake up. I worry this may be a sign of a hematoma or something is wrong.

Doctor Answers 35

Signs of hematoma after breast augmentation


It is not uncommon to have one breast hurt more and feel tighter than the other.  This is almost routine since our anatomy is not always the same from one side to another.  Signs of a hematoma that needs to be fixed includes:

Expanding size of the breast

Significant brusing

Progressively worse pain

Usually all of these signs are noted together when a breast hematoma occurs.

All the best,

Dr Repta

Scottsdale Plastic Surgeon
5.0 out of 5 stars 122 reviews

Signs of Hematoma After Breast Augmentation

The three signs of hematoma are swelling, pain, bruising.  Usually the affected sign gets very swollen and painful, and shows extensive bruising.  There may even be some bloody discharge from the incision.  Usually if you have a hematoma it is fairly obvious but if you are not sure have your surgeon check it out.

PostOp Hematomas are Characterized by Sudden Swelling, Pain, Bruising with Purple Discoloration & Significant Asymmetry

The type of swelling and discomfort that you are experiencing is probably normal. Patients undergoing breast augmentation can anticipate significant swelling in the immediate post operative period. The swelling can be asymmetric and tends to resolve quickly in the vast majority of patients.

In contrast, post operative hematomas are characterized by sudden swelling, pain, bruising with purple discoloration and significant asymmetry. Hematomas require re operative surgery to control bleeding and evacuate residual blood within the breast pocket. It’s important to recognize and treat hematomas following breast augmentation promptly to avoid secondary complications. Untreated hematomas can result in significant capsular contractures. In light of your concerns, it’s appropriate for you to seek consultation with your plastic surgeon. Although it’s most likely swelling, a careful evaluation is still appropriate.

Post Op Hematoma with Breast Augmentation

Minor differences in swelling and tenderness are not usually a cause for concern. If you have a significant hematoma, the difference will be obvious and dramatic. In either case, if you are concerned you should contact you surgeon who can give you an expert opinion.

Mark Preston, MD
Columbus Plastic Surgeon
4.5 out of 5 stars 14 reviews

Signs of a Hematoma

Slightly more swelling in one breast over the other is the rule, not the exception and is totally normal  This will settle down over time and they will be more symmetrical.  A significant change in size in one side compared to the other is the tell-tale sign of hematoma, and you should call your surgeon, immediately if this occurs.

Dustin L. Reid, MD
Austin Plastic Surgeon
5.0 out of 5 stars 63 reviews

Signs of a hematoma after breast augmentation

Signs of hematoma after augmentation are: Marked swelling, black and blue, increasing pain, uneven breasts. If you have any of these symptoms and signs GO no RUN to the operating surgeon. I assume the operating surgeon is in MIAMI? If not, please call my office to see me ASAP. You may need drainage surgery!

From MIAMI Dr. Blinski

Signs of hematoma after a submuscular breast augmentation

From what you are describing this does not sound like a hematoma. Breast hematomas usually present within the first 48 hours and are commonly unilateral (one side) significant swelling, firmness and bruising. If you had a hematoma you would know it! Fortunately enough, this sounds like normal post-operative swelling which is never symmetric and usually more pronounced on your dominant side.

I hope this helps.

Dr. Trussler

Andrew P. Trussler, MD
Austin Plastic Surgeon
5.0 out of 5 stars 19 reviews

Signs of Hematoma Post Breast Augmentation

Thank you for your question. I am sorry to hear about your discomfort. I recommend following up with your board-certified plastic surgeon. It is critical to keep an open line of communication with your surgeon and their staff. If you have any concerns you should alert them right away. Best of luck.

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 22 reviews

Swelling is normal after #breastaugmentation; not necessarily a sign of hematoma.

Firstly, swelling following breast augmentation surgery is normal, and you may experience some variation between breasts. If this concerns you, be sure to bring this up in your post-op visits with your plastic surgeon. 

Next, signs of a hematoma can include significant differences between swelling, pain levels, and positioning of the breasts. If one implant is riding high, for example, or purple due to leaking blood under the skin, these could be indicative of a hematoma. 

If you suspect that you may have developed a hematoma, it is best to call your surgeon's office immediately rather than ask online!  They need to know what is going on as soon as possible so that they can treat you quickly and appropriately.

Hematomas have sudden onset of symptoms

Some swelling and pain after breast augmentation is perfectly normal, as is mild asymmetry between breasts. For many women, this is worse after just waking up but improves throughout the day. It can take several weeks to a few months for this to resolve as the body heals and implants settle. Signs that what you’re experiencing is hematoma rather than normal post-op recovery include sudden pain, a dramatic change in size of one breast only, and purple or reddish discoloration like bruising. If any of these occur, do call your plastic surgeon right away.

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.