If a Small Haematoma is Left Untreated to Breakdown Itself & It Goes Away, Do I Need to Worry About Capsular Contracture?

4 days after BA my girlfriend developed increased swelling on her RHS at the side of her breast & under her arm,spreading around to her back.The swelling on this side was much greater than that on her LHS.It was tight, sore,& restricted her movement.There was no real discolouration,apart from a very feint redness.The surgeon gave her antibiotics. He said it may have been a small haematoma. After this,the swelling went & both sides are the same.No evacuation was performed.

Doctor Answers (7)

Hematomas and capsular contracture

+1

there is a generally held belief that blood in the surgical pocket will contribute to a higher degree of inflammation and therefore a larger risk of a hematoma. Although your apparent description shows the blood not exactly in the surgical area of dissection, it still likely is communicating with the pocket and your friend is likely at a slightly higher risk of the problem.


Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 reviews

Hematoma and cc

+1

Paitents who have hematomas seem to be at higher risk of developing a capsular contracture if not treated.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Hematoma and capsular contracture

+1

A hematoma does not universally result in a capsular contracture but there is definitely a higher risk associated with it.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

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Breast Hematoma and Capsular Contracture

+1

Your friend is very lucky (so far)!

In my experience, any hematoma, whether small or large, will significantly increase the risk of capsular contracture.  Your friend is certainly at a higher risk for contracture (in the future) even though the breasts may look and feel fine.

There is, unfortunately, no treatment to prophylactically reduce the risk.  I would recommend massaging the implants several times a day to try to keep the implant pocket soft.

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Small hematomas

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If the swelling has resolved, and both breasts seem soft, the outcome will probably be ok,  Large hematomas need to be drained, the smaller ones are more controversial. Exposing the implant to bacteria by reoperating has it's own risks. If she is doing well continue the massages, and be glad it was'nt a big one.

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I think everyone agrees that an untreated hematoma that is big if not evacuated will lead to capsular contraction that may be hard.If at the time the breast remains soft and there is not alot of tension surrounding the implant it is most likely some bruising and i would not  open the wound up but would do massage.

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Hematoma and Breast Contracture

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If a Small Haematoma is Left Untreated to Breakdown Itself & It Goes Away, Do I Need to Worry About Capsular Contracture?
4 days after BA my girlfriend developed increased swelling on her RHS at the side of her breast & under her arm,spreading around to her back.The swelling on this side was much greater than that on her LHS.It was tight, sore,& restricted her movement.There was no real discolouration,apart from a very feint redness.The surgeon gave her antibiotics. He said it may have been a small haematoma. After this,the swelling went & both sides are the same.No evacuation was performed.

At this point there is not much to do.  She will just have to wait and see how things look when she is about 4-6 months out from surgery.  The risk of capsular contracture do increase with any blood in the pocket.  But this doesnt mean that there will be a capsular contracture on every one of those cases.  If her doctor wants her to massage I would do that vigorously, if he has not ask her I would bring it up.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 46 reviews

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