What is Going On? (photo)

I had my breast augmentation on Monday so its only been 4 days. 575 cc in the left & 600 cc in right; silicone. 2 days ago I noticed left breast was increasing in bruising. Yesterday the bruising tripled & theres a lot of yellow discoloration around the nipple and bellow my breast. I called my doctor and he saw me yesterday. He was very short with me and told me that he may drain it next thursday on my next appt. He acted like I was wasting his time. Please take a look at the pics & give advice!

Doctor Answers (7)

What is Going On

+1

This looks like simple bruising from  bleeding (small amount) in the tissues. But it would be difficult to diagnose a hematoma in need of evaluation from photos alone, so a call to your surgeon is in order.

Thank you for your question and for the posted photos. Best wishes.


Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

What is Going On?

+1

Could be a small forming hematoma. Best to have operation of drainage today WED. Do not wait. Please let us know what happens !! 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Increased bruising on one side after periareolar breast augmentation.

+1

Though your bruising is indeed more severe on one side, your photographs (thanks for including) show symmetrical breast volume, meaning no obvious intra-pocket hematoma.

Since, by definition, periareolar incisions must surgically cut through the breast skin, gland, (and, if submuscular, the pectoralis major muscle fibers), there are certainly plenty of blood vessels that can be perfectly dry in the operating room that ooze (or even bleed more briskly) once patients wake up and start to move around, cough, move their arms, etc. Some bruising is normal; increased bruising may indicate an intra-pocket collection of blood (hematoma) that requires drainage to minimize the potential for capsular contracture, infection, or simply more scarring. But hematomas almost always cause asymmetric swelling in the affected breast.

Seeing whether or not your bruising is accompanied by increased swelling will help your surgeon decide if exploration to drain a possible hematoma is advised. Neither you nor he wish another operation unless it is absolutely necessary to protect or enhance your result, so watching (especially since your breast is not swollen on that side more than the other) to see what develops is prudent.

This is NOT about waiting til after the Holidays; it is good surgical decision-making based on the information you have given (and what your surgeon saw when he examined you). If anything changes, please call your surgeon. If you were my patient, I would want to know and would be prepared to operate on Christmas Day if necessary. But if re-operation is not absolutely essential, it's not just about cost and inconvenience to you and your surgeon; it's about an anesthesia provider, a scrub nurse, a circulating nurse, a recovery room nurse, and whatever office staff needs to attend to you on a holiday day or night!

Some bruising, once present, simply comes to the surface in some patients! Based on what you presently show and describe, I suspect that all will be well! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 126 reviews

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From the photos, it looks like there was some bleeding inside the surgical site that is now appearing as bruising on the skin.  Although this amount of bruising is more than typically expected, it can happen and will resolve with time.  If the swelling gets worse, call your doctor right away.

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Thank you for the question and pictures.

As you can imagine, it is not possible to give you precise advice without direct examination. However, your pictures are most consistent, in my opinion, with bruising that is resolving. The yellow discoloration is usually the sign of a bruise that is in its “final stages”.

 Of course, your plastic surgeon will always be your best resource when it comes to precise advice and/or meaningful reassurance.

 Best wishes for better communication with your plastic surgeon and Merry Christmas!

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Without an exam, it is difficult to say what is best for you. Yes, there is some bruising but it may represent normal bruising.  Follow up closely with your surgeon.

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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.