I had a breast reduction surgery completed 3 days ago (on a Thursday, today is Saturday). I had a post-op appointment on Friday where the surgeon observed that I have a hematoma in my left breast. I am scheduled for surgery on Tuesday to have it drained/removed. I am wondering if there are any other issues I should be concerned with in the mean time? I've noticed dried blood in my nose, which is not common for me. Can the left breast be this much bigger just from a hematoma?
What Are the Additional Complications of a Hematoma After Breast Reduction?
Doctor Answers 7
Surgically draining a hematoma
Hematomas can occur after any surgery including breast reduction. Some surgeons place drains other do not. A significant hematoma can occur even when drains are used, so a drain will not prevent this from occurring. If your breast is twice as large as the other side then this is a hematoma that may need to be surgically drained as it can have a detrimental effect on healing causing more pain, stiffness of the soft tissue and generally delaying an otherwise uneventful recovery.
Breast Reduction and Hematoma?
Thank you for the question and picture.
Once the hematoma is drained your breast symmetry will be much improved. The skin has been stretched and will take several months and even up to a year to retract back.
After effects of breast hematoma
Based on your picture and events, it is unlikely to have a problem after the hematoma (collection of blood) is drained. You may feel better and your breasts should be closer to the same size.
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Hematoma after breast reduction
A hematoma can occur in a small percentage of patients after a reduction. This can be treated by evacuating it in the operating room.
Types of hematomas after breast reduction and their treatment
Generally speaking, there are stable hematomas and expanding hematomas. It sounds as if you have the former and waiting is an option for resorption of small collections and drainage for larger collections. commonly they will liquefy after 7-10 days and are easier to extract at that point. Expanding hematomas typically are arterial in nature and may be associated with anticoagulants. These tend to increase in size and may compromise the circulatation resulting in interrruption of blood supply to the skin, breast tissue and fat as well as the nipple areola complex. These typically need to bre treated on a more urgent basis if they do not respond to ice and compression therapy.
Hematoma after breast reduction could compromise nipple blood supply
Hematomas can happen after any procedure. In a breast reduction, it is important that the pressure of the hematoma is not pressing on the blood supply of the nipple. Many times, there is significant pain and the drainage can not wait 3 days like your case, so keep your doctor advised of any increased pain or changes in niplpe color.
Hematoma Can Lead to Increased Size And Scarring
When you develop a hematoma of a certain size, it can really make the breast appear quite larger then the other side. This is not unusal when you have some significant bleeding. The best thing to do is to eveacuate the hematoma as best as possible, clean out the tissues, and re-close the breast. It will remain swollen and larger then the other side for a few months, but then should subside. The one thing that the hematoma can lead to is increased scarring internally, which can lead to a firmer breast in the long run. This doesn't mean that it will happen, but you have an increased risk over someone who did not develop a hematoma. I hope this helps.
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