My Artery Ruptured After Breast Aug. & Lift, Why Would this Happen?

Bleeding after surgery is a very small risk and bleeding 13 days after surgery is even more uncommon. In twenty years of practice I have had one patient just like you. For whatever reason the blood vessels stay cauterized and then started bleeding after the body's natural healing mechanisms kick in. It might also have happened if the natural stretching that occurs disrupted a blood vessel at the edge of the strecthing. I'm sure it was quite frightening for and I trust that your surgeon took good care of you. It should not really affect your final result.

This would have been a frightening experience for any patient to experience but is fortunately a rare event with breast augmentation surgery. You developed a hematoma (collection of blood) around your breast implant nearly two weeks after surgery. Just when you thought you were almost healed you had this setback. Each surgeon will have their own experience but in my practice there is a less than 1% risk of this occurring and requiring urgent additional surgery. Although a hematoma after breast augmentation is most likely to occur in the first hours after surgery, they can develop many weeks after surgery when healing is still going on.

To understand this better you must realize that during all surgery, many blood vessels and small arteries are cut in order to introduce and make space for the implant. Plastic Surgeons are experts at doing this surgery with minimal blood loss. Tiny blood vessels are cauterized (burned) or tied to prevent them from bleeding. Each vessel develops a  blood clot that is slowly replaced by scar over a few weeks to create a permanent seal. However, during the first few weeks these "seals" are weak and could start to bleed if the "seal" gives away. Increasing the risk of this happening are periods of elevated blood pressure (such as what happens with a cough or sneeze), too much physical activity and movement before you are healed or using medications that reduce your ability to form blood clots such as aspirin and ibuprofen or delay healing such as steroids.

It is unfortunate that you experienced this and likely nothing would have prevented this in your case.  I am glad that you were well looked after and wish you the best over the long term.

Regards,

Dr. Mosher

I am very sorry for your unfortunate complication.  Bleeding can occur with any surgery, but luckily it is uncommon.  First, you did nothing wrong and sometimes a bleeding event like yours represents some bad luck.  At the time of surgery, your tissues were dissected and vessels were cauterized.  I believe your cough led to a clot to pop off a vessel or you might of torn a vessel.  I am hoping you have already seen your plastic surgeon and he/she has dealt with the resultant hematoma (blood collection).   Left untreated, a hematoma can lead to infection or capsular contracture of the breast (hardening of the breast)  Good luck.

During surgery incisions are made and so obviously blood vessels are cut. These open vessels are cauterized at surgery and/or form clots within them so that they do not continue to bleed without end. In the first week or 2 after surgery these clots can become dislodged in which case the blood vessel will start to bleed again. This bleeding can be significant requiring additional surgery to stop the bleeding and remove the expanding pool of blood that is outside the blood vessels.

Clots can be dislodged by exercise, heavy lifting, coughing, a head down position or other factors. This is why it is so important to follow your surgeon's after surgery instructions. Do not start vigorous physical activity like jogging, situps or even yoga until you are cleared to do so. I know of cases where a patient went jogging a week after a rhinoplasty. A clot dislodged during the run and the nose immediately swelled up. Another patient bent down in the shower to pick up a bar of soap a week after a facelift. One side of their face immediately swelled up. That side had to be re-opened and the blood evacuated that same day.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Hello,

Sorry to hear about your experience.  It is likely that an artery that was cauterized to make room for your breast implant pushed out the cauterized blood clot that was keeping it closed.  Another option, but less likely, is that a very tightly stretched artery was stretched tighter by the coughing and ripped.  These things are possible and there is no way to control them from occuring after the surgery is finished.  It is partly the reason why plastic surgeons ask patients not to do too much such as excercise, lifting, etc in the weeks following surgery.

All the best,

Dr Repta