What if Breast Hematoma Goes Untreated?

I am 6 weeks post op. i have a diagnosed hematoma under 1 breast that caused capsular contracture. Had lot of bleeding on one side post op, then purple discoloration that spread and turned entire bottom of breast hard. Now it's breaking up and I feel like 5 firm separate areas. Skin is still discolored. Other than capsular contracture and the obvious embarassing discoloration, what happens if I just never remove it or treat the hematoma? So far no signs of infection. Thank you

Doctor Answers 9

Breast hematoma

Thank you for your question. A hematoma can be very mild or very pronounced in its presentation. A mild one may induce slightly more swelling and increased bruising and will likely resolve on its own. A more severe hematoma can result in dramatic asymmetry in terms of swelling, feelings of light headedness due to loss of blood, severe bruising, and can be rapidly growing. If you every experience the latter, then I would contact your surgeon immediately and if you have trouble, you may even go to the ER. Larger hematomas often have to be surgically drained.  I would follow-up closely with your plastic surgeon.

Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Untreated hematoma after breast augmentation

Untreated hematomas (collection of blood in pocket) after breast augmentation can lead to long term problems. Early treatment likely reduces these risks.

  • Capsular contracture: the blood causes inflammation which can lead your body to produce a thicker capsule. This can happen in the short or long term.
  • Infection: old blood is perfect food for bacteria. As long as it is in there, the risk of infection is higher.

The best course of action for you depends on your individual circumstances. Old blood may need to be drained. If you truly have significant capsular contracture, a revision may be necessary to improve this. This is often performed after tissues have softened. 

Not treating the hematoma could lead to a poor result and higher chance of infection. It is critical that you see a board certified plastic surgeon to determine a plan that is most likely to get you to a good result safely.

Best wishes,

Michael Vennemeyer, MD

Michael Vennemeyer, MD
Southlake Plastic Surgeon
5.0 out of 5 stars 48 reviews

Hematoma after breast augmentation should be drained early to avoid further problems

Bleeding is a complication that can happen from any surgery.  In breast augmentation, if a hematoma (collection blood and clot around the implant) occurs, it is better to surgically have the hematoma removed within 2-3 days to avoid risk of capsular contracture (hardening of the implant capsule).  If significant time has elapsed from the surgery and hematoma, then, it is wiser to wait until all inflammation calms down before another surgery is done.  A hematoma can get infected if left alone and so you have to look out for redness, pain, fever, etc.  If an infection sets in, then, the implant has to be removed and the implant pocket needs to be cleaned out and the area has to be allowed to heal for 6 months to a year before attempting to put the implant back in.

Richard H. Lee, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 28 reviews

Discoloration will improve on its own.

After 6 weeks have already passed, there is no reason to go back into the breast pocket to evacuate the hematoma unless there is any sign of infection or a capsule has formed.  The discoloration will likely resolve altogether with time.

Jimmy S. Firouz, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 18 reviews

Untreated Breast Hematoma

At six weeks after having a hematoma, there is no compelling reason to re-enter the breast implant capsule. This was an issue to consider at the time the diagnosis was made, but that time has passed. It will likely be necessary in the future to perform a capsulectomy, but that awaits further healing and how the breast looks and feels with more time. Infection is always a risk and just because it has not occurred yet does not mean it will not occur. But that in and of itself is not a reason for surgery now.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Hematoma after breast augmentation

Hematoma is the most common preventable cause of capsular contracture. If it is diagnosed early, it is usually reasonable to actually go in a have the clot removed to prevent unnecessary inflammation related to the clot. Now that 6 weeks have passed, it is likely that there is nothing more to be done aside from massage as the discoloration will improve with time. Stay in touch with your surgeon as there are some doctors who will employ Singulair to help attempt to prevent the capsule.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Hematoma after Breast Augmentation

You have touched on the two major complications that are associated with hematoma that involves breast implants.  The first is that your rate of capsular contracture is significantly higher.  This can be a very significant complication, and will likely require at least one and potentially multiple revisional operations to treat.  Infection of the hematoma is also a possibility, and this can be devastating and require removal of your implants.

I strongly recommend that you follow up with your plastic surgeon and discuss your best options.

All the best,

Dr. Skourtis

Mia E. Skourtis, MD
Portland Plastic Surgeon
5.0 out of 5 stars 1 review

Untreated breast hematoma

Other than capsular contracture? That is a big complication which may require additional surgery so I do not understand why you would not want to be treated in a timely manner. The discoloration will resolve but you should be vigilant about followup and address surgical treatment with your physician.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Untreated breast hematoma

Two main potential problems with untreated hematomas....higher risk of capsule contracture and possible infection.  The discoloration will eventually resolve.   The capsule contracture may  need to be addressed surgically.   

Leonard T. Yu, MD
Maui Plastic Surgeon
4.3 out of 5 stars 26 reviews

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.