Is additional surgery always required with post-op (breast reduc/lift) hematoma? Is it safe to "wait and see"?

I am 2wks post op today. (sutures gone) The night of surgery, I devloped a hematoma in rt breast. My surgeon assured me it would resolve itself. Earlier this wk I was referred to the ER (unrelated chest pain) a c/t scan showed a 5+ cm x 6+cm hematoma in rt breast. I shared the ct report with my surgeon at my 2wk, he stands firm it will resolve itself. He says, "the body will either absorb or make a way to drain it". Everything I have read here indicates surgery to drain, is "wait and see" safe?

Doctor Answers 2

#BreastReduction - Hematoma post-op

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You should, of course, be treated in person for this and remaining in contact with your plastic surgeon is the first step.

That being said, and in a general sense only, it is often a question of degree.  The larger the hematoma the greater the indication for its early evacuation.  Your situation is complicated by the fact that it's two weeks later.  With each passing day the need and urgency for evacuation of a hematoma like this presumably diminishes.  Furthermore, there is always at least some bleeding after a surgical procedure, and determining what constitutes a normal amount versus a clear hematoma is not always that precise.  And, finally, collections of blood will often liquefy and resorb on their own.  As long as you are otherwise okay (no fever, chills, sweats, redness, infection or signs of systemic problems) treating it expectantly - letting your body try to heal itself - is not unreasonable at this stage.

Remain in contact with your PS and, if you have any hesitation, seek a second opinion in person.  That's the only way you can be fully assessed.

I hope that this helps and good luck,

Dr. Alan Engler
Member of RealSelf100

Hematoma after a Breast Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hematomas are an accumulation of blood within the surgical site. Small hematomas can resolve all by themselves. Larger Hematomas may resolve by themselves, however it will take a long time. Aspiration or removal of the hematoma makes the resolution of the accumulation occur faster. Trust your plastic surgeon.

If you have any more questions about breast reduction surgery, please read my book, "Cosmetic Breast Surgery - a complete guide from A to double D".

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 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.