What procedure would you recommend for a Breast Implant Revision after hematoma? (photos)

It has been one year since my breast augmentation with Mentor saline implants. I had a hematoma which was removed by the surgeon about two week after surgery. I currently have two different breasts. The non hematoma breast settled lower and the breast that had the hematoma is firmer to the touch (not squishy like the other), shaped like a ball and is higher on my chest. I do not have pain. What action would you recommend if I came to your office? I am unsure what my next step should be.

Doctor Answers 10

Procedure to Correct Firm Breast After Hematoma

As others have said, the procedure of choice is to remove the scar tissue ( capsulectomy), and this would require replacing the implant, but the result should be good symmetry with the other breast, and a soft breast.  The procedure would require a drain for a couple of days, but the recovery should be no more difficult, and less painful than the original breast augmentation because the muscle has already been elevated.

Chicago Plastic Surgeon
4.8 out of 5 stars 95 reviews

Capsular contracture

Thank you how your picture. Your hematoma has caused a capsular contracture. The recommended treatment for this would be removal of the implant and removal of the capsule. Replacement with a new implant possibly textured beneath the muscle. Revisit this with your original surgeon. 

What are the complications and treatments for a hematoma following breast augmentation?

A hematoma following a breast augmentation is often times associated with a complication known as "capsular contracture". This is the result of a normal production of scar tissue around the implant that has gone awry and contracts around the implant. This contraction produces the issues you are dealing with. The treatment requires a surgical release of this scar contracture called a capsulectomy. This will return your right breast to the appearance of your normal left breast.

David A. Ross, MD (retired)
Chicago Plastic Surgeon
4.6 out of 5 stars 89 reviews

What procedure would you recommend for a Breast Implant Revision after hematoma?

You may have capsular contracture. This is typically treated by removing the capsule. You should discuss this with your surgeon. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

What procedure would you recommend for a Breast Implant Revision after hematoma?

Unfortunately you have the typical resultant fibrosis or capsular contracture following a bleed post op. Only open capslotomy/ectomy can resolve this issue.. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Hematoma after augmentation

It would appear from your picture that you have a capsular contracture.  A year has passed. You will probably need a capsulectomy or capsulotomy. Of course a diagnosis can only be made in person.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 29 reviews

Uneven breasts

It would appear that you have had an early capsular contracture surrounding the right breast as a result of having the hematoma.  I think that letting the breast settle for several months initially, then making a  decision about what may  help the most to revise the breast should be considered.  Perhaps a capsulotomy or capsulectomy with implant exchange may be necessary.

Good luck to you.

Frank Rieger M.D. Tampa Plastic Surgeon

Capsular contracture

It looks like you developed a capsular contracture based upon your history and photo. Best to be seen in person to determine the next steps.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast implant capsule contracture 1 year after hematoma. What should I do now?

   Hematomas, particularly those that are not immediately evacuated, can instigate the development of capsule contractures. According to the Baker classification  you are a Baker 3 capsule contracture because your breast is firm, and deformed. It would be a Baker 4 (most advanced) if you had pain with it.
   If you were my patient I would recommend removal of the capsule (capsulectomy), and replacement of the implant with a new one. If cost were no obstacle, I would recommend that we do likewise on the opposite (normal appearing) side. Doing both sides gives you the best chance  of having symmetrical breasts because both breasts are re-starting from the same point. i realize that a lot of PS would disagree with me. I want to also point out that there are an enormous number of short cuts that your PS might want to take, beginning with opening but not removing your capsule and washing and re-inserting your same implant. I allow my patients to vote on what they want me to do once they understand what the options and their costs are. I usually have my patients start on a capsule contracture prevention protocol which works for most patients.. 

Stephen W. Gordon, MD
Las Vegas Plastic Surgeon
4.3 out of 5 stars 11 reviews

Contracture after hematoma

Based on your symptoms and photograph, it looks like you developed a capsular contracture on the side that had a hematoma.  This is not an uncommon outcome after a hematoma -- even though your surgeon evacuated the blood in your breast, the residual blood in the tissues was enough to cause the scar tissue that formed around your implant to become thicker and tighter than that on the other side.  As a result, you have a nice, normal left breast and a tight, hard right breast.  A capsulectomy to remove the thick scar will allow your body to form a new, hopefully softer capsule that better matches your left breast.  You should talk to your Plastic Surgeon about your options.

Andrew Wolfe, MD
Denver Plastic Surgeon
5.0 out of 5 stars 129 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.