Diagnosed with Hematoma and Capsular Contracture, Do I Need 2 Procedures? (photo)

hi,im 27,nonsmoker,had BL+BA 700silicon 6 wks ago. one breast bled & discharged from day 1 but PS ignored my concerns. developed a large hematoma under breast that was firm (its softer now but still firm), the breast started intense cramping and got super tight and high. no fever, no infection from what i know. found a new surgeon who suggests i remove the implant and wait 6 months to replace but he only goes up to 400cc. Can i remove the hematoma/implant and replace with new one in 1 procedure?

Doctor Answers 3

Hematoma and Capsular Contraction

Hello. It seems possible to remove the implant, handle the hematoma and capsular contraction, and replace the implant in the same procedure. The exact treatment needs to be decided by the board certified plastic surgeon that you trust the most. If you are wary of the opinions that you have been given so far, it never hurts to see another doctor just to be safe.


Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Tampa Plastic Surgeon
4.8 out of 5 stars 75 reviews

Yes, full revision and replacement is possible in one procedure


The hematoma is likely gone by now, cleared by your body.  What you will have is overtly tight and/or thick capsule that will need to be removed.  The implant should also be replaced.  You may want to consider a drain in the breast after your surgery for 3-4 days as this may lower your chance for redeveloping a capsule contracture.  I do not see any reason why these cannot be done at the same time.  It is a somewhat safer process in terms of redeveloping a capsule contracture to wait before putting in a new implant but I have not run across a patient to date that has been agreeable to doing so for understandable reasons.  Below is a before and after photo of one of my patients who underwent a similar procedure as you are discussing in one stage.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Hematoma and Capsular Contracture, 6 weeks after surgery

Without examining you, I am reluctant to second guess your surgeon, but.....

Absent any signs of infection, simply removing the hematoma seems to be an acceptable alternative to what has been proposed. 

It seems like you already have two diametrically opposing recommendations. It might be well to see another consultant before making a decision.

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.