3 days post, normal bruising after stressful recovery?

Surgery 3 days ago abroad, drains in overnight. Woke up in alot of pain with bruising. 390cc textured high profile partly/completely under muscle. I am worried about bruising, I went there alone, broke phone, took a suitcase back on the plane for a 2 hour flight. Recovery has not been restful, was lightheaded/confused for few days. Though pain and swelling is decreasing I worry about haematoma/infection? I smoked 5 cigarettes since the op. But taking antibiotic. Advice much appreciated.

Doctor Answers 6

Bruising after breast augmentation.

The concern when someone is worried about bruising is always a hematoma.  A hematoma is a collection of blood that fills the surgical space.  Usually this happens in the first 24-48 hours, although it can certainly happen in a delayed fashion.  A hematoma usually presents with increased pain, size, purplish discoloration and feels warm to the touch.

It's a bit difficult to tell in these photographs, but you seem to be fairly symmetrical in terms of size, shape and even bruising.  This is more bruising than I typically see in my patients, but some of this may have been caused by your postoperative course.

It would be best to be assessed by a plastic surgeon, however unless there is a large collection of blood (which would increase your risk of complications) the majority of this type of bruising will simply settle with time.  Try to take it easy, avoid stress and heavy lifting, and certainly avoid the smoking!  I hope it settles down.

Ottawa Plastic Surgeon

3 days post breast augmentation, normal bruising after stressful recovery?

I am very sorry to hear of your difficulty.  The bruising can be normal but I recommend that you send this photograph to your plastic surgeon for his or her opinion.

The right breast looks fuller and larger than the left.  Obviously  you had bleeding  following your surgery which is why the surgeon used drains.  However  if the right breast feels extremely tight with a lot of pressure and pain  a hematoma or further bleeding needs to be ruled out.   I would suggest that you return to see your plastic surgeon for an in person examination..  If that is impossible then see a plastic surgeon  locally for an examination  as it is very important to rule out a hematoma.

Breast Augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/Silicone Implants/Revision Breast Surgery

I appreciate your question.

Since there has been a change in your post op course, please contact your plastic surgeon so he/she can examine you and recommend the most appropriate treatment plan at this time.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute

Surgery 3d ago

Hello, it sounds like you had a very stressful postoperative course.  It is hard to comment on wound healing based on photos alone.  If you have any specific concerns perhaps it would be possible to contact your surgeon.

Keep up with the surgeon

You will need to stay in touch and keep  sending photos and updates.
Seems like it will be OK from the photos, but you are not out of the woods.
Smoking is not helpful for healing.
Best wishes.

Patient with a number of concerns after elective surgery abroad.

I am sorry you are worried, but this situation is of your own making. If indeed you have a hematoma and/or an infection, will you fly back to your surgeon for the proper intervention? You traveled without a caregiver, and could have fallen and had serious injuries or caused complications. Every US patient must have an adult caregiver for at least 24 hours so that the effects of anesthesia can wear off. Perhaps you stayed longer than a day, but you lifted a suitcase and traveled while lightheaded and confused.

I really want to answer your question but am absolutely flabbergasted by your bad decision-making. Sorry to have to tell you that, and I'm trying to be kind without being too blunt or sarcastic.

Drains mean your surgeon chose to place an "exit" for blood s/he was unable or unwilling to control in the operating room. Unfortunately, drains also allow bacteria "in" while allowing blood "out." Antibiotics only decrease the risk of infection, but do not eliminate those risks, especially when those bacteria have a "superhighway" right into your breast pockets and implants, which have no circulating antibodies OR antibiotics to "fight off" infection. (Hematomas don't count, except as culture broth.)

Oh, and a few cigarettes to decrease circulation and oxygenation of healing tissues! I'm not even going to go there.

If we really want to discuss choices that were made, we could also ask about textured implants under the muscle. This really is a good topic for discussion, but with drains to contaminate your implants, you may have to have them out if there is hematoma that becomes infected, antibiotics or not.

My advice to you is mostly too late, but not for other patients who are contemplating surgical tourism.

Don't do it.

For now, all you can do is communicate with your surgeon and see if there is an ABPS-certified plastic surgeon in your area who is now "good enough" to care for your complications when s/he was "passed over" when you chose your surgeon abroad. This may prove both difficult and costly. Please try to prepare for this, even though things may be "fine" for now. You have a much higher risk for capsular contracture as well, so your surgical journey may not be over when this procedure heals. Sorry. Good luck. Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 238 reviews

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