Why Does It Feel Like my Incision Isn't Healing Correctly? (photo)

I had my BA on August 10. It feels like I've had nothing but issue after issue. Day 1, bleeding from incision, told it was a hematoma. Day 10, bleeding again, this time dark blood, large clots. A week later, more drainage, this time, brownish liquid.Gross. In the breast where the incision was, I can stick a finger in a hole in what feels like is tissue that hasn't healed or was properly sutured. What can happen? Will I need it surgically repaired? Will it heal itself? I'm driving myself crazy.

Doctor Answers 8

Breast Enhancement Surgery

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You either have a fluid collection under the incision or the incision itself is infected and needs a minor procedure to clean up the fluid

Hematoma after breast augmentation is interfering with healing of your incision

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Thank you for your question and photographs. The swelling you see is possibly recurrent hematoma or liquefication of an old hematoma. It is important a you be followed closely by your plastic surgeon. There is always concern of extrusion of the implant following a hematoma and interference with wound healing

Breast augmentation hematoma

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Hi,  It certainly sounds like you had a hematoma and it then went from liquid blood to clots to a more "chocolate" like bloody drainage.  I would think that evacuation would have considered but you have advanced to a possible implant exposure.  This is not to say that it will happen but when you put your finger (not the best idea !!) in the wound that you know leaked blood, then there is a track to the implant.  You need to see your doctor immediately to evaluate you and put you on antibiotics.  That "bubble" that is shown in your pics might very well be more drainage waiting to happen. 

Keep fingers out of your wound

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If you have a wound separation such that you can insert a finger, the implant is at risk of contamination.  You need to see your plastic surgeon in followup.  He may want to start you on antibiotics.  Rather than  driving yourself crazy, please call your doctor!

Healing After Augmentation

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It is impossible to make an accurate diagnosis without an examination.  Your history suggests the possibility of a hematoma but your plastic surgeon would be much better able to make that diagnosis.  I hope you have been in contact with your surgeon.  If not, you should do so now.  Also, do not probe the incision as you may introduce bacteria into the implant pocket.  In general, I believe the best treatment for a hematoma is to surgically drain it.  If it is significant it will often find its way out of the incision or it may be absorbed but significantly increase the risk of a capsular contracture in the future.

Wound problems after breast augmentation

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Wound problems after breast augmentation can be a very serious issue placing your implant at high risk of infection. Bleeding or hematoma can cause a wound separation, and a suture abscess can also cause the wound to thin and open. In all cases keep your fingers out! Keep the area clean and see your surgeon right away.

Post Operative Wound Problems

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While an in person exam is needed for accurate diagnosis, your history and the pictures provided lead me to think that you have a hematoma (collection of blood) or seroma (collection of serum) that is putting pressure on your incision. In either case you should see you plastic surgeon, who after examining you will be able to make the diagnosis and treat you accordingly. If you haven't already, call him. Good luck.

Hematoma after breast augmentation.

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I would resist make a diagnosis from a photo, but it does look like there may be a fluid collection under the scar where it seems to be bulging, and this should be seen as soon as possible by your surgeon, who can then decide whether to aspirate this, get a culture and use antibiotics if indicated. 


Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.