Hematoma 16 Days After Breast Augumentation - Will It Go Away?

I woke up one day with big, painful and hard left breast... it happen almost suddenly! I went to the PS and he did say it was a hematoma and I will see him wednesday again. My question is how often it goes away on its on and how often surgery to drain the blood is necessary? thanks

Doctor Answers 16

Late hematoma after breast augmentation

It would be unusual to have a hematoma 16 days after a breast augmentation, but if it is (as opposed to just some bad bruising), it is best to remove the blood surgically.  Hematomas in many cases can be observed, and can even be aspirated with a needle after several days when the clotted blood tends to liquify.  However, in the case of a hematoma around a breast implant, if it is not thoroughly removed, it will tend to fibrose (become like scar tissue) as the clot matures, which many including myself believe can lead to capsular contracture.  If your surgeon suggests removing it surgically by opening the incision, don't be alarmed as it's often the prudent thing to do.

Hematoma 16 days after surgery

It is believed that hematoma may contribute to capsule contracture. The longest I had a patient develop hematoma was 14 days. I took the patient back to the operating room to evacuate the hematoma and stop the source if the bleeding. Patient is now months out and didn't skip a beat. My vote is to reiterate and remove the hematoma.

Mark D. Epstein, MD
Stony Brook Plastic Surgeon
4.9 out of 5 stars 231 reviews

Hematoma after Breast Augmentation

I treat symptomatic hematomas with surgery to evacuate the blood and stop any persistent bleeding. Small resolving hematomas can be managed with observation. From your photo, it looks like you have a minor bruise which will resolve with time. 

Hematoma after Breast Augmentation

Hematoma 16 Days After Breast Augumentation - Will It Go Away?
I woke up one day with big, painful and hard left breast... it happen almost suddenly! I went to the PS and he did say it was a hematoma and I will see him wednesday again. My question is how often it goes away on its on and how often surgery to drain the blood is necessary? thanks

It is really difficult to say if you have a hematoma or if it really deep bruising.  If it is a formal hematoma, where there is some blood in the pocket, I would address that by removing the blood.  If is just bad bruising, then you just need time.  Only a physical exam can determine the difference.

Good luck.

Hematoma Management VARIES Depending On SIZE

With regards to a hematoma after breast augmentation, it just depends on the size and the symptoms.  From your picture, it appears you have some minor bruising in the lower pole.  This in itself is usually not a reason to go in and drain the hematoma.  However, if the rest of the breast is firm, tense, and painful, then I would go in and evacuate the old blood.  Rarely do you find what caused the bleeding, but old blood sitting around the implant can cause an imflammatory reaction that can lead to more scar tisssue ( capsular contracture) down the line.  I hope this helps.

Breast Augmentation Hematoma

Hematoma is a known risk of breast augmentation.  It would be very unusual to develop a hematoma 16 days following your augmentation.  Although it is difficult to state for certain without an exam, it appears from your photo that you had some bleeding in a deep plane post-op which is only now becoming evident.  If this is the case, it should resolve in a few days and I would not be too concerned.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast hematoma

Thank you for your question and for sharing your photo. A hematoma can be very mild or very pronounced in its presentation. A mild one may induce slightly more swelling and increased bruising and will likely resolve on its own. A more severe hematoma can result in dramatic asymmetry in terms of swelling, feelings of light headedness due to loss of blood, severe bruising, and can be rapidly growing. If you every experience the latter, then I would contact your surgeon immediately and if you have trouble, you may even go to the ER. Larger hematomas often have to be surgically drained.

Surgical Intervention Necessary

Postoperative bleeding and resultant hematoma formation can occur following breast augmentation surgery.When this situation arises, surgical intervention is usually always indicated to avoid long-term complications.
When blood is left within the implant pocket following postoperative bleeding, the wound healing process can be adversely affected.Under these circumstances, undrained hematomas can result in pain, breast distortion, capsular contracture, implant displacement, and infections.For these reasons, hematomas should be drained as soon as possible when they occur after breast augmentation surgery.
It’s important that you discuss this issue with your plastic surgeon.If you’re unhappy with his response, a second opinion may be appropriate.

Hematoma after Augmentation

Anytime there is a change in the breast size, I ask my patient to immediately notify me, such that I can perform an in office examination.   

I would recommend immediate contact with your plastic surgeon as I am concerned by your swelling combined by pain, which is characteristic of a hematoma.   This may require operative intervention to control bleeding, prevent infection, and minimize risk of capsular contracture.

I wish you a safe and healthy recovery.

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 84 reviews

Hematoma of breast

If you have bruising that is one thing, but if you have a hematoma, then you may need to have the fluid removed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.