Hematoma After Breast Reduction Surgery

Hematoma is certainly one of the more common complications that can occur with breast reduction surgery. While there is no exact right answer, generally, if the involved breast is over 1.5 times the size of the other breast, I will typically drain this. More importantly, if I feel the hematoma will have a detrimental affect (wound healing,skin loss, infection) on the involved breast I will recommend a drainage procedure of some sort. This could be needle aspiration or an open procedure. A second opinion is worth while if you do not trust the answer you are getting from your surgeon.

Hematomas unfortunately happen to 1-2% of patients who have surgery, including for breast reductions. The decision to drain a hematoma surgically versus just let it dissolve away on its own depends on a few things: 1. the size of the hematoma, 2. how uncomfortable the patient is, 3. whether it's causing compression or loss of blood supply to the nipple or any other part of the breast, and 4. if it's getting bigger in size. If you have a small hematoma that is not causing you discomfort and is not compressing anything or getting bigger, it is ok to keep an eye on it and let the body break it down and dissolve it. The whole process can take about 2-3 months, so I typically only do this if the breast is barely different in size and very minor. Anything bigger than that I typically take to the operating room and drain it so that the patient can recover a bit faster and move on with her life.
-Dr. David Mattos, New York Plastic Surgical Group

Thank you for your question. 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.