Hematoma Day of Breast Augmentation, 2 Blood Vessels Bleeding, Why Would this Happen?

9 hours after my breast aug. my left breast start leaking blood. It stopped on my way to my doctors and by the time they put me back into surgery it was 2 times the size of my right breast. The doctor took me back into surgery, drained and cleaned the area, removed and reinserted the implant. He inserted a drain for the next few days. They said I had 2 blood vessels that were bleeding. What causes this? Is it normal to have to pay additional costs for this? What happens from here?

Doctor Answers 11

Breast Augmentation - Hematoma Day of Breast Augmentation, 2 Blood Vessels Bleeding, Why Would this Happen?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I'm obviously very sorry to hear about this complication.  Complications, including this one (which is well known for this or any other surgery) can occur and one consolation is that this one, if recognized and addressed early enough (as it appears to have been for you) has a very high rate of success and, ultimately, you getting the result you wanted.  That is not the case with all complications, so it may be helpful to look at it that way.  As with most complications, you may never know exactly why it happened...

Financial policies vary widely from surgeon to surgeon.  In general, for something like this, surgeons charge very little or nothing for their fee.  However, depending on where the secondary procedure needs to be performed there may well be additional fees for the anesthesia, operating room costs, and in the event that a new implant is required (as can occur).  Policies are best established well before the surgery.  In my experience, surgeons bend over backwards to get the desired result with the least amount of trouble and difficulty, even if there is a complication, but that does not always guarantee that there won't be some additional fees.

I hope that this helps, and good luck,

Dr. E

Great Doctor

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hats off to your plastic surgeon.  He did the right thing by evacuating the hematoma immediately. 

Hematoma is a common risk of breast augmentation surgery especially if the implants are place under the muscle.  The national average is about 5% of cases.

I would thank your surgeon for taking great care of you.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

Hematoma of the breast

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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.  It is not uncommon for their to be additional costs associated with surgery (eg. facility and anesthesia).  However, it is common for the surgeon to waive or reduce their fees.

Hematoma after breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Developing a hematoma is a risk of surgery and can happen even when your surgeon takes all necessary steps to minimize their occurrence. Fortunately, your surgeon was quick to resolve your concern. Additional costs may be incurred, however you'll have to discuss with your surgeon.

Hematoma Day of Breast Augmentation, 2 Blood Vessels Bleeding, Why Would this Happen?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From your excellent written description I must compliment your chosen surgeon upon his care for you. Unfortunately "things happen", but the care you receive was excellent and appropriate. As for additional fees that is your surgeon's determination. In my practice I do not charge for "immediate" complication surgery. From here let's hope you obtain an excellent result. Best to you. 

Complications of breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

1-2 % of patients may have hematomas.  some depends upon the method and experience of the surgeon.

Unfortunately, most patients will need to pay for at least the operating room and anaesthesia.  The surgeons fees are up to your doctor.  All patients accept a certain risk of unusual events that can occur .

Make sure 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Bleeding After Breast Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There can be a variety of causes for bleeding after your breast augmentation surgery. A clot can be dislodged from a blood vessel by your body movement, by high blood pressure, by disappearance of epinephrine in the anesthetic, by clotting abnormalities, among other things. Post surgical bleeding is a known possible complication of surgery. It is fortunate that it was discovered early so that your surgeon could deal with it promptly. Hopefully you will have a good outcome in spite of the stress of this bleeding episode.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Postop hematoma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hematoma can occur after any surgery and, assuming you weren't taking anti-coagulants, can occur when small clots dislodge. Hopefully, everything should go on to heal well and your doctor treated the complication appropriately. Generally, revision of a cosmetic operation is not covered by health insurance but the surgeon will not charge a fee for his services. If the revision was performed outside his own office, there might be a facility charge. Consult your patient financial agreement and discuss your concerns with your plastic surgeon. Best of luck!

Issues regarding breast hematoma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Unfortunately, bleeding and its manifestation as a hematoma, is a known risk of breast augmentation. There are several causes of it. Anything that can dislodge a clot from a vessel that had been cauterized can precipitate this bleeding. An elevated blood pressure can do this such as that caused by significant pain after surgery or some exertional activity. Blood thinners that had been taken within 10 days prior to surgery can also be a culprit.

Unfortunately, there are costs for taking you back to surgery. Sometimes, your insurance may pay for this but it is not too common because it is related to a cosmetic procedure, an exclusion to coverage.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Complications are a part of surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I'm sorry to hear about your complication.  Unfortunately, postoperative hematoma is a known complication after breast augmentation, occuring about 1-2% of the time.  At the completion of the procedure, the surgeon makes sure there is no evidence of bleeding, however, blood clots can become dislodged for a number of reasons in the immediate postoperative period.  This is what causes the hematoma.  Even with good surgical technique, hematomas happen to the best of us.  You should be thankful that the hematoma was recognized early and was treated in a timely fashion.  The downside is that someone has to pay for the extra trip to the operating room.  Some insurance companies will pick up the tab--but increasingly, policies have exclusion policies for complications resulting from cosmetic surgery.  If this is the case, most surgeons will not expect to be paid again, however, they usually will not pay for any extra charges such as hospital fees, etc.  I specifically discuss this possibility with my patients before surgery and encourage them to read their insurance policy to see if there is such an exclusion clause.  I hope this helps you!

Elan B. Singer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 26 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.