Does Having a Hematoma Post-op Increase Your Risk of Capsular Contracture?

An untreated hematoma would increase your chances of capular contracture significantly. However, in my experience once a hematoma is cleaned out the chance for capsular contracture is about the same. And for other patients reading this a drain may or may not be necessary after evacuation of a hematoma. So if you've had a hematoma and received no drain this isn't necessarily a bad thing.

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.Unfortunately, hematomas can increase the risk of capsular contracture in the long run.

A hematoma after breast augmentation increases your risk of capsular contraction. It sound like your doctor is treating you well. We know that capsular contraction rates are about 10% after six years in women with silicone gel implants. Capsular contraction rates with saline implants are much lower about 1-3% for some reason. We do not know exactly what causes capsular contraction. I do not know of any data about the exact incidence of capsular contracture rates after a hematoma but I think they are higher than someone without a hematoma. There are chemical mediators in scar tissue that cause the capsular contracture and your scar tissue is definitely increased with a hematoma. Massage after th wound is healed in probably the only thing you can do.

Follow up with a board certified plastic surgeon.

Capsular contracture has been researched and studied for years now.  Truth be told there are several associations that have been linked to contracture and one of those unfortunately is a hematoma.  It is difficult to quantify by how much your risk is increased, so try not to worry to much about it. Other things that have been linked to CC are talc on surgical gloves, seroma formation and bacteria.  Interestingly people who have none of these risk factors may get a CC while others that have all the risk factors may never get a contracture. The key is to have open communication with your surgeon and if you notice anything different with your breasts notify him immediately. Hope this helps. Good luck

Dear Wooten3955,

Sorry to hear you had a hematoma.  It sounds like your doctor did the best thing for you by not ignoring it, cleaning it out, and placing a drain.  You are probably at a slightly higher risk, but not necessarily.  I wouldn't worry regardless, that doesn't help. 

As for being proactive in trying to prevent a possible capsular contracture, there is nothing that has shown to be effective in preventing it.  This includes medications like Accolate, Singulair, and high doses of vitamin E, as well as post operative activities like implant massage.  Perhaps the most important thing you can do is to take your antibiotics while your drain is in.

Another medication I give my patients after surgery is a coritcosteroid for the first week; this is to reduce inflammation.  There is no data that this will decrease the risk of CC, but it definitely decreases post operative discomfort and makes the patient feel back to normal.  Coriticosteroids do not come without risk, and your doctor might find that those risks are unacceptable for you.

Best of luck, and it sounds like you are in good hands.

Yes, unfortunately, you developed a hematoma after breast surgery.  This is a rare occurrence and can happen to even the very best surgeons despite every precaution.  While the risk of capsular contracture is increased with hematoma, the risk is still very small.  It is best to keep in mind that these are only statistics and every patient is different.  in all likelihood you will be fine, but should continue to follow up with your surgeon.

 

Good Luck

Hematoma is a risk with any surgery and unfortunately this happened in your case. The good news is that you were treated promptly and effectively and in most cases this event will not affect your aesthetic outcome. Your risk of capsular contracture has been  increased but still remains fairly low.  The type of implant used and the pocket the implant is in will influence your risk. Many surgeons encourage implant displacement exercises for smooth surfaced implants beginning early on after your drains are removed.  Vitamin E supplementation, low dose antibiotics, implant stretches, anti-inflammatories, external ultrasound and other strategies have not produced predictable or tangible reductions in the risk of  developing breast implant capsular contractures. However, many of these approaches are unlikely to cause any harm and may be recommended. Be positive and follow your surgeon's advice.

Dr. Mosher

Hematoma does cause higher risk for capsular contracture if not treated early. You plastic surgeon recognized this rare, but possible complication and he treated you appropriately. From now on, you should have an uneventful recovery and you risk of capsular contracture should not be higher than if this would've not happened.

Yes, but only slightly, thanks to your surgeon. You plastic surgeon did exactly the right procedure by addressing and evacuating the hematoma early - the earlier the better. Blood soaks into the tissues if left too long, and the capsular contracture rate goes up significantly. The determination of whether the drain was necessary can only be made by your surgeon at that time. Follow his instructions. Massage exercises will be advised. Follow them closely, as they are important. Basically, you want the surrounding pocket to stay as large as possible and not contract down onto the implant. The massage exercises will help with this. Also a natural Vitamin E complex containing alpha, beta, gamma and delta tocopherol 400 to 500 mgm per day or twice a day seems to have been helpful through the years.

Unfortunately a few patients do develop a post op hematome. Your surgeon did the right thing by irrigating the area and draining it. The hematoma was dealt with in a timely, and therefore has minimized the risk of you developing a capsular contracture. In my experience, I do not find that there is an increased risk of development of a contracture, provided you massage the breast area daily for 2-3 months