Hematoma Questions

I had a hematoma 11 days post op after revision a peri-areolar breast lift (had implants put in 6 months ago). The doc immediately aspirated and then aspirated it again 4 days later, stating there was no new blood. My breast is badly bruised & swollen. I have read a hematoma can cause scar tissue and am also worried the swelling can impact the healing of my incision. Do you have any recs to help heal the hematoma beyond what my doc has already done? Creams? Ice? Massage? Anything? Thanks.

Doctor Answers 5

Hematoma Questions

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Thank you for your question.  Your bruising is slowly dissipating and your breast is not overly enlarged.  Since the implant was performed 6 months previously, the lift was performed above the implant.  Most likely the hematoma was in the breast tissue and not the implant, decraesing risk of scar tissue formation.  Continue close followup with your surgeon. Best Wishes on a  speedy recovery. 

Hematoma post op breast lift revision

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Hi.  You are 11 days post op and this seems to be tissue bruising.  Your doctor has aspirated and this breast does not seem overly enlarged.  Since your breast implants are now protected over 6 months, (assuming that you did not have any implant work 11 days ago), then you should absorb this hematoma/bruising over time.  This is very early and you need time. Bruising in the tissue does not usually cause a capsular contracture considering implants placed so long ago.  Be patient...stay close to your ps and you will do fine.  Any creams or ice/heat is individual to ps's so ask the right questions.

Hematoma after Breast Lift?

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Thank you for the question and picture.

Hopefully, the hematoma that you have experienced is located in the breast tissue and not around the breast implants that had been previously placed.  I suggest massage to all my patients who have breast implant surgery.

Best wishes.

Hematoma after Breast lift

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Since your implants were done 6 months ago, and I assume that there was no implant work done at this second surgery (consisting of periareolar breast lift revision only), then the hematoma should be in your subcutaneous tissue only and not in the implant pocket, so it should not affect your implant pocket or cause capsular contracture as it probably would if it was around your implant.  In that case, the hematoma should be drained at surgery to hopefully prevent this.  Hematomas in the subcutaneous tissues eventually liquify over 10-14+ days and can be aspirated as your surgeon has done.  Sometimes not all the old blood is easily found and aspirated, and the surgeon wants to avoid hitting and rupturing the implant.  If the swelling is significant but no more can be blindly aspirated, they can consider getting an ultrasound exam to see if there is any fluid collection that can be drained or aspirated while visualized by ultrasound so that it is found and the implant is protected.  A certain amount of blood may cause some thickening in the tissues will have to resolve over what could take 6 months or so.

Hematoma after periareolar lift revision should not be a problem!

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Although you did not say, it appears your implants were placed at initial surgery 6 months ago, and this was revision of the scar only. If this is the case, the hematoma is within the breast tissue only, and despite the colorful display at present, will heal without any effect on your implant capsule, position, or overall softness. This hematoma does not seem to have caused any stretching on the scar either, so your revision would continue to heal just as if there was no hematoma at all.

If there was pocket work or implant removal/replacement, then there could be effects on these results, but this is more a theoretical possibility rather than an actual outcome expectation! Hematomas IN the breast pocket at the time of initial augmentation are the ones that cause capsular contracture. This sounds as if it's something entirely different, and you should not be concerned.

For now, I would follow your surgeon's advice, wear a supportive brassiere, avoid strenuous activities for two more weeks, and do not suntan or use a tanning bed as long as your scar is pink and immature (6-12 months).

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

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