Hematoma in Breast - Will It Clear Up on Its Own?

Postoperative bleeding and resultant hematoma formation
can occur with any cosmetic breast procedure. When this situation arises, the
management of hematomas is dependent upon a multitude of variables. The type of
breast procedure, the location of the hematoma, the size of the hematoma, and
the presence of an implant are all extremely important factors.

The significance of hematomas in patients who have
undergone breast lift or breast reduction surgery is often dependent upon the
size of the hematoma. When hematomas are small it’s not unusual for them to
resolve on their own without treatment. Under these circumstances the vast
majority of patients heal without residual deformities.

Large hematomas may require surgical drainage. When
untreated, these hematomas may become encapsulated and form a firm mass. In
some cases, untreated hematomas can result in excess scarring and distortion of
the breasts. For this reason large hematomas should be surgically drained
whenever possible,

When hematomas develop following breast augmentation
surgery, significant secondary complications can occur. Under these
circumstances undrained hematomas can result in pain, breast distortion,
capsular contractures, implant displacement, and infection. For this reason,
hematomas following breast augmentation should be drained as soon as possible.

If you’ve developed a hematoma following cosmetic breast
surgery it’s important to consult your plastic surgeon as soon as possible.
Your surgeon should be able to formulate a treatment plan that addresses your
problem.

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.

Unfortunately, without a complete history and physical exam and through pre operative photography there is not enough information to make an informed plan, please consult your surgeon or another local board certified plastic surgeon

My preference is to surgically evacuate any hematomas of significance around a breast implant.  Studies show a much higher rate of capsular contractures later, if this is not done.

Expanding hematomas which threaten wound integrity or vascularity with impending exposure have to be treated. Treatment of a stable hematoma is more controversial with some surgeons opting for evacuation to minimize risks of capsular contracture or organized clot whereas other prefer observation with thoughts of resorption and minimizing repeated implant exposure.

It would seem unlikely that you have a hematoma as both breasts are relatively the same size and shape. If unsure see your plastic surgeon for a follow up examination. A small hematoma will resolve on its own a larger hematoma must be drained to prevent future complications. 

Thank
you for your question. I have included some typical expectations of breast
surgery recovery and signs to watch for following breast augmentation:
Stiffness, swelling
and bruising in the chest region: These are normal experiences as the skin,
muscles and tissue heal. Pain medication and muscle relaxants will help you
cope with any discomfort. Consistent sharp pain should be reported to your
board-certified surgeon.Hypersensitivity of
nipples or lack of sensitivity: This is normal and will gradually resolve over
time.A mild to severe itchy
feeling of the breasts is possible as healing progresses. An antihistamine like
Benadryl can help to alleviate severe, constant itchiness. If the skin becomes
red and hot to the touch, contact your board-certified surgeon
immediately.Asymmetry, the breasts
look different, or heal differently: Breasts may look or feel quite different
from one another in the days following surgery. This is normal. No two breasts
in nature or following surgery are perfectly symmetrical.Discuss returning to
work with your board-certified surgeon, in our office it is typically 3-5
days post-surgery but you may not overexert yourself or do any heavy lifting.You may resume
exercise and your normal routine at six weeks unless your surgeon advises
otherwise.It is important to keep an open line of communication with your board-certified surgeon. If you are experiencing a lot of discomfort or your condition worsens, please inform them immediately. Best of luck to you! 

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 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.

The majority of small hematomas will resolve overtime on their own. They start as a firm area and soften over a few weeks. Ultimately, they are absorbed by the body and leave no discernible deficit. For large hematomas, particularly around implants, an operation is usually necessary to remove them. This is because very large hematomas may never go away completely and can lead to issues such as infection, capsular contracture, or firmness in the breast.

 

Whether it will clear with no after effects depends on the size.If the breast is hard and rigid it is better to remove it.If it is small and localized you should do fine.