PS says wait & see on hematoma 2 days post-op; feels fine, no pain, redness or bruising?

During the night following my BA, I experienced severe pain, tightness and my left breast rose and swelled. At my post-op appointment, my PS confirmed a minor hematoma. He debated evacuation and opted to wait on a possible natural resolution. At 48 hours post-op, with little to no bruising, and based on my pictures, could my left simply be reacting (much higher and tighter) differently than my right, and not be suffering a hematoma after all?

Doctor Answers 6

Possible Hematoma

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A hematoma will typically cause one breast to be significantly larger and firmer. Bruising may be visible and it will typically cause more discomfort on that side. Ultrasound imaging can be done to clarify. If a hematoma is present, returning to the OR to evacuate as soon as possible would be appropriate.

All the best 

Post-op hematoma

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Thank you for your question. There are two types of surgeons, the ones who have had a post-op hematoma, and the ones who will eventually have one. If you perform enough procedures, no matter how skilled the surgeon is, he or she will have a complication at some point. This is the case with any operation including breast augmentation. Surgeons have different opinions when it comes to addressing a hematoma. Much of it depends on the severity. With a breast augmentation, my typical preference would be to evacuate the hematoma, but this is not always the case. Each case is different and therefore your surgeon is the best one to work through this complication and determine the most appropriate solution.  It appears your surgeon is addressing the hematoma correctly. You will still have a very nice result and little increase in your complications down the road if you have the hematoma taken care of appropriately. It is possible your surgeon is following you closely and not evacuating it yet because it could simply be healing differently than the other. I am sorry you have not had a smooth recovery, but it sounds like you are being taken care of by your surgeon. Good luck to you.

Breasts hematoma ?

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Dear madam,

    Thanks for submitting your pictures.  From observing your pictures, I do not see signs of hematoma, however, if I suspect hematoma in any of my patients , I take them to  operating room and evacuate the blood clots . That is done to avoid capsule contracture that will occur most likely, if the blood clots will be left in the pocket.

    The asymmetry that you have might be also  from tightness of the pocket, which will improve with time. Implants displacement massage will help the implants to settle  faster. It takes about 3-4 months for the settling process to occur.

                 All the best,

                                           Dr Widder


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PS says wait & see on hematoma 2 days post-op; feels fine, no pain, redness or bruising?

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Thank you for your pictures and questions. Sorry to hear that you are having some problems after surgery. It is possible that each side could be healing differently and that could explain the difference. However, if there is a significant asymmetry and there was some concern for a hematoma, that could be concerning. It is not usually advisable to leave a hematoma in place as this can contribute to the formation of capsular contracture over time. But this is something you should discuss in detail with your surgeon, only he or she can make the proper decision on how to address your concerns.

Best of luck!


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Depends who you ask and their personal preference. Many surgeons feel taking the patient immediately back to OR to remove hematoma will give the patient a better long term result while others feel that leaving a hematoma won't make a big difference in the over all outcome.

Post-Op Hematoma after Breast Augmentation

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Healing will go on for 2-3 months for the early period.  There may be some swelling, bruising, malposition, color differences.   Sensation will be abnormal.  Scars will be changing. If my patients have concerns that something is unusual about their healing process, it is important for them to call the office and discuss these concerns or come in to be examined.

Always contact your plastic surgeon if you have concerns about post-operative infection, bleeding, swelling, fever, excessive bruising, or any new and sudden changes in the feeling or look of your implants, breasts or incisions. Any of the following may be post-op difficulties, about which it is best to contact your surgeon directly:

·       Excessive bleeding (hematoma) and bruising

·       Reduced sensation of #nipple

·       Deflation/rupture

·       Capsular contracture

·       Wrinkling/rippling. Palpable and/or visible

·       Firmness, and distorted appearance

·       Interference with breast feeding

·       Mammogram interference

·       Cost for revision surgery if necessary

·       Calcium deposits in the tissue around the implant

·       Breast tissue atrophy/chest wall deformity

·       Hypertrophic scarring

·       Tissue loss

·       Infection requiring antibiotics or implant removal

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