I had breast augmentation under the muscle 2 days ago. Normal Bruising or Hematoma? (photo)

I had breast augmentation under the muscle 2 days ago and have noticed bruising under my right breast around the incision area. I don't feel any extra pain or swelling in that breast but am worried it could be a hematoma. From the picture, does it look like normal post-op bruising or a hematoma?

Doctor Answers 10

Normal Bruising or Hematoma?

From your pictures I suspect you have bruising.  A hematoma would present usually with more enlargement of the breast on that side and more pain.  Continue to follow up with your surgeon.

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Orange County Plastic Surgeon
5.0 out of 5 stars 9 reviews

Appears to Be Normal Bruising

Thank you for your question and photos. This looks like normal bruising. A hematoma is usually  not subtle. It is typically painful, swollen and very bruised on the affected side.  Keep your regularly scheduled appointment with your doctor to ensure that your recovery is unventful.  Good luck.


Based on your photos, it does not look like you have a hematoma, but rather some bruising around your incision. Please followup with your PS for a check up. I'm sure you'll love your results in a few weeks. Dr. Basu Houston, TX

Normal Bruising or Hematoma?

Although this does not look like a hematoma, photos on  the internet do not particularly provide a safe source of diagnosis. 

My one concern would be an allergic reaction to the adhesive on the steristrips. If you start get blisters on the red/purple areas, removal of the strips should be considered. 

A call to your surgeon is in order. \

Thanks, best wishes.

Normal Bruising or Hematoma?

Best to be seen in person by your surgeon to check this issue. Very hard to diagnose via the internet. 

Postoperative healing

Hi, it appears to be bruising and not a hematoma.   Did you follow up? What did he say?  How is it now?   

Michael A. Fiorillo, MD
New York Plastic Surgeon
5.0 out of 5 stars 81 reviews

This is not a hematoma. Lack of asymmetric swelling is the key!

At least at the time of the photographs (thanks for including), there is no asymmetric swelling of your breasts on the frontal view, only peri-incisional bruising. This is almost always caused by the skin incision closure sutures, and usually does not represent bleeding within your implant pockets.

This, of course, depends on your surgeon having used a fluid-tight closure of the deep tissues (breast fascia to abdominal wall muscular fascia) beneath the skin closure. Fat-to-fat sutures do not work, and some surgeons utilize only dermis/skin closure. Many (like yours) utilize steri-strips to reinforce their closure, and to provide a scar-reducing contact-inhibition layer over the skin edges. I have found over the years that steri-strips cause too many blisters from traction on the epidermis, as well as hiding the wound from my inspection. (Difficult or impossible to see early wound separation or infection beneath an occlusive dressing.) I use a clear Tegaderm dressing through which I can examine the incision while completely isolating it from external bacterial contact. It's also water-tight, so showering is OK, and I remove it in 7-10 days when the incision edges are completely sealed and wound security is well on its way!

While I cannot see your incision edges to determine if there is any separation causing or from this bleeding, your breast is not enlarged more than the other side, meaning there is (again, at the time of your photographs) NO evidence of a hematoma within your implant pocket. Typically that will cause nearly doubling of the breast size, not insignificant discomfort, sometimes arm numbness (pressure on armpit nerves), breast skin taut and often shiny-appearing, and usually much patient anxiety. 

Bleeding within the pocket (hematoma) requires re-operation.

If things continue to look like they do in your photographs, this bruising should absorb on its own without further concern.

When in doubt, however, check with your surgeon, who knows exactly how much bleeding was encountered in surgery, if there are any other specific concerns related to you, and who will be responsible if there is any problem during your recovery. Best wishes and Happy Holidays! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 220 reviews

Bruising or Hematoma after Breast Augmentation

        At the point the pictures were taken, you have a bruise or a clinically insignificant hematoma (i.e. one that does not require intervention).  If the area of bruising gets larger or the breast becomes significantly larger, please see your plastic surgeon.

Breast implants

The photos you show may be a sign of early bruising or possibly a hematoma. Hard to say without an exam.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

Normal Bruising or Hematoma after Breast Augmentation?

Thank you for the question and pictures.

Based on the pictures, I think that it is most likely that you are experiencing “normal bruising”. However, keep in mind that your plastic surgeon is your best resource when it comes to precise diagnosis, advice, and/or reassurance.  I am sure that he/she will want to be involved and know of any concerns/questions you have;  you may want to send him/her the same pictures/questions.

 By the way, I think you are on your way to a very nice result after breast augmentation surgery.

Congratulations and Merry Christmas!

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.