I had silicone breast implants placed 15 days ago. The left is soft and painless. The right is painful and harder to the touch. I had bilateral capsular contractures with saline implants in the past and am very concerned. Could this be an infection? Hematoma? Or contractures again?
How Do I Know if I Have an Infection or Hematoma After Breast Implant Surgery?
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Doctor Answers 14
Hematoma or infection
In short, your symptoms could be any of the three that you mentioned. Hematoma is generally accompanied by bruising, and your affected breast will be larger than the unaffected one. Infection may or may not be associated with fever. I generally ask my patients to begin breast massage soon after implant placement. There is some evidence that this can help reduce the occurrence of capsular contracture. Additionally, Accolate or Singular may contribute to the avoidance of capsular contracture. It would be wise to see your doctor ASAP. He or she will be able to diagnose this with a good physical exam and possibly labs. If these issues are addressed early, they are inconsequential, but the longer time between diagnosis and treatment, the worse the outcome.
Hard Breast Atter Recent Breast Augmentation Surgery
Since you have two breasts and both had the same procedure, it is understandable that you would be concerned about how different they feel after recent surgery. In theory, the harder right breast should feel more similar to the left and should not be considerably more painful at this point after surgery. You should return to your treating plastic surgeon immediately and discuss your options. It will not be a capsular contracture at this early point after surgery, but it may be a small hematoma or fluid collection.
Firm, painful breast 15 days after surgery
Please go back to your surgeon for a personal evaluation. With your history of prior capsular contracture, I'm assuming that you had more done than just a simple breast implant exchange. 15 days after surgery, it's possible to have a hematoma or seroma. With a hematoma, you might see new bruising on the breast, but not always. With a seroma, you might feel a fluid wave or "swishing" in the breast, but not always.
The fact that your breasts are so different at this point is reason to see your surgeon again ASAP.
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Whenever we do bilateral surgery, one side is always going to hurt more, bruise more and swell more, so that in itself is not alarming. It is difficult to tell with the picture as it is not very clear, but your best option is to be reassessed by your PS. Remember the signs of infection are swelling and hardness of the area, redness, warmth and pain.
Breast hematoma vs infection
If you are having fever and chills as well as swelling of the breast, then this could be sign of infection rather than hematoma. I would visit with your plastic surgeon who can better assess your situation.
Hematoma vs Infection after Recent Implant Exchange
If you have drains, this should be pretty easy to figure out. If not, infection will present with fever, redness, soreness, and swelling. 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 swelling combined by pain, could be a 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.
Pain and hardness early after breast augmentation
From the symptoms you describe and the time frame, infection and hematoma are most likely. Capsular contracture typically takes at least 4 to 6 weeks before setting in. It is important to follow up with your surgeon as soon as possible.
Painful Hard Breast
I think your concern is very reasonable due to the fact that one breast has no problem and you have had capsular contracture in the past. These are concerns that I would want to be made aware of if I were your surgeon. Please call him(or her) to be seen very soon. Good luck!
Early post-op issues after implants
After having implant exchange surgery and removal of capsules, it is likely that one breast required more work than the other. But, any questions this early should be directed to your surgeon if you are worried about a possible hematoma.
Early Post-op Concerns Need to be Directed to Surgeon
No one can tell you if you have a hematoma or infection from the information you provided. This should be addressed by your surgeon as soon as possible. Even if it does represent a hematoma, that hematoma can become infected if not properly and timely treated.
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.