Breast implants are swollen, uneven and painful. The bigger breast had fluid/blood leakage inside. What could be causing this?

Based on your photographs you are still very early in your recovery. It is not uncommon for the breasts to look and feel different because of any asymmetries present before augmentation, differences in swelling, or blood around the implant. Blood inside the breast can occur after surgery despite a surgeon’s best efforts to ensure a clean dissection and any visible bleeding is stopped. Bleeding is not an infection or implant illness. Each plastic surgeon has their own method to deal with blood inside the breast. In your case, there is resolving bruising at the bottom portion of the breast. It is hard to appreciate how much blood is around the implant. If there is a significant amount of blood in the breast, I would generally recommend removing it to prevent scarring around the implant (capsular contracture). I would recommend discussing your concerns with your plastic surgeon and ask how he/she usually deals with this issue.

From your photos it appears you are very early in your recovery when bruising and swelling is not uncommon. However as your surgeon has identified some other issues it is important for you to keep in close contact with your surgeon who will advise what is needed to address the concerns. Bleeding is not a sign of infection or implant illness.

It is impossible to conclude about your problem without in person evaluation and ultra sound exam. It is very likely that you have blood cloths around implants; if so, removal of implants to allow for removal of blood cloths, and placement of implants back to the same pockets, may be needed ASAP. Good luck.