Difference between hematoma and granulomas?

Question

I had a BBL in 2015 in NY. I never had any complications, however, I started to feel discomfort on my leg, more specifically the near groin part and my right hip. I had an MRI in 2023 and they said I had Granulomas contain dense calcific rims and/or situated between gluteus maximum S and gluteus medius bilaterally. Now, after an injury, I had MRI and was told I have a hematoma in my right gluteus maximus. Was the hematoma because of the BBL or this are two separate things?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the difference between hematomas and granulomas and whether your current condition could be related to your previous BBL.

A hematoma is essentially a collection of blood outside of blood vessels, usually caused by an injury to the walls of these vessels. This can happen due to trauma, surgery, or other causes of tissue damage. Hematomas can be painful and may cause swelling and discoloration of the affected area.

On the other hand, granulomas are small areas of inflammation caused by a collection of immune cells known as macrophages. Granulomas typically form when the immune system attempts to wall off substances it perceives as foreign but is unable to eliminate. In your case, the granulomas described in your MRI results seem to have dense calcific rims and are located between the gluteus maximus and gluteus medius muscles. This could be a reaction to the materials or fat injected during your BBL.

In your situation, the hematoma and granulomas are likely two separate issues. The hematoma you currently have in your right gluteus maximus is likely due to a recent injury, as hematomas generally result from direct trauma. Meanwhile, the granulomas found during your MRI are likely a delayed immune response to the BBL procedure from 2015, which is not uncommon with such procedures.

It's important to address both conditions appropriately. For the hematoma, rest and monitoring are usually recommended, and it should resolve on its own over time. However, if you experience significant pain or changes in the area, you should seek medical attention. The granulomas may need monitoring or treatment if they cause discomfort or complications.

I hope this helps clarify the difference between the two conditions and how they relate to your medical history. If you have further questions or concerns, please feel free to ask.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Camille Cash, MD · Answer

If your MRI revealed a hematoma nine years after your BBL it is most likely related to your recent injury and not your BBL.  A hematoma is a collection of blood in the tissues where granulomas are a collection of granulation tissue.  I encourage you to discuss your concerns with the physician who ordered the MRI.

Mats Hagstrom, MD (license on probation) · Answer

If your hematoma happened from the BBL, it would be present on your MRI in 2023?
Most likely your hematoma is from bleeding from your trauma.
Finding on your 2023 MRI is most likely changes related to your previous surgery(bbl)
Best,
Matt Hagstrom MD

Difference between hematoma and granulomas?

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