Are there risks of leaving the hematoma to dissolve on its own?

Question

I developed a hematoma in my right breast 10 days post op (had implant revision with lift around areolas). My PS said he could not drain it because it will risk infection. I will be 3 weeks post op tomorrow. The swelling has gone down but I am still badly bruised. I will be seeing my PS again tomorrow. Are there risks of leaving the hematoma to dissolve on its own? Or should It be surgically removed?

Christian Subbio, MD · Answer

The risks of draining is infection.  The risks of leaving it is capsular contracture or infection.  Only your surgeon can give you the best advice as he she knows all of the variables.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Jed H. Horowitz, MD, FACS · Answer

hello j1092xo General risks of surgery include infection, pain, delayed would healing, hematoma (a collection of blood at the surgical site), bleeding, hardness of the implant or reactions to anesthetic. You should visit or contact your PS about this concern. #risk #infection

Mathew A. Plant, MD, FRCSC · Answer

Its a fine line between what should and should not be drained. If there is just bruising then there isn't much that can be done, but if there is actually a pocket of blood then removal is a consideration. Blood causes inflammation which can lead to capsular contracture, so typically we dont want to see any blood in the pocket at all. Ultimately your surgeon is the one who is seeing you in person, so you have to trust that judgement call over anything you get online. Best of luck!

Douglas Taranow, DO, FACOS · Answer

Thanks for the question.There are always several correct answers, but they depend on more information.  A small hematoma may be left without consequence in most cases.  Larger hematomas should be drained (despite the increased risk of infection...usually very small) to ward off a delayed capsular contracture.  Follow your surgeon's advice as they are seeing you in person.Best of luck.Dr T

Amir Nasir, MD · Answer

The main risk are infection, capsular contracture, and skin necrosis. These are all uncommon for small hematomas but can be real risks for larger ones. I am glad that you will be seeing your plastic surgeon about this as he or she is the best one to help you make the decisions about whether to drain or watch expectantly. 
I hope this helps!

Connie Hiers, MD, FACS · Answer

Small hematomas can probably be left alone to dissolve, but larger hematomas could increase your chance of capsular formation and interfere with healing. Your surgeon would be the best one to know if it needs to be drained.

Arthur Shektman, MD · Answer

There are risks involved with leaving a large hematoma alone, such as secondary infection, deformity of the breast and capsular contracture.    However draining it can also cause an infection.  You need to have a conversation with your plastic surgeon and address your concerns with him/her.  You may also wish to seek a second opinion if your doctor seems dismissive of your concerns.

Tom J. Pousti, MD · Answer

I am sorry to hear about the complication you have experienced. Yes, there are risks associated with  every option. Risks associated with leaving undrained blood around the breast implant; secondary infection and/or capsular contracture would be my concerns. Good advice should be made based on careful clinical evaluation of your unique situation.Best wishes.

Steven Wallach, MD · Answer

If it is a large hematoma then you should probably have it drained and the pocket washed out. Blood is a nidus for infection.

William B. Rosenblatt, MD · Answer

It should be drained. The risks of leaving it are capsule contracture, infection and breast deformity. Unless it is tiny it should be opened and cleaned out.

Are there risks of leaving the hematoma to dissolve on its own?

Answers (13)

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