What is the difference between a hematoma and just regular bruising?

Question

What is the difference between a hematoma and just regular bruising? How do I know when to contact the doctor about a bruised or swollen area?

Erik Miles, MD, FACS · Answer

For starters, you should contact your plastic surgeon anytime you have a question or concern after surgery.  I tell my patients that there are no dumb questions in the postoperative period.  Both a hematoma and normal bruising are caused by bleeding in the surgical space. What differentiates a hematoma is that it is a larger or organized collection of blood that sometimes requires further management.  Patients with hematomas can be more swollen or distended from the underlying collection of blood. Sometimes the bruising is much more severe near the hematoma. Your surgeon needs to evaluate you in order to determine if you have a hematoma and what if any further management is required.

Badar Jan, MD · Answer

An excellent question. Bruising causes a patchy discoloration of the skin without a defined area of swelling or lump. 
A hematoma has associated bruising but also tends to have a specific lump. Also a hematoma is something that requires some attention.
I wouldn't hesitate to discuss any concerns you may have with your surgeon, whether its in regards to bruising or a hematoma
Best wishes, 
Dr. Jan

Jerome Edelstein, MD · Answer

A bruise is really just a small amount of blood within or just below the skin.  It is harmless and will resolve over 2 weeks or so.  A hematoma is an actual collection of a larger volume of blood.  Big expanding hematomas after breast augmentation cause the breast to swell tremendously, and become very hard and very painful.  This often requires surgical intervention.

Daniel Barrett, MD · Answer

MSG222A hematoma is a collection of blood in the space under the skin that is sizable. Imagine a baseball size of blood under the skin.Bruising can be seen with a hematoma but is basically discoloration of the skin as blood breaks down.If you are concerned about this you should follow up with your physician for an exam.I hope this was helpful,Dr. Daniel BarrettPlastic and Reconstructive SurgeryBeverly Hills, CA

Martin Jugenburg, MD · Answer

A hematoma is a collection of blood that is not in the blood vessels. After a breast augmentation there is a chance of developing significant purple bruises and swelling. Unless you have pain to a specific area, can feel a localized soft protrusion like bulge, or asymmetry you probably just have normal bruising that will subside in approx. 10 days. If you have questions or concerns contact your surgeon. All the Best.

Jeffrey Umansky, MD · Answer

Thanks for your question.  A hematoma is a collection of blood from a bleeding blood vessel.  The breast will become quite swollen and painful.  If one breast is significantly larger and more painful, call your Plastic Surgeon right away.  If both breasts are slightly swollen and black and blue, you likely just have bruising.  If you are not sure, see your Plastic Surgeon for an exam, as a hematoma often needs to be treated with surgery.  Hope that helps!

Sean Doherty, MD, FACS · Answer

Patients should always contact their surgeons directly with questions about hematomas or bruising. A hematoma is a collection of blood in a surgically created area--like a pocket for a breast implant. A bruise is part of healing and likely around the suture site. A hematoma most likely needs to be treated immediately. I urge all patients that have this question or concern to contact their surgeon immediately.

Colin Hong, MD · Answer

A hematoma is a large collection of blood and this has to be drained surgically. Bruise are small amount of blood inside the tissue and should improve without any surgical intervention. Hematoma may be very painful but regular bruising by itself should not cause pain.

Matthias Solomon, MD · Answer

Dr. Seckel and others have clearly defined these terms; to give an analogy to make it easy to understand. Imagine a hematoma to be a balloon filled with blood; you pop it and it can be drained. Bruising is essentially like having blood soak up a sponge; the tissue gets soaked with blood. You cannot drain it. The body needs to slowly absorb and break it down. All bruising will eventually disappear without complications while if a hematoma is not drained, it can cause significant problems.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for your question and Dr. Seckel has given you a very professional answer to your question.  Essentially a little bruising is not something to be concerned about but a hematoma, a collection of blood, should be removed.Dr. Corbin

What is the difference between a hematoma and just regular bruising?

Answers (12)

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