Hematoma 2 weeks after Breast Augmentation. 375cc silicone. Should I be worried? (photos)

More often than not, a hematoma need to be drained, especially if it is symptomatic,  If it is small on US, it is reasonable to treat it conservatively.  However, a hematoma puts you at risk for capsular contracture on that side down the line.

Thank you for your pictures. Your plastic surgeon needs to look at your ultrasound and your examination to determine if this needs to be treated. Most hematomas need to be drained surgically. If this is a very small fluid collection then it may not. The determination for surgical treatment is up to the judgment of your plastic surgeon. Good luck.

A small hematoma might not require surgical drainage but on balance any significant collection of blood after breast augmentation should be surgically drained.

Thank you for your question and photos.   From the photos, there is not a big difference in the size of the breasts.  The management plan sounds very reasonable.  Every breast implant will have some fluid around it.  Best advice is to keep in close contact with your surgeon, flow their advice, and he or she will help you through the recovery period.

looks like you are doing all the right things for now. relax and continue to see your surgeon regularly

Hematoma can be very painful post-operatively. When it occurs in its maximum condition- it should be drained. This is done by an operative procedure temporarily removing the implant-- evacuating the blood-- and reinserting the implant. It appears from your photos that you do not have an emergency hematoma. I recommend watchful waiting and stay in close contact with your Board Certified Plastic Surgeon.

Hello,It seems that you have managed your concerns well, and that you are healing from your surgery well overall.  The bruises are to be expected with this dynamic.  Your infra-mammary incisions seem intact and healing.Hematomas, or bleeding post surgery, are not unusual.  In your case it appears that it is a non-expanding hematoma; meaning that you are not currently actively bleeding. The management of this can vary. In such situations it is reasonable to allow it to diminish non-operatively as you have described.  Depending on the size of the hematoma, sometimes we are concerned over the potential capsular contracture that may result, and consider a washout of the pocket.  This is decided on by the specifics of the case, and the surgical concerns of your surgeon.I hope this helps.Thank you,S.P. Maggi, MD, FACSAustin Plastic Surgery Center. 

Hematoma simply means a collection of blood  after surgery ( or some other trauma) so the treatment really depends on the size or amount of bleeding and blood collection. From your pictures an the ultrasound report it appears that the amount is small, so it is quite appropriate to observe this without any further treatment as they most frequently absorb. The bruising is simply some of the blood products that seep into the layers under the skin and are visible. This should also disappear over a few weeks just like any bruise. As alluded to by Dr. Blinski, there may be an increased risk of capsular contracture  with hematomas, but my sense is that you hematoma is small, and we probably have small hematomas quite frequently without even knowing they exist unless we look for them with an ultrasound. So I think you should not worry unduly. Occasionally as the hematoma absorbs, the blood turns from clotted blood to more liquid and can drain from the incision instead of absorbing. If you see this occur, contact your surgeon, but over ally it looks like you should do just fine.

It seems like the plan is very appropriate. Allow another month for the swelling to fully reside.  It may take longer on the breast with the hematoma as compared to the other side.  Your chances long term of getting a capsular contracture may be increased.

Your plastic surgeon is in the best position to know if the hematoma is large enough to drain.  A large hematoma can lead to an increased risk of developing a capsular contracture.  A small hematoma most likely will resolve on its own.