Placing a Drain 2 Weeks After Breast Augmentation Help Hematoma?

Thank you for your question. A hematoma can be very mild or very pronounced in its presentation. A mild one may induce slightly more swelling and increased bruising and will likely resolve on its own. A more severe hematoma can result in dramatic asymmetry in terms of swelling, feelings of light headedness due to loss of blood, severe bruising, and can be rapidly growing. If you every experience the latter, then I would contact your surgeon immediately and if you have trouble, you may even go to the ER. Larger hematomas often have to be surgically drained.  A drain may be placed afterwards to help with clearance of inflammatory fluid and reduce swelling.

A hematoma of the breast should be surgically drained. Afterwards the surgeon may choose to use a drain. However placing a drain only is inadequate treatment.

drains for hematoma

usually its necessary to drain a breast hematoma if it is larger enough to be visible or cause pain.

the pocket is usually irrigate out, cleaned and a drain may or may not be placed at that time..

One of the most widely recognized factors in capsule contracture is blood around an implant, and the only reliable way to clear all of the blood from around an implant is to open the pocket and physically remove all of the blood and wash the tissues.  Depending upon when the bleeding actually occurred and how long the blood has been there, this actually may be the only reliable way to get the blood out anyhow as if it has been there for more than a day or so, it will be clotted and firm and very hard to get out simply through a drain.  Once the blood is removed through an open incision, THEN a drain might be placed, but only after open removal of the blood.  In addition, this gives the surgeon a chance to inspect the pocket and see if a source of the bleeding can be identified and treated.  Unless your surgeon is considering placing the drain without making an incision, which is very risky from the standpoint of puncturing or damaging the implant, he will have to open the pocket anyway to place the drain.  Why not do things the right way and evacuate the blood completely?

The treatment of a hematoma is not placement of a drain.  The treatment is re-exploration of the breast implant pocket, control of the source of bleeding, irrigation of the surgical site, replacement of the implant and the possible insertion of a drain.  

A drain is not usually used to drain a hematoma. Usually additional surgery is requires to evacuate the hematoma and irrigate the pocket of the old blood.

There are many factors that go into answering this question.  Hopefully your surgeon is following you very closely.  Hematoma is unfortunately one of those things that can happen after any surgery and drainage may be needed.  Sometimes a trip to the operating room may be needed, sometimes it can be done without one, and sometimes a radiologist can help place a drain.  In the end it is going to depend on multiple factors such as when the hematoma started, if it is getting better or worse, and your best source of advice is going to be your surgeon.  Don't be afraid to ask him/her questions and make sure you are seen frequently.  The more communication the better....  Good luck!

Dear Jewels,

Thank you for your post.  A drain alone will not help with a 2 week old hematoma.  If the hematoma is getting smaller naturally over time, then allow it to continue.  If it is a large hematoma then placing a drain will not help as the blood as coagulated and is to thick to drain.  Opening up the pocket and physically removing the hematoma is necessary.

Best wishes,

Pablo Prichard, MD

Evacuation of a hematoma following a breast augmentation will require an open evacuation and exploration, not a drain.  The hematoma needs to be removed, the pocket fully irrigated with antibiotic solutions, a new implant may possibly be used to replace the original implant, and a drain now needs to be used.  Hematomas often lead to future capsular contractures around the implant, as well as the possibility of producing an infection in the breast pocket.

 

Don't be fearful of this condition, however.  Talk to your Plastic Surgeon and discuss which option may give you the best results.

 

Good luck to you.

 

Frank Rieger M.D.  Tampa Plastic Surgeon