I Am in Severe Pain After my Breast Augmentation - Is It a Hematoma?

Complaints of pain and swelling after breast augmentation are always to be taken seriously.  You should insist on seeing your surgeon personally.  If he has seen you already and feels there is nothing wrong, you can either accept his opinion or seek a second opinion.

If he is unwilling to see you with such complaints, you should seek a second opinion.

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.  If your doctor is not concerned, then I would consider another opinion from a board certified plastic surgeon in your area.

Sorry that you are having this type of issue.  We are all at a bit of a disadvantage as the photo you sent does not give a good view.  We also don't know the extent of surgery or what the plastic surgeon did in the operating room.  We also don't know if the doctor has seen you with the current symptoms.  In any case, the plastic surgeon, or whoever is covering for him should be available to you.  If he truly does not want to see you, then it is OK to seek a second opinion from a board certified plastic surgeon.  If all else fails, you can go to the ER, and they will call the plastic surgeon taking call.  BTW, I would call the hospital's ER first and ask if they have plastic surgery coverage for that day.

I am sorry that you are suffering.  You need to call your plastic surgeon again and be seen.  Your picture and description sound like you may have hematoma.

Their may be some miscommunication between you and your surgeon. You say he has washed his hands of it. Is that after seeing you or without any examination for your current complaints? Since you pay for surgery and aftercare at one time if he has not seen you for this complaint and refuses to do so move on -go to the emergency room or find another surgeon. If he/she has seen you and doesn't feel it is a hematoma that is another story. Without having examined or operated on you there is no way for us to know what the problem is from this limited photo.

If your surgeon has seen you but the 2 of you disagree on the severity of the problem that is a different situation. In that case my suggestion would be to ask your surgeon for a referral to a colleague who can reassure you or help your surgeon change his/her mind. Doctors are only human and every one of us is prone to tunnel vision when it comes to our own patients and their results/complications. If there is a problem after surgery it is usually best and cheapest for the operating surgeon to correct it.

The severe pain that you are describing, together with the swelling on the photograph makes me very suspicious for a hematoma.  This should be addressed immediately.  Also, the redness may be from an infection.  Either way, you should call your surgeon and he/she should see you immediately.  As you can see from the responses on here, a surgeon should never be unavailable to a patient that is describing the symptoms that you are.  If your surgeon will not see you, then you should find another surgeon or go directly to the emergency room.

I agree you should go immediately to see another board-certified plastic surgeon and if you cannot get into someone's office then simply go to the ER and they will call the plastic surgeon on-call for the hospital.  This sounds like a post operative hematoma which is not an absolute emergency, but it does need to be addressed as soon as possible.  Any board certified plastic surgeon will be able to tell if you have a hematoma on examination.  If you do, then the solution is going back to surgery to wash out the hematoma and replace the implant.  The good news is afterwards you will notice a rapid improvement.  Hematomas occcur in about 1% of all breast augmentations.  If they are tended too properly and recognized the final results are still excellent and not compromised.  If they are ignored, then most patients go on to develop a capsular contracture on that side. I hope this helps!

Sincerely,

James F. Boynton, M.D., F.A.C.S.

As you stated, you really need a second opinion and your surgeon is unwilling to see you.  You should schedule a visit to another surgeon asap and do not hesitate going to the ER if you feel it is necessary. 

Thank you for the question.

The description of your symptoms are very concerning.  I would suggest follow-up ASAP with your plastic surgeon;  if he/she is unable or unwilling to see you then a 2nd opinion may be your only option.

Best wishes.

It is too hard to tell by the photo you provided. Although everyone has different degrees of pain and discomfort after breast implant surgery, the amount of pain you are describing is atypical. However, guessing at your diagnosis through this venue will just generate more anxiety for you. I would highly recommend you reattempt to see your plastic surgeon as soon as possible!

Good Luck

Dr. Babak Dadvand