How to Tell the Difference Between a Bruise and a Hematoma After BA? (photo)

I am Day 6 dual plane, 325cc BA (mastopexy 6 months ago). I have significant bruising on the R breast that started on day 3, nothing on the L.The breasts still look the same size to me. I still have some discomfort/pain/tightness feeling, around the bruised area when raising my arms fully. I feel more of a "fullness" in bruised area but no 'lump' exactly. My PS was considering putting a needle in "to see", but I wasn't sure. If there is maybe a small hematoma, is it imperative to drain it?

Doctor Answers 11

Haematoma or bruising

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It looks much more like bruising as your breast is not really much more swollen on the right. However that is assuming your pain levels are similar each side. A classic sign of a haematoma is excessive pain and swelling in the affected breast.

Better to be safe-- check in with your surgeon.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is not unusual for patients to develop bruising following breast augmentation surgery. In the vast majority of cases, this is an isolated finding. It usually occurs as a result of bleeding within the subcutaneous tissue.
Unfortunately, bruising may also occur when hematomas occur within the breast implant pocket. In this situation, swelling, enlargement, firmness and pain are usually present as well.
Although your pictures suggest simple bruising, it’s hard to know with certainty without performing a physical examination. For these reasons, it’s important to consult your plastic surgeon. Your surgeon should be able to differentiate between these two conditions.

Probably bruising

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Judging from your photos alone, this may only be bruising. The presence of a hematoma is usually associated with unusual firmness, tightness and swelling. It can also be painful. Keep an eye on it and see your surgeon if you are concerned. Best of luck!

You might also like...

Bruising after breast surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It looks like severe bruising, but if the skin is very tense and hard you should return to your plastic surgeon immediately to make sure it's not a hematoma.

Breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Always follow the advice of your own Plastic Surgeon.  What I can see from the photos is very common.  After the surgery some of the muscle fibers will bleed and cause a bruise.  Prolonged bleeding that does not stop is called a hematoma.  It looks like a bruise from the photos posted.  I might suggest on my patient to use ice packs and Arnica and Bromoline. After a few days I might suggest on my patient to use warm moist heat over the area.  It should resolve.

Jay H. Ross, MD, FACS
Palm Harbor Plastic Surgeon

Bruise vs hematoma

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question. Your plastic surgeon is in better position to tell what this could be. Examination of the breast is paramount in this situation. It would not help you here if I say it's a hematoma when it's not or say its a bruise when it's a hematoma. You need to follow up with your plastic surgeon. Follow his advice and instructions. I wish you all the best.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Hematoma and Breast Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I agree with Dr. Gottlieb an exam is irreplaceable.  Based on your pictures it does not look like a hematoma.  Please continue to see your PS and relay on his/her exam and experience.  If it is a hematoma is should be drained because it could lead to infection and/or capsular contracture.

Dr. ES

Bruise or Hematoma After BA

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Nothing beats an in person exam, but this looks like a bruise, not a hematoma. If it is a small hematoma, it will probably need no intervention, and will absorb.

All that's imperative is follow up with your surgeon.

Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Breast Enhancement Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Things look great, a hematoma presents with rapid increase in size and a dramatic increase in pain, otherwise great result!

Hematoma or Bruise After Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is nice to see that you are paying attention to your surgery to think to ask this question!  Bruising is not unusual following breast enhancement and is not typically any concern as it will go away just like any other bruise you have had in the past.  It appears from your photos that this represents simple bruising and not a true collection of blood which is known as a hematoma.  However, there is no substitute for seeing your surgeon in person and letting him/her directly examine the area to give you the definitive answer, as photos are not equal to a direct exam.  Best wishes!

Brian Howard, MD (retired)
Alpharetta Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.