Best Way to Treat a Hematoma After Breast Augmentation?

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. In your situation, your swelling could also be a seroma (inflammatory fluid).  If the size and swelling is steadily decreasing in size, then it is reasonable to continue observing.  Otherwise, it may need to be drained.

Post-operative bleeding and resultant hematoma formation
can occur following breast augmentation surgery. When this situation arises,
surgical intervention is usually always indicated to avoid long term
complications.

When blood is left within the implant pocket following
post-operative bleeding the wound healing process can be adversely effected.
Under these circumstances, undrained hematomas can result in pain, breast
distortion, capsular contracture, implant displacement,
and infections. For these reasons, hematomas should be drained as soon as
possible when they occur after breast augmentation surgery.

It’s important that you discuss this issue with your
plastic surgeon. If you’re unhappy with his response a second opinion may be
appropriate. 

Unfortunately, without a complete history and physical exam and through pre operative photography there is not enough information to make an informed plan, please consult your surgeon or another local board certified plastic surgeon

Hematoma after breast implant surgery must be drained.  This is an infrequent complication of breast augmentation, but is probably the one most physicians fear the most.  Plastic surgeons that perform large numbers of augmentation will invariably see and treat patients with this condition -- it happens to all surgeons.  Despite the fact that I have developed a technique to perform breast augmentation and lose less than  a teaspoon full of blood for the entire operation, I have had 2 or 3 patients with post-operative hematomas that I had to drain.

Hematoma after breast augmentation is one of the contributing factors to capsular contracture and even implant infection and therefore need to be drained to help prevent these complications.

It is hard to second guess your surgeon -- he/she has followed you through this process and has been able to examine you and should have a better idea of what should be done.  There are ways to drain fluid collections sterilely and with minimal risk of puncture of the implant.  You may want to discuss these options with your surgeon

This is a difficult problem to diagnose over the internet and it is hard to second guess the treating physician but based on your description, I would be compelled to drain the collection. One non-invasive option is to obtain an ultrasound to evaluate the mass. While it is possible that an exploration or treatment will result in possible infection, the alternative of not treating could lead to a higher rate of capsular contracture.

It would seem unlikely that you have a hematoma as both breasts are relatively the same size and shape. If unsure see your plastic surgeon for a follow up examination. A small hematoma will resolve on its own a larger hematoma must be drained to prevent future complications.

Don't feel bad about getting a second opinion. Any risk of draining the fluid or removing it surgically, especially if it is a hematoma, is negligible compared to the risk of doing nothing. Just leaving it there will be a set up for future complications like capsular contracture, especially with an untreated hematoma which will turn into a fibrotic mass of scar tissue.

Evacuation is the ONLY way to correctly treat a hematoma, especially after breast implants. I would want to drain the area due to the risk of infection not to try an avoid it. Get another opinion NOW! I

Wow this is one of the most interesting situations I've hear of yet.  First I'm baffled by why your surgeon when back in at 5 weeks.  If I have any concerns I wouldn't consider going back in until 6-8 months later.  The breasts need to heal before any revision is considered.
The mass you have needs to be opened up and cleaned out.  The risk of infection is high with any fluid collection around the implant so it needs to be removed.
My advise, find another surgeon who understands what needs to be done.

The whole story is both confusing and suspect. I am not sure why a surgeon would "bump up" implant size a mere 5 weeks after the augmentation risking operation through inflamed tissue and when facing a seroma / hematoma would risk an abscess or capsular contracture by not getting a diagnostic study (such as an ultrasound) with possible needle guided drainage.
This is not what most of us would do. There must be more to this than has been shared.