Best Course of Treatment for a Hematoma?

I recently had explant and mastopexy, grade IV capsular contracture to left. Capsule removed with significant inflammation and blood evident, in last few days have had some swelling, inflammation and hardness to breast. PS says it is a hematoma, he tried to aspirate it but the blood has congealed. He said that my body should just slowly break it down and re absorb it, can I use ice packs to help with pain? Or should I apply heat? What is the best treatment?

Doctor Answers 5


A sonogram will give an estimate of the size of the hematoma.

If the hematoma is large to cause symptoms, then surgical evacuation and insertion of a drain to  treat hematoma.

Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Best Course of Treatment for a Hematoma?

It is hard to name a "best treatment" as each patient must be evaluated individually. Larger hematomas can threaten the overlying skin and often are best evacuated either by aspiration, drain placement or surgery. What your surgeon has suggested sounds quite reasonable, and you should be followed up regularly until this is resolved. I would be cautious about ice or heating pads. After a breast lift your sensation may be abnormal, and you may lose protective sensation. Patients have gotten burns or frostbite requiring surgery in that setting. 

All you questions can be best answered by your own surgeon, who has the benefit of an examination that none of the RealSelf physicians have had. Thanks, and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews


very small hematomas will resolve but they are also not visible. the larger ones need to be evacuated otherwise they can lead to more problems.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Hematoma after Breast Surgery?

I'm sorry to hear about the complication you have experienced after breast surgery. Considering that plastic surgeons may vary in their recommendations for treatment course, I think you will be best following your own plastic surgeon's advise. Remember, that he/she is ultimately responsible for your care and that the advice you receive from multiple online consultants can be conflicting and/or confusing.

 Generally speaking, hematomas such as you describe do tend to liquefy over the course of the next few weeks.  At that point, it may be that the blood will reabsorb on its own or be amendable to aspiration.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Early intervention minimized complications.

Hematoma formation following breast implant removal can occur for a variety of reasons but is fortunately rare.When post-operative hematomas are small, they often resolve spontaneously.Larger hematomas often require treatment to prevent secondary complications.Treatment may include repetitive needle aspiration, CT-guided drain placement, or occasionally open surgical drainage.

When large hematomas are not evacuated, there’s an increased potential for wound breakdown, infection, and scarring.These problems can ultimately impact the aesthetic result from breast implant removal.

Early intervention will ultimately minimize the potential for complications, improve your aesthetic result, and improve the quality of recovery.It’s therefore important to maintain close contact with your plastic surgeon.Your plastic surgeon should be able to formulate a treatment plan that not only addresses your anatomic findings but your aesthetic concerns as well.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

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.