What Self Treatment Do You Reccomend for Hematoma After Breast Reduction of 4 Weeks?

i had a breast reduction 4 weeks ago, now have developed hematoma, doc said it was nothing to worry about it would calm down by its self, what can i do myself to speed up recovery, i have no infection at all,scars are healing really good, but breasts are quite sore were the vertical scar is, not got a scar underneath breasts. thanks

Doctor Answers 12

Hematoma Formation Following Breast Reduction

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         Hematoma formation following breast reduction surgery 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 aspirations, 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 reduction.


         It’s unusual for patients to develop hematomas four weeks after surgery. Since this hematoma is small and not expanding, conservative management is probably appropriate. Management consists of gentle massage and compressive support bras. Over the course of time resorption should occur. 

Breast hematoma

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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 half to be surgicall drained.
Smaller ones may resolve faster with lymphatic massage to help decrease the swelling associated with the hematoma.

Small hematomas will resolve spontaneously

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Hematomas can occur after any surgery including breast reduction.  Some surgeons place drains other do not.  A significant hematoma can occur even when drains are used, so a drain will not prevent this from occurring.  If your breast is twice as large as the other side then this is a hematoma that may need to be surgically drained as it can have a detrimental effect on healing causing more pain, stiffness of the soft tissue and generally delaying an otherwise uneventful recovery.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Treatment of a hematoma

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If you have a large hematoma, then surgery is the treatment of choice. If it is small and he wants it to resorb on its own, then there really is nothing that you yourself can do for it.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Treatment of hematoma after breast reduction

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Hematomas are possible complications of breast reduction surgery, and their management may include observation or surgical drainage. Be sure to follow up with your surgeon if it does not appear to resolve on its own.

Olivia Hutchinson, MD
New York Plastic Surgeon

Treatment of a delayed hematoma

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The treatment of a delayed non-expanding hematoma may vary on the size. Smaller hematomas will undergo resorption whereas larger ones may benefit from aspiration to minimize fibrosis.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Hematoma after breast reduction

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Hematoma at 4 weeks post-op is unusual. If it is not enlarging, looks more like a bruise, and the incisions are healing well, I would observe only and wait for it to resolve. If there is any underlying fluid collection, it should ideally be drained. I would protect the site, and limit activity (no exercise) to speed resolution. I would also recommend wear of a lightly compressive, yet comfortable bra. 

Avoid ASA or IBUPROFEN with Hematoma

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The best thing that you can do is to avoid any aspirin, ibuprofen, or naloxen containing anti-inflammatory medications.  Acetaminopken is finr, but the others will increase your chance of bleeding again.  Also, avoid any herbal supplements, and any anticoagulants ( warfarin, heparin, etc.)  Most of the time, a small enough hematoma will resolve on its own.  I hope this helps.

Hematoma after breast reduction

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At 4 weeks after surgery, unless there is a size difference between the breasts indicating a possible fluid collection that needs drainage, the treatment of an old hematoma would be conservative with gentle massage and keeping your activities minimal ie no vigorous exercise.  Your surgeon should be following you closely for the resolution.

Hematoma after Breast Reduction

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Hematomas usually need to be addressed by the surgeon by removing the blood.  At times if the hematoma is small enough where it is not compromising the skin flap then it can be watched and hopefully it will absorb.

From a patient standpoint not much is done if your surgeon chooses to do watchful waiting. 

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 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.