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

         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. 

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.

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.

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. 

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.

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.

If you have a hematoma, then your surgeon needs to address it.  If it is determined to be very minor and does not need draining or evacuation, then the best option is time.  Soften mild massage or ultrasound treatment can help mobilize the tissue and allow the fluid to be absorbed more quickly.  Good luck.

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.

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.

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.