Is the treatment removing the implant and capsule then cleaning out the old hematoma?

Question

Do you think this is a hematoma? I had breast revision few months ago replacing my implants plus doing a lift, over two months later there is dark bruising still and breast is hard on upper part and side. The bruising has not gone it's just getting darker, is treatment removing implant and capsule, cleaning out old hematoma that's probably dried now? Will bruising go away. Thanks p.s they are subglandular, 755cc

Steven Sigalove, MD FACS · Answer

Your photos are not entirely clear and do not allow complete evaluation of your breasts, however, your description and one view of one of the photos potentially sounds like you may have a postoperative hematoma. A hematoma, if present, should be evacuated, as it can potentially become infected, and it can also increase your incidence of capsular contracture, both of which could potentially require surgical correction. You shuld be seen by your plastic surgeon for evaluation ASAP to determine if surgery is needed.

Nirmal Nathan, MD · Answer

Dear Fastfox27,Thank you for your question. Given that you are 2 months from surgery, if the area is not getting bigger or significantly worse, I would recommend observation. You can ask your surgeon about starting massage to break-up some of the scar tissue. After 6-12 months if you are still unhappy you can consider revision.It is my practice to try to keep the breast pocket as bloodless as possible, because blood can irritate the breast capsule and cause a condition called capsular contracture. If your breast implant becomes overly visible, painful or firm I would ask you surgeon as these are potential signs of capsular contracture.Good luck,Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgeons

Tom J. Pousti, MD · Answer

I am sorry to hear about the complication you have experienced.   Management of a hematoma will vary from one plastic surgeon and from one patient to another.  Some plastic surgeons will recommend returning to the operating room for drainage;  others will allow for gradual resolution of the hematoma (typically these types of collections may liquefy and absorb, or require aspiration, within a few weeks).
 As long as the hematoma is not increasing in size and/or causing compromise of the overlying incision lines or tissues ( and you are followed closely by your plastic surgeon) is, then continued "observation" will likely be just fine.
 If in doubt, request follow-up with your plastic surgeon, earlier than already scheduled if necessary, to discuss your concerns/questions. Best wishes for an outcome that you will be pleased with long-term.

Ken Stewart, MD, FRCS Plast · Answer

Difficult to judge from photographs. But I would definately return to see your surgeon. They may wish to organise some imaging such as an ulttasounf or MRI. 
If you do have a late presenting haematoma i would re-operate to wash out. Haematomas may contribute to late capsular contracture.

Is the treatment removing the implant and capsule then cleaning out the old hematoma?

Answers (4)

Answer: A scan

Answer: A scan

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Is the treatment removing the implant and capsule then cleaning out the old hematoma?

Answers (4)

Answer: A scan

Answer: A scan

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.