One Week Post Op Silicone Unders Breast Aug Concerned About Hematoma

1 week ago I had breast aug. Immediately after waking my right side was much more painful & swollen. I'm still in pain on right side & the muscle is very swollen & high w/more bruising (yellow) on that side. I saw my PS yesterday & he said my right side is "normal" & that my left side (looks & feels fine) is abnormal & be patient. I asked about hematoma & he said I don't have one but based on my pain levels and large swelling I'm concerned. Should I get a sonogram or 2nd opinion or wait?

Doctor Answers 8

Hematoma after breast augmentation

It is not unusual for the two breasts to look and feel somewhat different after breast augmentation due to swelling. However, the combination of significantly more pain, swelling and bruising of one breast is suggestive of a hematoma (a free collection of blood in the implant pocket). If this is the case and it is left untreated, it may lead to an early capsular contracture (hardening and tightening of scar tissue) around the breast. I would ask your plastic surgeon to do an ultrasound to be sure it is not a hematoma, and if he or she refuses, get a second opinion. The bottom line is that a post-operative hematoma needs to be drained promptly, and once the question is raised it needs to answered with a test such as an ultrasound.

Indianapolis Plastic Surgeon
5.0 out of 5 stars 101 reviews

Breast hematoma

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.

If your plastic surgeon is not concerned, and your right sided swelling continues to improve, then I would recommend waiting.  If the size continues to swell more, then I would revisit with your plastic surgeon to express your concern.  

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 38 reviews

Hematoma after breast augmentation?

Again, difficult to tell without examining you or seeing photos, but it sounds like you may indeed have a hematoma.  Although one side may be more sore than the other, and one breast can be a little more swollen or even a little more bruised than the other, I emphasize the word "little".  If one side is significantly more swollen, bruised, and painful, this could very well represent a hematoma.  If the breast is definitely much more firm on that side, like it is tightly "filled" with something (in comparison to the other breast), it may indeed be tightly "filled" with blood in the implant pocket.  If left alone, it will almost invariably lead to a capsular contracture, so it should be surgically evacuated.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Hematoma one week after augmentation?

Of course none of us can make a diagnosis without seeing you but your post op course does not sound normal.  If your swollen side is much more firm than the opposite side, you likely have blood or serum in the implant pocket.  You should go back to your doctor and express your concerns.  If you are still unsatisfied an ultrasound and/or a second opinion is in order.  It is very, very important to treat hematomas promptly or you are all but guaranteed to get a capsular contracture on that side.

Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 73 reviews

Breast augmentation

It is difficult to say without an examination, or photo, whether you have a hematoma.  On the basis of your description, a hematoma is certainly a possibility.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews


Without seeing at least a photo there is no way to tell if what you are referring to is a hematoma. But a board certified plastic surgeon should be able to recognize one. You said there is more bruising, but that it is yellow. This sounds like a small bruise that is resolving or nearly completely resolved. A true hematoma at one week would most likely have a lot of dark bruising at the base of the breast depending on how much breast tissue you had to begin with. The less breast tissue to start with the more bruising you would see. It is not uncommon for one breast to seem more painful than the other.

David E. Kim, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 99 reviews

Appropriate concern

On the basis of your uneven swelling, bruising and pain, a hematoma is certainly possible. I would revisit your surgeon ASAP. If you do not feel comfortable with the answer, get a second opinion. Clinical exam is usually adequate to make the diagnosis, but an ultrasound may be helpful in uncertain cases. Good luck!

Brian Klink, MD
Vacaville Plastic Surgeon
5.0 out of 5 stars 94 reviews

Hematoma after breast augmentation

If you are experiencing pain and notice one breast is larger and higher with bruising, then you could possibly have a hematoma after your breast augmentation. I recommend you see your plastic surgeon again or get a second opinion. Do not wait. The ultrasound may give some information, but usually this is a diagnosis your surgeon can make clinically. If you do have a hematoma and it is not treated (evacuated) you could end up having capsular contracture (scar tissue formation) on that side.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 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.