Should I Worry About Hematoma? Should It Be Treated?

I had BA 2 weeks ago (Mentor textured silicone implants, 300cc mod+ prof). Immediately following surgery I retained a lot of water around my abdomen and had a lot of bruising around my breasts. Some of the blood migrated to the left side of my abdomen, which is now finally disappearing. However it's taking a lot longer in my breasts, especially the left. It used to be my smaller breast-now it's very slightly bigger and firmer than the right. Last week, my PS told me it would heal naturally.

Doctor Answers 16

No Hematoma

It does not appear that you have a hematoma, but you do have extensive bruising.  You did the right thing by following up with your PS.  Try placing ice bags on and around your breasts to decrease the bruising and pain.  Frozen bags of vegetables work great for icing.  Purchase 6-8 large bags of vegetables, corn or peas work best, broccoli and cauliflower are too lumpy.  Place them in a large freezer bag and drape them completly over the breast.  When the veggies get warm, swap them out for a new bag out of the freezer.  The best part is when you are done icing, you can eat the veggies!

With Warm Personal Regards,

David R Finkle, MD

Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Extensive bruising after breast augmentation

That is a lot of bruising on both of your breasts for 2 weeks out from surgery.  Bruising simply from the trauma of surgery (which should be minimal for 300 cc implants plased through an inframammary approach!) should be slight if not nonexistent.  Hematoma left around implants will predispose you to capsular contracture.  Consider a second opinion. 

Douglas J. Mackenzie, MD
Santa Barbara Plastic Surgeon
4.8 out of 5 stars 29 reviews

Should I Worry About Hematoma? Should It Be Treated?

The classic sign for a hematoma is unilateral (one-sided) pain and swelling, often with bruising, out of proportion to the symptoms and signs of the other side.  However, hematomas and excessive bruising (you have, in my opinion, more bruising than average) can occur, particularly when there are bleeding disorders (whether inherent or chemical, such as with aspirin, and whether or not these are recognized preoperatively).  Small amounts of bleeding are normal and will typically be absorbed by the body without significant consequences.  Larger amounts, though, cannot be left in place as they will typically lead to infection, capsular contracture and other complications.

However, this is not something than can be appropriately addressed via this forum.  You need to be assessed by your PS and you should consider having a second opinion just to be sure.

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Hematoma after Breast Augmentation

Your surgeon would be able to easily diagnose a hematoma. Symptoms are typically moderate to severe swelling and pain on one side, not symmetric bruising with one side slightly more swollen. 

Hayley Brown, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 90 reviews

Breast implants and hematomas

You do have a lot of bruising and it is normal for the discoloration of bruising to migrate according to gravity while it changes color and finally resolves. You may or may not have a hematoma but the good thing is that all of the skin looks healthy and you do not sound like you have much pain. Expanding hematomas cause pain and affect the overlying skin. 2 weeks is still a bit early.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Hematoma after Augmentation

Without the benefit of an exam or additional photos, it appears that you do not have a hematoma; but you do have a significant amount of bruising.  The migration that describe of the eccymosis descending into the abdomen is normal and is due to gravity.  Hematomas do rarely occur following an augmentation and should be treated promptly.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast hematoma vs bruising

You seem to be unusually bruised for a BA but equally so on each side and the two sides look comparable in size indicating that you probably don't have a significant hematoma.  It looks like just extensive bruising which should resolve spontaneously but keep in close touch with your surgeon to be sure.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Seek second opinion

I would seek a second opinion since the bruising you're experiencing is still quite prominent for being 2 weeks after surgery.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Breast Enhancement

I am worried about a hematoma when there is rapid increase in breast size with pain, at that point you will need to see a surgeon ASAP

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Hematoma After Breast Augmentation

It is difficult to assess whether you have a hematoma, but extensive bruising on one side is always cause for alarm.  The two other signs are one side more swollen than the other and increased pain.  If all three of those are present I would be very concerned you have a hematoma.

Mark A. Schusterman, MD
Houston Plastic Surgeon
4.9 out of 5 stars 77 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.