Updated September 2018
You had a breast augmentation, and now you've found a firm lump beneath the skin that is accompanied by a bruise. Is it a hematoma? Is it something more serious?
Learn about hematoma signs and symptoms, and how to treat a hematoma.
What is a breast hematoma?
A breast hematoma occurs when blood leaks outside of a blood vessel, pooling under the skin and forming a clot. The pooled blood absorbs bacteria, leading the surrounding tissue to become inflamed, which results in increased swelling and pain.
All of this leads to the skin above the hematoma appearing bruised and broken. Beneath the skin, the clot is firm and hard to the touch, mimicking a breast tumor. The breast lump may be small or large—equivalent to the size of a plum.
What causes breast hematomas after breast augmentation?
Breast augmentations cause trauma to the breasts. This intentional injury—cutting through breast skin, tissue, ducts, nerves and perhaps muscle to place the implants—damages the blood vessels in the breasts, making them particularly fragile in the early weeks after breast augmentation surgery. If the blood vessels rupture and bleed out, a hematoma can develop.
Some leakage is common during and after breast augmentation, but with a hematoma, the blood pools beneath the breast.
Breast hematoma signs and symptoms
A hematoma after breast augmentation can be hard to detect because some women consider the pain and swelling accompanied by it to be part of the standard healing process, especially during the first few weeks after surgery.
So what does a hematoma after breast surgery look like and how does it feel?
Signs to look out for are:
- Severe swelling beyond the normal, post-surgery amount
- Severe pain that may not lessen with painkillers
- Skin darkening around the breast implant, like a large bruise, but it doesn't fade with time
- The appearance of broken skin around the bruise-like area
- A hard breast lump beneath the skin
- A greatly enlarged breast, beyond what the implant size should look like
How a breast hematoma is diagnosed and distinguished from a breast tumor
As a woman, it can be very alarming to find a breast mass like a hematoma. In some cases, breast hematomas cause scar tissue to form under the skin, making it resemble a breast tumor. But while breast hematomas are merely a blood clot, breast tumors are a collection of abnormal cells.
Deciphering the difference calls for a trip to your doctor. He or she will examine the breast, then request for either a mammogram or ultrasound, or both. If neither imaging test provides a clear diagnosis, a biopsy will be performed and the pathological report will tell whether the breast lump is cancerous or not.
How a breast hematoma might affect your breast implants
If blood pools in the implant pocket, it can affect the position of your breast implant and increase your risk of capsular contracture. It can also cause skin discoloration, scarring, and breast deformity.
In rare cases, your implants may need to be removed and replaced if your plastic surgeon suspects bacterial contamination, or if the implant pocket was affected by the hematoma.
Breast hematoma treatment
Though a breast hematoma sounds serious, in fact, it is not. However, because breast hematomas mimic breast tumors, should you find a breast lump after breast augmentation, it is important to have it checked by your plastic surgeon.
If through evaluation and MRI or ultrasound your surgeon finds the lump to be a hematoma, treatment may go as followed:
Minor breast hematomas
Minor hematomas will usually resolve on their own. The damaged blood vessel will naturally clot and the collection of blood will be absorbed by your body over time. In this case, your plastic surgeon may choose to just monitor the hematoma.
Severe breast hematomas
Severe hematomas may need drainage or hematoma removal surgery. During the drainage technique, a tube is inserted beneath your breast implant and the pooling blood is suctioned out. If removal surgery is required, the damaged blood vessel will be cauterized or sealed with stitches and the blood clot will be removed.
Preventing a hematoma after breast augmentation
Despite your surgeon's skill and best efforts, a breast hematoma can occur after breast augmentation. That said, you can take these steps over to prevent it:
- Give yourself about four weeks to heal. It is during this time the blood vessels in your breasts are most at risk of leaking. You should take it easy, staying away from overexertion.
- Avoid activities that cause strain or raise your heart rate and blood pressure. Consult with your breast implant surgeon about what activities you can perform and how.
- Avoid blood thinners and certain medications or supplements. Analgesics, anti-inflammatories and many herbal supplements can increase your risk of bleeding and interfere with your body's clotting mechanism. Talk to your plastic surgeon about these and any other drugs you plan to take—both pre- and post-op.
Want to know more about hematomas after breast augmentation?
If you think you have a breast hematoma after breast augmentation, you're not alone. We understand it can be scary and know there is nothing more comforting than hearing from other women who've gone through it. Pose your questions and concerns in one of our hematoma breast augmentation forums to get feedback from real women who've been in your shoes.
Or, if you're looking for an expert opinion before you see your plastic surgeon, hop over to our Q&A forum and chat with our vast network of board-certified breast surgeons.
Stepha, P. (2018). An Overview of Breast Hematomas: Symptoms, Causes, Diagnosis, and Treatment. Very Well Health. Retrieved from https://www.verywellhealth.com/breast-hematomas-430281
Vera, V. (2015). The False Breast Cancer: What You Need to Know About Breast Hematomas. Breast Health Healing Foundation. Retrieved from http://www.breasthealthandhealing.org/the-false-breast-cancer-what-you-need-to-know-about-breast-hematomas/