What is a Haematoma?

A Haematoma is the pooling of blood in tissue or an organ due to the rupture or injury of blood vessels such as veins, arteries, or capillaries. This accumulation of blood can cause blood to leak and collect in the surrounding tissues.

Haematomas can develop in various parts of the body, including the skin, muscles, brain, and organs. The size and impact of a Haematoma depend on the extent of the vessel damage and the body's ability to reabsorb the blood. Following surgery, including cosmetic procedures, Haematomas can affect the healing process and the results of a surgical procedure.

The body's natural response to a Haematoma is to break down and reabsorb the blood, a process that can take several days to weeks, depending on the size of the Haematoma. In some cases, medical intervention may be required to alleviate symptoms or prevent complications associated with large Haematomas.

How Can a Haematoma Affect Breast Surgery?

A Haematoma can affect breast surgery by delaying the recovery process and altering the final result. Breast Haematoma can happen after procedures such as Breast Augmentation, Breast Reduction, and Breast Lift when blood collects in the breast tissue or the space between the tissue and the chest wall. Although the risk is lower in Fat Transfer procedures, Haematoma can still occur. Haematomas occur in between roughly 2 and 10% of cosmetic breast surgeries. The majority of breast haematomas are minor and resolve on their own or with minor treatment.

The presence of a Haematoma after surgery can lead to several issues, including pain, swelling, and potentially capsular contracture. It’s important to seek reputable clinics with experienced surgeons to perform Breast procedures safely. 

• Increased pressure and pain: As blood accumulates, it can create pressure within the breast, leading to discomfort and pain. This pressure can stretch the skin and tissues, causing further distress and potentially impacting the sensitivity of the area.
• Swelling and bruising: A Haematoma can cause significant swelling and bruising, altering the appearance of the breast. This can be particularly concerning for patients who have undergone surgery for cosmetic reasons.
• Delayed healing process: The presence of a Haematoma can interfere with the natural healing process. The excess blood may create an environment which encourages bacterial growth, increasing the risk of infection. The pressure from the Haematoma can compromise blood flow to the surgical site, potentially leading to tissue damage or necrosis.
• Aesthetic complications: For cosmetic surgeries, the formation of a Haematoma can impact the final aesthetic outcome. It may lead to asymmetry, irregular contours, or in some cases, the need for revision surgery to correct the issues.
• Risk of capsular contracture: A Haematoma after Breast Augmentation can increase the risk of capsular contracture, where the scar tissue around an implant tightens and distorts the shape of the breast.

Considering these potential complications, it’s important to detect and treat a Haematoma early. Postoperative monitoring and immediate medical assessment can help to detect a Haematoma and resolve the issue quickly. 

What Are the Symptoms of a Breast Haematoma?

Breast Haematoma symptoms include swelling, tightness in the affected area, pain or tenderness in the breast, and visible bruises or discolouration on the breast skin. 

Swelling and tightness

One of the primary indicators of a Haematoma in the breast is swelling in the affected area. The accumulation of blood within the tissue leads to an increase in volume, causing the breast to appear enlarged. This swelling can extend to the surrounding areas, including the chest wall and the armpit.

Pain or tenderness

A Haematoma can cause significant pain or tenderness in the affected breast. The severity of the pain may vary depending on the size and location of the Haematoma. The pain is usually localised to the site of the Haematoma but can also radiate to nearby areas.

Visible bruise or discoloration

Bruising is a common symptom of a Haematoma, which results from blood seeping into the surrounding tissues. As the Haematoma develops and the blood breaks down, the affected area may show colours ranging from dark red, blue, and purple to yellow and green.

Lump or mass formation 

A palpable lump or mass in the breast can indicate a Haematoma. This mass is the clotted blood that has been collected in the tissue. It may feel firm or spongy and can be differentiated from the surrounding breast tissue by its distinct texture.

Changes in breast shape or size 

As the Haematoma causes swelling, it can alter the shape or size of the breast. These changes are often asymmetrical when compared to the unaffected breast and can be noticeable both visually and physically.

Heat and redness 

In some cases, the affected area may feel warmer to the touch and look more red compared to the rest of the breast or the other unaffected breast. 

Restricted movement

If the Haematoma is large or located near the muscles or joints, it may restrict movement, making it uncomfortable or painful to move the arm or shoulder on the affected side.

How to Treat a Breast Haematoma

The treatment of a Breast Haematoma depends on its size, the level of discomfort, and how soon after surgery it was detected. The patient's symptoms and overall health are also taken into consideration. Minor or smaller Haematomas often heal naturally, without intervention as the body reabsorbs the blood over time. Larger Haematomas might require medical intervention, including Aspiration or surgery. 

Aspiration

Aspiration involves your surgeon using a needle to drain the accumulated blood within the Haematoma, alleviating pressure and relieving pain. Aspiration can be performed using ultrasound guidance to ensure accuracy and to minimise the risk of damaging surrounding breast tissues. 

Surgical intervention

Large or complicated Haematomas that don’t respond to less invasive treatments may require surgical removal. Surgery is more likely to be needed if the Haematoma is affecting the breast's appearance, causing significant pain, or further complications.

This procedure, also known as Evacuation, drains the Haematoma and repairs any damaged blood vessels or tissues. This treatment of Haematoma allows the surgeon to remove the Haematoma thoroughly, repair any damaged vessels, and reduce the risk of recurrence or additional complications. 

Observation and monitoring 

In cases where a Haematoma is not immediately life-threatening or severe, careful observation may be recommended. This includes regular medical check-ups to monitor the size and progression of the Haematoma, ensuring it does not expand or cause additional problems.

Compression garments

In some cases, wearing a compression garment can help support the breast as it heals and reduces swelling. This can also reduce the risk of developing a Haematoma and can help to treat minor instances.

Follow-up care 

After receiving any form of treatment for Haematoma, you need to go for regular follow-up appointments with the doctor to monitor the healing process and ensure that the Haematoma has been effectively treated. During this period, you may have to go through physical exams and imaging tests like ultrasounds.

The treatment plan for each individual with Breast Haematoma is usually developed and supervised by a healthcare professional experienced in managing post-surgical complications. Therefore, if you notice a Haematoma following surgery, speak with your surgeon to discuss the next best steps to prevent further complications.

The choice of treatment depends on multiple factors, including your overall health, the extent of the Haematoma, and the severity of symptoms or complications. 

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