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How do you treat a blood clot in the breast after a breast augmentation and lift?

Q:

Eight days ago I had saline implants removed, replaced with silicone under the muscle, and a breast lift. After the saline implant surgery I developed a hardening in my left breast. The doctor removed all scar tissue in the breast, but it is still very swollen.  He said there is a blood clot in that breast. He told me I could either have it surgically removed or take Singulair for a few months and it will dissolve by itself.  What is your opinion?

A:

Singulair has been used to prevent capsular contracture (excessive scarring around breast implants. A small surgical hematoma can be allowed to dissolve and be absorbed, but if it is large, it must be removed to prevent healing problems. The hematoma may predispose you to capsular contracture, and as you already have a history of capsular contracture the use of Singulair is consistent with the goal of preventing a recurrence of the capsular contracture.

A:

Breast Capsular Contractures

Capsular contractures can occur after breast augmentation. In my experience occurs much less with saline versus silicone implants. If they do occur, they occur early and one can use Singulair for several months if one has no liver problems. If it does not resolve in 3-6 months, one can do a capsulotomy to relieve this area or place it in a different plane. In general, for saline implants, if you do a capsulotomy, it resolves the issue. In silicone implants, it may be more complicated as contractures occur later and they can be harder to correct.

R. J. Rohrich, MD

A:

If you do have a collection of blood around the implant that is enough to make the breast significantly larger and more painful, this sounds as though it is a hematoma. There is no way for someone answering your question online to know your situation better than your plastic surgeon but the classic treatment for a hematoma is to return to the operating room and remove it to hopefully decrease the risk of developing a capsular contracture in the future or infection. I would recommend you return to your board-certified plastic surgeon and review your options, especially since you are so close to having had surgery. I wish you well.

Dr Edwards.

M. C. Edwards, MD

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