A Case of Late Unilateral Hematoma and Subsequent Late Seroma of the Breast After Bilateral Breast Augmentation

Abstract

A previously unreported case of recurrent late postaugmentation collections, namely, a seroma and a subsequent hematoma, in an otherwise well female patient is reported. The authors found no obvious reason for the recurrence in this patient.

Incidence of Breast Hematoma after Placement of Breast Prostheses

“…Several authors have described similar hematomas greater than 1 year from their respective operations, with at least one requiring urgent operative treatment. 15,16 Late hematomas do occur and should be kept on the plastic surgeon's differential diagnosis when evaluating swelling of the breast following prosthetic placement, even several years after the procedure.…”

An unusual case of late hematoma after implant-based breast reconstruction mimicking an anaplastic large cell lymphoma: a case report and literature review

“…Schiavon et al [24] report an example of unknown etiology of late hematoma, showing a case that presented as a recurrent late complication, even. No causative factor was found also in the original case described by McArdle et al, [27] in which the patient presented late hematoma followed by late seroma 9 months after.…”

Clinical Implications and Management of Non-ALCL Breast Implant Capsular Pathology

“…Late hematomas in breast implant patients usually present as unilateral swelling of the breast that is more commonly chronic and progressive but can on occasion present acutely. 30,[33][34][35][36] The exact incidence is unknown, and descriptions of late hematomas are limited to several case reports and small case series. 34,37,38 Many of the published cases have been deemed idiopathic, but some patients report an inciting traumatic event.…”

“…34,37,38 Many of the published cases have been deemed idiopathic, but some patients report an inciting traumatic event. 30,[33][34][35][36] Several causes have been attributed to their onset, including capsular tear, erosion of a capsular artery with prevention of retraction by the fibrotic capsule, chronic inflammation, and chronic microtrauma from motion of the implant in a contracted capsule. 30,33,34,36,37,39,40 After these inciting events, progression of late hematomas has been compared to that of chronic subdural hematomas, with small recurrent bleeds forming clots that create osmotic environments that slowly pull fluid into the capsule over time.…”

“…30,[33][34][35][36] Several causes have been attributed to their onset, including capsular tear, erosion of a capsular artery with prevention of retraction by the fibrotic capsule, chronic inflammation, and chronic microtrauma from motion of the implant in a contracted capsule. 30,33,34,36,37,39,40 After these inciting events, progression of late hematomas has been compared to that of chronic subdural hematomas, with small recurrent bleeds forming clots that create osmotic environments that slowly pull fluid into the capsule over time. 35 To diagnose a late hematoma, computed tomography, magnetic resonance imaging, or ultrasound is used to identify fluid with or without an organized mass (clot).…”