Late haematoma and seroma in patients with silicone mammary prosthesis: Our reports and literature review

Late Unilateral Hematoma After Breast Reconstruction With Implants

“…13 Hematomas reported after these circumstances tend to present as a sudden onset of painful swelling of the breast. 16 Our patient did not complain of pain in her breast. However, the implant was surrounded by a double capsule with a hematoma between the 2 layers.…”

“…Capsular contracture or pocket position (subpectoral vs subglandular) does not appear to be a causative factor in late hematoma onset. 16 Magnetic resonance imaging and US are useful diagnostic aids to detect fluid collection surrounding the implant, 16 but in our experience, both have failed to identify the double capsule and the nature of the fluid collection (eg, seroma or hematoma).…”

“…Late hematoma onset after a breast implant procedure is still a rare complication, yet reports in the medical literature have increased since the introduction of aggressively textured breast implants. 5,9,16,18,23 It seems reasonable that mechanical friction and subsequent "implant degloving" between the texturized implant surface and the inner capsule layer may be at the root of this phenomenon. Capsular contracture or pocket position (subpectoral vs subglandular) does not appear to be a causative factor in late hematoma onset.…”

“…28 However, late hematoma management is surgical and involves capsulectomy and breast implant replacement, possibly with a smooth device, or removal. 16,28 Because our patient had an anatomical implant that was not available with a smooth shell, and because polyurethane implants were not accessible due to hospital restrictions, we elected to insert a new device that was similar to the implant we removed. Although this decision may raise criticism, in similar circumstances, others have replaced an aggressively textured implant with a similar implant without recurrence of this complication.…”

“…To date, only 17 patients have been described who have had a late hematoma after a reconstructive implant procedure 2-8 and 31 who have had the condition after cosmetic augmentation mammaplasty. 2,[9][10][11][12][13][14][15][16][17][18][19][20] In this report, we present a single case of progressive, slow swelling of the right breast due to an intracapsular hematoma. This pathology occurred 2 years after a bilateral, reconstructive breast implant procedure in which Biocell textured implants were placed (Natrelle; Allergan, Inc, Irvine, California).…”