title: Late unilateral hematoma after breast reconstruction with implants: case report and literature review.
abstract: Although reports of late hematoma after placement of breast implants are rare, there has been a noticeable increase in these reports in recent years. Various etiologies have been proposed, usually relating to history of trauma, anticoagulant use, or physical strain. In this case report, we describe a 61-year-old patient who slowly developed a unilateral intracapsular hematoma 2 years after breast reconstruction with Biocell (Natrelle; Allergan, Inc, Irvine, California) textured implants. This case is unique because of the intraoperative finding of 2 capsules surrounding the implant, with the hematoma between the 2 layers. We also discuss the possible pathophysiological mechanisms of this phenomenon.
  
  
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authors.affiliation: Plastic Surgery Department, St Andrea Hospital Rome, Via Stazzo Quadro 20 B, Riano, RM, Italy. francesca.grippaudo@uniroma1.it
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Grippaudo
authors.forename: Luca
authors.initials: L
authors.lastname: Renzi
authors.forename: Brando
authors.initials: B
authors.lastname: Costantino
authors.forename: Benedetto
authors.initials: B
authors.lastname: Longo
authors.forename: Fabio
authors.initials: F
authors.lastname: Santanelli
mesh_terms: D019928:Breast Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011474:Prosthesis Design; D016896:Treatment Outcome
keywords: breast reconstruction; breast surgery; double capsule; late hematoma; textured breast implant