Different Drs Give Different Answers As to when to Replace Implants Why?

I had revision surgery for cc and dr switched from saline to silicone. Had hematoma and serious infection that went undiagnosed for about 2 months. have seen several other drs for 2nd opinion. dr who did the surgery said to replace implant in 4 weeks. another dr said 3 months and another said 6-9 months and would need pretty much total reconstruction. all are board certified and wondering why all the different opinions.

Doctor Answers (10)

How long to wait to replace infected breast implant

+1

The reason that you are receiving differing answers is because there is no textbook answer and therefore it is up to each individual's judgment based on personal experience. I would advise 6 months.  


Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Longer you wait ,less risk for complication

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I am sorry about your experience. You have a difficult problem and the reason that you are getting different answer is because of the complexity of the problem. i would suggest that you wait at least six months or longer if the breast tissue does not heal completely.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 56 reviews

Opinions will differ, choose the surgeon that makes you comfortable

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I am sorry to hear about your complications.  Thankfully, most complications are treateable, although it may take some time before you are back to where you want to be.  While infections during breast implants are rare, they may happen, and I favor waiting a while before attempting to replace the implant.  In general, three months seems like a reasonable time to wait.  Going in too soon may lead to surgery being performed in a breast that is still recovering and lead to a repeat bout of infection.  Good luck

Marwan R. Khalifeh, MD
Chevy Chase Plastic Surgeon
4.5 out of 5 stars 55 reviews

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After an Infected Breast Implant is removed, How Soon can it be Replaced?

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Regarding: "Different Drs Give Different Answers As to when to Replace Implants Why?
I had revision surgery for cc and dr switched from saline to silicone. Had hematoma and serious infection that went undiagnosed for about 2 months. have seen several other drs for 2nd opinion. dr who did the surgery said to replace implant in 4 weeks. another dr said 3 months and another said 6-9 months and would need pretty much total reconstruction. all are board certified and wondering why all the different opinions
"

Your frustration is understandable but not entirely fair. If you ever dealt with contractors, mechanics or plumbers you get a much more confusing selection of options (and prices) and this from people who CAN look inside and know exactly what can and should be done.

In Plastic Surgery there is a significant difference between what CAN BE done and what SHOULD BE done. The latter represents solutions that the vast majority of surgeons agree on while the former are options which depend on the surgeon's experience, understanding and personal preference.

You state you had a Capsular contracture with a saline implant (? access incision? under or over the muscle ? years after the surgery ? volume of implants). That the "revision surgery" (? implant exchange with silicone gel implants only? Exchange with gel implants after ? partial capsulotomty? after partial capsulectomy ? after complete capsulectomy - all ? WITH or ? without change of implant pocket ; either from over to under the muscle or under to over the muscle).  The consulted Plastic surgeon would need to ask for and know what to do with each scenario.

We KNOW that delayed infection is the most common cause of capsular contracture. The most common factor associated with capsular contracture is a HISTORY of having had a capsular contracture. The other leading cause of capsular contracture is bleeding. As such, you already have the two leading risk factors of recurrent breast implant scarring.

In the case of an infected implant, it needs to be removed and patient treated as long as it takes to assure NO bacteria remain in the breast implant pocket before another implant is placed. There is NO agreed upon implant free period. While some surgeons go in as early as 3 months after infected implant removal, many cautious surgeons would wait a full 6 months to replace the implants to lower the risk of implant re-infection and contracture reappearing.

Dr. Peter Aldea 

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Breast implants

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The differing answers indicate that there is no one answer!  However, a minimum of 2-3 months are required to effects of infection to resolve.  The more time, the better.  I was taught to wait at least 3 months.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
3.5 out of 5 stars 2 reviews

Breast implants and infection...

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The question you ask is indeed a difficult one to get a straight answer to, mostly because we do not have the science to back up a straight answer. I would like to add to my colleagues answers that a consultation with an infectious disease specialist would be beneficial for you. Treating these infections, depending on the type of bacteria you had can be tricky and you want to have been treated adequately. The general opinion of when to replace an implant in this situation is 6 months, however, there are those in the infectious disease literature who recommend a full year prior to re-implantation.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 38 reviews

Breast Implant Infection

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Thanks for the Question Ms. DC! I tell all my patients that when you see 10 Board Certified Plastic surgeons, you may get 9 different strategies or surgical plans....this is the art and science of medicine. Evidence based surgical practice, based on outcomes research, is the ideal way to practice medicine...however, sound, scientific outcomes research studies in plastic surgery are difficult to orchestrate and are therefore limited. We are getting better as plastic surgeon researchers to perform these studies, but there are obvious obstacles : how and who can study what looks good after breast augmentation or after a nose job....patient satisfaction? Doctor satisfaction? Or in your case, when to re-plant a breast prosthesis after infection, when infections are a very rare event?

This question was asked at a recent Plastic Surgery Society meeting and the most common answer given was to remove the implant, treat the infection with an appropriate antibiotic protocol and replant the implant, if desired by the patient, no sooner than 6 months. This may be the standard of care in my opinion.

Hope this helps!

Dr. C

johnconnorsmd.com

John Philip Connors III, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast implants don't like infection - neither do plastic surgeons.

+1

What you are seeing is a difference of opinion and nothing more. All are generally accepted methods of treating your predicament.  As noted above, the art of medicine involves the experience of the surgeon and that indeed varies widely.

Good luck.

Brian K. Brzowski, MD
Ogden Plastic Surgeon
5.0 out of 5 stars 19 reviews

Waiting Period for Implant Replacement after Infection

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Although I have yet to have placed an implant for augmentation which became infected and needed to be removed, I have on one accasion removed an implant which became infected (the original surgeon was on the West Coast).  In that situation, I waited 3 months before replacing the implant.  I agree that one should usually wait 3-6 months.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Dr opinions

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As you are learning medicine is not an exact science and doctors all have different opinions based upon their education and experience.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.