Infection after breast augmentation surgery

I had breast implants done on October 4th. I had a suture from inside try to come through and the nurse pulled it out and trimmed it. Ever since then, I've had an infection. Have been on two types of antibiotics and they go away and then come back. Today I have one pretty bad spot that's sort of bleeding, not much infection pus or anything (I know it sounds sickening) but I'm freaking. I've been cleaning the area with Hibiclens and putting antibiotic ointment on it and keeping it covered with gauze. Any other suggestions? Heat perhaps? There's no pain and the area's not warm to touch, it's just yucky.

Doctor Answers (51)

First, call your surgeon immediately! An infection has...

+5

First, call your surgeon immediately! An infection has the potential to require not one, but two or more operations--one to remove the implant, then a second to place another implant several months later (after the tissues have fully healed and matured).

Infections requiring implant removal are thankfully rare. The highest risk period is likely the initial healing period after surgery for several weeks. Diabetics and smokers are much more at risk, but the risk is never zero. After the initial healing period, we, on rare occasion, see "random" infections of the breast wherein it is difficult to identify a specific cause.

In an attempt to reduce the risk for a late infection, I generally give antibiotics before surgery intravenously and by mouth for five days after surgery. Additionally, I recommend a single dose of antibiotics prior to any invasive procedure or for dental cleaning or dental work (notably, surgeons differ on their antibiotic recommendations, and antibiotics themselves carry their own risks).

Signs and symptoms of a breast infection include:

  • Breast swelling
  • Pain or redness
  • Fevers, chills, or general weakness are other symptoms

Infections in the initial healing period would commonly have redness at the incision site and pain with or without swelling can be seen. If there is significant drainage from the incision site or an opening of the incision, this is particularly at risk of infecting the implant pocket.

When in doubt, generally antibiotics are given. Play it safe! If there is a question about an infection after breast augmentation surgery, it is important to be evaluated by your surgeon.


Denver Plastic Surgeon
5.0 out of 5 stars 45 reviews

Infection after Breast Augmentation-see your doctor right away.

+4

I agree that you need to see your doctor to determine exactly what is going on.

It sounds as though you are "spitting" deep sutures, which is not that uncommon although your description sounds as though you are having an unusually prolonged healing.

The concern is that the superficial "suture abscess" could track deep and infect the implant. If this were to occur it would be very serious.

Again, see your doctor. If he/she feels that this is simply a "suture spit" the doctor should be able to remove the sutures that are near the surface.

Ask the doctor if he/she feels Epsom Salt Soaks will help you heal-this works well for many patients.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

This may be serious--does not sound like "dissolving stitch"

+2

Many answers have correctly talked about dissolving sutures, stitch abscess, and the difference between a superficial wound or incisional infection, and implant or pocket infection. Two courses of antibiotics would generally be overkill for superficial incisional or stitch-type infections; removal of the offending stitch should be all that is necessary, unless more than one stitch has become infected (usually from skin bacteria, but ocassionally from other sources, like pets or contaminated finger touch).  If there is still drainage, I am concerned that your pocket (and implant) have become infected. If this is indeed the case, your implant (s) will almost certainly need to be removed to properly treat this infection. Stronger antibiotics, infectious disease consultation, and/or intravenous antibiotics almost never solve an implant infection, as antibiotics cannot sterilize an infected foreign object in the body (breast implant).  Your surgeon should not delay removal if this is anything other than a simple stitch drainage that heals promptly without exposing your implant to bacterial contamination.

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 118 reviews

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Infection After Breast Augmentation

+2

There are two types of infections after breast augmentation. Wound infections are superficial and usually clear with wound care and antibiotics. In a pocket infection the implant has become contaminated, this will not respond to antibiotics and will need to be removed.

If the wound infection is not responding normally to antibiotics, the pocket infection needs to be ruled out .Furthermore, avoid strong antiseptics like Hibiclens, for they will significantly delay normal healing. Plain soap and water, and a topical antimicrobial (like neosporin or silvadene) will work better.

Do not delay surgical treatment if it becomes obvious that the antibiotics are not working.

Jose M. Soler-Baillo, MD
Miami Plastic Surgeon
5.0 out of 5 stars 32 reviews

Infection after Breast Augmentation Surgery

+2

Infections after breast augmentation surgery are not very common, however, if they occur, it can be a long drawn process until getting back to normal. Based on your description, it appears, that you have a superficial infection, or a stitch abscess in the area. Stitch abscess is somewhat different from superficial infection.

When the surgeons place absorbable sutures, we rely on our body’s ability to break down suture material. Unfortunately, some suture materials are more difficult to break down than the others. As the body breaks down suture material, white blood cells entered the area to help out with the process. If for any reason the body is unable to break down the suture material, it will extrude, or spit out, the stitch. In this case, the stitch will come out with a small amount of purulent material. However, most of it consists of proteins, white blood cells, other inflammatory cells, broken down suture material but not bacteria. That is why it is called sterile access. The term sterile abscess means is that it looks like an abscess, or infection, but it does not have bacteria in it.

Most of the time, antibiotics are not required for a true sterile abscess. However, most surgeons, myself included, would place patient on antibiotics just in case, especially if the wound is close to the implant.

It is very important to keep a close tab on the condition of the wound, have regular follow-up care with your surgeon and inform the office about any changes, like fever, chills, increased pain, different quality or odor of the drainage, increased redness increased swelling.

With proper care this should heal well. Best wishes.

Sincerely,

Boris Volshteyn M.D., M.S.

Boris Volshteyn, MD, MS
East Brunswick Plastic Surgeon
4.0 out of 5 stars 8 reviews

Infection after Breast Augmentation

+2

I am sorry you're having some problems.

It sounds like you had a suture extrude and some continued draining from that spot. If there is continued drainage, there may be more sutures to be removed.  Be sure to have your doctor evaluate this right away.

Treating the area as you are usually helps the area to heal and the problem resolve.

If the breast is getting red or if you are developing a fever, it is important to let your doctor know, right away.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 12 reviews

Breast Augmentation and Infection

+2

Breast augmentation is a safe procedure that has risks associated with any surgery.  I would advise you to follow up with your plastic surgeon, who should be familiar with wound care and treatment.  It does not sound like an infection of the implant itself. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Problem after breast implant surgery

+2

The problem you are having sounds a lot like a stitch reaction, sometimes called a stitch granuloma. These start as a small bump over the area of a stitch that grows a bit and then starts leaking slightly. Its not really an infection, but more like a slowly healing area. If there is a piece of stitch in that area it will have to be removed to get better. Once the stitch is removed you will heal over time. A little bleeding or possibly leaking a small amount of clear or slightly yellow stuff is normal. The antibiotics should not affect this too much (in a good or bad way).  Since you do not have fever, the area is not red, and there is not a lot of leaking fluid you probably don't really have an infection. 

If the wound does not heal in a couple of weeks or if your symptoms get worse you should definitely see your surgeon.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 10 reviews

If the problem is just with the sutures coming out...

+2

If the problem is just with the sutures coming out rather than dissolving, this should resolve spontaneously. Go directly to your surgeon and have them evaluate if this is the case. A deeper form of infection around the implant will not be cured by antibiotics and will require implant removal and replacement at a later date, perhaps in 6 to 12 weeks. You can suspect that you have this kind of infection if you have fevers or if the breast involved is enlarged, painful, or red.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Incision trouble

+1
Plastic surgeons often place sutures underneath the skin and then rely on the body's healing to dissolve those sutures over time - sometimes the body doesn't dissolve the stitch, but instead works it out to the incision. It sounds like this is what happened to you. Sometimes this will happen more than once, as there was more than one stitch placed. It is important to see your surgeon when there are any changes in your incision (i.e. a new "bad spot") to avoid a deeper infection that may result in loss of your implants. Stay in close contact with your surgeon and his or her nurses to avoid a serious complication. Good luck.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 66 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.