Infected Implant After Brest Reconstruction No Radiation

Had double mastectomy with expander placement. One expander became infected and was removed. Have since had bilateral silicone implants placed with lat flap to non-expanded breast. Lat flap breast has since become infected. What are my chances of clearing this infection without having to remove the implant? Concerned in CP

Doctor Answers (6)

Infected Breast Reconstruction Implants

+1

Hi,

I'm sorry to hear about the problems you've had on your breast reconstruction journey. When you say that the lat dorsi flap is infected, I'm assuming that the infection is around the implant underneath the lat doris flap.

The lat dorsi flap does provide a good blood supply to the surface on the breast implant. You (obviously) should be on very strong IV antibiotics to try to clear this infection and your plastic surgeon will monitor you closely to see if the antibiotics are working. If the antibiotics aren't doing the trick, your plastic surgeon might need to remove the implant, wait 3 - 6 months, then put a tissue expander in and start the process again.

There are numerous reports of removing an infected implant, agressively washing out the area with antiseptic solution and antibiotics and then putting a new implant straight back in, but the failure rate for this is pretty high. I've done this twice and got away with it once. You should discuss these options with your surgeon.

Good luck with it all.


Australia Plastic Surgeon
5.0 out of 5 stars 3 reviews

Breast reconstruction, nipple reconstruction, breast cancer, DCIS, mastectomy, TUG flap, DIEP flap, Latissimus flap, fat graft i

+1

Infections are always difficult to deal with but cultures should be taken and the appropriate antibiotics started.  This is a way to downstage an infection.  Taking you to the operating room and removing the device and replacing it with a new device is an option as well.  Also taking the device out and leaving it out is possible as well.  Work closely with your surgeon to be guided in the process.  Every surgeon handles thesee cases differently.  I personally like to remove the devices and use your won tissue to replace the volume decrease after you have been treated appropriately with antibiotics and have had no other issues.

Robert Whitfield, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 12 reviews

Infected with implant

+1

difficult . I  will remove an implant and take  cultures  at one setting. Treat the infection with the help of an infectious disease team if needed. wait till it is cleared and re-insert  a new expander to re-create the space.  

 

Paul Albear, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Infected implants

+1

If you have a bad infection of your implants, then more than likley they will need to be removed and then the reconstruction revisited in a few months later  once things have settled down.  Good luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Infected implants

+1

Dear Concerned, 

In cases similar to yours you might need to have the implant taken out and the pocket irrigated with antibiotic solution, a drain may be necessary. You may have to go without an implant for a few weeks to allow for clearance of the infection and healing of the area. In addition to oral antibiotics of course.

Sometimes changing the pocket where the implant is placed and using smooth implants  can help.

Unfortunately this is a difficult situation that has to be treated aggressively.

I recommend discussing that with your doctor.

Best of luck!

 

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 25 reviews

Breast reconstruction

+1
The answer depends on how far post op you are and if the infection is superficial. You may need either a sonogram or an MRI to see if there is fluid around the implant. If there is fluid it is more likely that the implant would need to be removed.

David L. Abramson, MD
New York Plastic Surgeon
3.0 out of 5 stars 4 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.