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Is Cephalexin Strong Enough to Clear Infection in Breast Implant?

I had Breast Augmentation surgery 8 days ago. I was sent home from the surgery centre with a 5 day prescription of Cephalexin. 2 days after finishing the perscription, my left breast is sore and slightly red. The doctor removed the stitches today and said the incision has healed nicely but prescribed another 7 days of Cephalexin for the apparent infection in my left breast. I am wondering if this antibiotic is strong enough or if some more aggressive treatment should be used on the infection?

Asked 37 months ago by Tammy lynn in canada

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Cephalexin infection

Continue your post-op care and follow-up with your plastic surgeon!

I appreciate your question. In general, Cephalexin is an effective, broad spectrum antibiotic that is commonly used in plastic surgery procedures. The point that I would like to stress is the absolute importance that you continue your care and follow-up with your plastic surgeon. If you feel that your condition is worsening, then you need to call his/her office immediately. Findings to look for are increased redness, tenderness, swelling, and heat to the affected side. Other related... more

Stephen A. Goldstein, MD

Denver Plastic Surgeon

ASAPS ASPS

An infected breast implant probably won't resolve with antibiotics

I'm sorry if I have frightened you. Reading your question it is not clear that you have a breast infection. Your surgeon may be continuing a prophylactic antibiotics as a precaution. Our own practice follows our hospital infection control recommendation for prophylaxis derived from the American College of Surgeons. We use a cephalosporin through the intravenous 30 min before we start surgery, and do not use any antibiotic after the procedure. The single dose is sufficient and we have not... more

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Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

With Implants in place, several variables exist

It sounds like your surgeon is being appropriately cautious, and anything that might be going on is a relatively minor problem, or you would be experiencing more remarkable symptoms. In other words, when implants get infected, because they don't have an immune system or their own blood flow, the infection usually progresses rapidly. This causes rapidly worsening fever, chills, swelling, redness, pain, and often drainage and failure of the incision to heal. It is not subtle. So, if all you... more

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Armando Soto, MD

Orlando Plastic Surgeon

ASAPS ASPS

Antibiotics after Breast Augmentation or Bioprosthetic Device Implantation

Any time there is a bioprostentic device in the body one has to be vigilant about making sure it does not get infected. Watch it carefully and if there is any clinical signs of worsening infection, let your doctor know - this includes fevers, chills, wound drainage, fluctulance, widening area of redness and tenderness. You can be extra careful yourself and schedule an appointment to see your surgeon in follow-up in 2-3 days, even if it looks and feels better.

Hratch Karamanoukian, MD

Buffalo General Surgeon

Antibiotics for breast implant infection

Thanks for the question. Implants are not part of your body's natural tissue and can be more prone to infection and less able to clear infections compared to your natural tissue. Some doctors will typically use Keflex (cephalexin) in all post-operative cases to reduce the chance of infection. Technique during surgery is even more important, including irrigation of the pocket with triple antibiotic irrigation solution, minimal handling of the implant and meticulous closure. I have treated... more

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

Antibiotics after breast augmentation

Cellulitis after breast augmentation is a reason to be concerned and your plastic surgeon is acting appropriately. Although the surgeons here can all conjecture on the course of management, only the plastic surgeon who saw you in consultation can assess whether this is fulminant cellulitis or erythema. I would follow up with your surgeon.

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

Infection concurrent with breast implants usually results in capsular contracture even when cured by antibiotic.

Without a culture of the infection, your surgeon has to choose an antibiotic empirically. Keflex is a suitable choice and it is as "strong" as any antibiotic. Whether it covers the specific bacteria that is causing your infection is uncertain but it probably does. The problem for you is that if you indeed have and infection, even if Keflex clears it up, the likelihood of a capsular contracture in the future is very high.

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Continue this antibiotic, but call your plastic surgeon and voice your concerns

If your plastic surgeon recently saw you, he clearly feels that whatever "infectious" problem you are having will resolve with a first generation cephalosporin such as Keflex. This antibiotic provides reasonable coverage of infections caused by skin flora, especially gram positive bacteria such as strep and non-resistant staph. If you are still concerned that this antibiotic is inadequate to treat your condition, call your surgeon directly and voice these same concerns. The... more

James C. Grotting, MD

Birmingham Plastic Surgeon

ASAPS ASPS

No Strength to Antibiotics

Keflex is a commonly used antibiotic to prevent infection known as prophylaxis. If your surgeon is concerned about an early infection another course of antibiotic is reasonable as is close surveillance. Personally, I would use a antibiotic that is more effective for the organisms most commonly the cause of implant/wound infections. Spectrum ( range of bacteria the drug effects) is how we choose a drug, it has nothing to do with strength. I may chose a broader spectrum drug such as augmentin... more

Michael S. Beckenstein, MD

Birmingham Plastic Surgeon

ASAPS ASPS

Yes Cephalexin is

Cephalexin is fine for simple skin infections, even in the setting of a breast implant. It is difficult to say for sure that you have an infection without examining you. However, if one of my patients had redness around the incision site and tenderness that seems like an infection, I would prescribe the same medication to start.

Sirish Maddali, MD

Portland Plastic Surgeon

Cephalexin and Breast Implants

Cephalexin is a first generation cephalosporin that treats skin flora like staph aureus. Stap aureus is a common skin bacteria that can cause infections. This usually does the trick, however with increased resistant organisms developing, sometimes other antibiotics are necessary to cover infections. Cultures of a draining wound are taken when there is concern that the antibiotics are not effective, and therefore can tell what anitbiotics will work. Keep close tabs on your problem with... more

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

It can work if suture infection or stitch abcess is involved

If the redness you are experiencing is due to a stitch abcess (the suture got a superficial infection), then removal of the suture with the antibiotic should be fine. If you truly have an infected implant (in other words the infection is deep), then the antibiotic won't help. You need to be sure to keep in contact with your doctor, and report immediatly increase in redness, pain, swelling, drainage, fever, etc., all signs that the infection is progressing rather than regressing. more

Scott E. Kasden, MD

Dallas Plastic Surgeon

ASAPS ASPS

If a breast implant is really infected, it usually needs to be removed

To Tammy lynn, Hi. One possibility is to treat you with intravenous antibiotics, which is more aggressive, but I don't necessarily recommend this because it may not make a difference. Hopefully, your left implant is not infected. If it is infected, the redness and soreness will get worse and you will develop swelling. Then antibiotics will not usually save the implant. The most common approach is to remove the implant and replace it in 6 months. I really hope you don't have to go down that... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Slight redness may not mean an implant infection

It is early in your course and you should not be discouraged, as having minor redness can happen around the incision or even on the breast itself. For those purposes, Cephalexin should do fine for minor redness or skin related cellulitis. However, if there is a deep seated infection around the implant, no antibiotic will be strong enough and the implant would have to come out. Keep your doctor posted on any changes, such as fever increased pain or drainage from your incision. Good luck! more

Francisco Canales, MD

Santa Rosa Plastic Surgeon

ASAPS ASPS

Follow closely with your plastic surgeon

Mild redness close to the incision might not indicate a clinical infection. These are the warning signs of a true infection: 1. Redness,swelling and soreness extending away from the incision. Progression of this infection (cellulitis) is a warning sign. 2. Fever,fatigue etc... 3. Disharge from the incision. I would follow closely with him until all redness is gone. Cephalexin is an appropriate choice at this stage.

Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

ASPS

Overt breast infection after augmentation is fairly rare

Your doctor maybe overly cautious. Having an overt infection in the breast after an augmentation is fairly rare. So the Cephalexin or Keflex is likely fine. You will just have to keep an eye on it and if you start having pain, worseing redness, not feeling generally well or fevers then contact your plastic surgeon immediately. Hope that helps.

Farbod Esmailian, MD

Orange County Plastic Surgeon

ASPS

You might not have an infection at all

Cephalexin is an appropriate prophylactic antibiotic for breast augmentation surgery. Having a little redness and tenderness does not necessarily indicate infection but your doctor is being thorough by giving you another round of antibiotics. You didn't mention your temperature but not having a fever is a good sign against your having an infection. Stay in close contact with your doctor about this!