Can Occasional Gum Bleeding Due to Flossing Cause/increase the Risk for Capsular Contracture After Breast Augmentation?

Can occasional gum bleeding due to flossing cause/increase the risk for capsular contracture after a breast augmentation?.

Doctor Answers (2)

Capsular contracture and dental flossing

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Late Capsular contracture is thought to be caused by colonization of the implant by commensal bacteria and biofilm formation.  Dental Flossing does cause temporary bacteremia (bacteria in your blood stream) but it has never been shown to cause an increase in capsular contracture.  Many normal bodily functions also cause a transient bacteremia, so most surgeons do not believe flossing, with or without bleeding, is a significant factor in capsular contracture formation.


Houston Plastic Surgeon
5.0 out of 5 stars 63 reviews

Gum Disease and Risk of Breast Implant Capsular Contracture

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Severe scarring around breast implants or, Capsular Contracture is KNOWN to be associated with bleeding in the implant pocket (either due to blunt, rough surgical technique or postoperative bleeding), foreign bodies in the implant pocket (from inserting gloves or gauze repeatedly in the pocket) or from infection sustained at the time of surgery or years later. It is not rare to have a woman with a great resultand soft enlarged breasts for years to suddenly complain of a hard breast. This can often be traced to a severe urinary tract infection a few weeks or months earlier.

There is NO doubt that infections or procedures which release bacteria into our blood stream ("bacteremia") may pose a threat to people with scarred heart valves (such as mitral murmur). If allowed to survive, such bacteria can seed the valves, populate them and progressively damage them ("Bacterial Edocarditis"). It is thought that a similar process may be seen with delayed Breast Capsular Contracture - bacteria from a different part of the bofy (Bladder, Gum etc), travel through the blood and seed the implant surface creating a slimy colony layer - called a BIOFILM - which is nearly impossible to eradicate and then cause a scar reaction manifested as a capsular contracture.

Bleeding gums are suggestive of gingivitis which has also been associated with heart disease. It behhoves you to see a dental professional and correct it with proper oral care. 

Lastly, in my practice, I tell my patients the NEGLIGIBLE cost of a pill of Augmentin or Penicillin V taken before any dental cleaining is WELL worth it if it can prevent implant seeding by bacteria and capsular contracture. 

Great question.

Peter A. Aldea, MD
Memphis, TN

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