Can I get Breast implants, even with a history of MRSA (Methicillin-resistant Staphylococcus Aureus) in my left breast due to mastitis?
Breast Implants for Patient with History of MRSA?
Doctor Answers 6
Proceed with caution, but proceed.
I have discussed this problem with an infectious disease colleague and have some suggestions. The first thing to know is that not all MRSA's are the same. The strain that is acquired in the hospital setting (" nosocomial") is different than the ones that arise outside of this setting ("community acquired stains"). The commuinty acquired strains are sensitive to more antibiotics, making them easier to treat. Frequently these are sensitive to Ciprofloxacin (Cipro), Levoflaxacin (Levaquin), Trimethoprem/sulfamethoxazole (Bactrim), or Tetracycline which can all be administered orally. Whereas the nosocomial strain is usually only sensitve to Vancomycin, and intravenous drug.
People can be carriers for MRSA. One place that most people can easily be checked for is the nose or nasopharynx. Certainly, you shold have a nasal swab to culture for this. Also, if you have any discharge from you nipple, this also should cultured. If either of these cultures are positive, you should be treated prior to surgery. If there is a positve culture from nipple discharge, this should definitely be cleared up prior to even considering breast augmentation.
Other areas can also be sites where you can carry this bug: the axillae (armpits), and the pubic region. To treat these areas, five days prior to surgery you should wash and shower with Hibiclens, a cleanser that contains Chlorohexidine. When washing with this, you should let this dry on your skin prior to rinsing this off. This will have great effectiveness in reducing or eliminating the MRSA if you carry it in these regions. With your history, I would definitely wash with this prior to surgery.
Your surgeon should review the cultures taken when you had mastitis to determine the best antibiotic to be used at the time of surgery, and after. You will probably get different recommendations about what antibiotic to use, and how long to use it for after surgery. However, in the absence of a positive culture from the sites mentioned above, I am not sure that antibiotic therapy prior to surgery whould be recommended.
Lastly, understand that no surgery is without risks. While the incidence of infections following breast augentation are low, they still can occur. Be aware of this, and understand that you are probably at increased risk. Establish a good relationship with a board certified plastic surgeon who is thorough, and who will approach this operation with you carefully.
History of MRSA and Breast implants
A history of MRSA and a desire to have implants are two different things. If you were treated for your mastitis, and it sounds like you did, then I do not see a specific contraindication if it is several months after treatment. Can you get an infection again, sure..like anyone else.
Breast Implants and MRSA
You will need to be on antibiotics before surgery. You will need vancomycin IV at the time of surgery and should be continued on antibiotics after surgery for about 1 week.
You should not be having any discharge from the nipple and if you do it should be cultured prior to surgery.
I would also recommend having the implants placed through the inframammary incision (under the breast) as this incision is far away from the nipple and minimally disrupts the breast tissue and ducts.
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I just treated a patient with positive MRSA cultures
I sent my patient to an Infectious Disease consultant and his recommendation prior to surgery was Bactrim (antibiotic) starting 1 weeks prior to surgery and 1 week after, Bacroban ointment to her previously infected area, Vancomycin IV prior to surgery and then for 48 hours.
This is a lot to go through but it is precisely what we did even though my patient only had a positive culture from a routine nasal swab.
Discuss this with your plastic surgeon prior to your surgery.
MRSA could be a problem
MRSA is certainly a difficult situation as is any infection when it comes to breast implants. If a breast implant becomes infected then it must be removed. No amount of antibiotic will clear the infection unless the implant is removed. It would be nice to know if you are a carrier for MRSA. A consideration for nasal cultures is a possibility. It would be important for your to wash your skin with a surgical scrub beginning the night prior to surgery and the morning of surgery. If the source of your previous infection was a mastitis then I would not recommend the peri-areolar incision. You should also be aware that you may be at an increased risk for an infection but no absolute percentage can be given.
You need to be free of the MRSA
As long as you are totally free of infection in the breast and have been properly cultured to see if you are not an MRSA carrier, you can have breast implants. You might carry a slightly higher risk of infection and realize that infected implants are treated by removal as antibiotics cannot cure an implant infection.
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.