Will sepsis affect my breast augmentation?

Question

I had severe sepsis in February and was hospitalized for 10 days (kidney infection gone bad). Will this effect my ability to have a BA? Will I be more prone to infection or other immune problems? Should I start taking antibiotics before my surgery as a precaution?

George Bitar, MD · Answer

A prior history of sepsis with a known cause, like kidney infection,  does not preclude you from having breast augmentation.  If you have fully recovered, are in good health, and had no pre-disposing risk factors for developing an infection in the first place, then your risks are about the same as anyone else.  There are things that patients can do to reduce their risk of infection associated with surgery.  It is important to discuss these strategies with your surgeon as they do not apply to all  patients and all surgeries.  If you are diabetic, you should keep your blood sugar in a normal range.  If you are a smoker you should quit before and after surgery.  If you are a weight-loss patient you should be sure that your vitamin and protein levels are within acceptable limits.  For the average patient, one to three doses of antibiotics around the time of surgery is sufficient.  You can lower the bacterial count on your skin with a Hibiclens shower the night before and morning of surgery.  Avoid shaving the areas around the operative site for 72 hours before surgery as this increases bacteria on the skin.  There are also some surgical centers that now screen patients for elective surgery for MRSA or antibiotic resistant bacteria.  This is only necessary if you have a prior history, or a risk factor for carrying the bacteria.

Robert Kearney, MD, FACS · Answer

Your past history of an infection does not increase your risk of having a breast augmentation. Just make sure that you don't have a urinary tract infection going into this surgery.

Ronald J. Edelson, MD · Answer

You do not give enough specific information on the cause of your sepsis. However, it sounds like it is resolved and should not cause any increased risk with breast implants. It is probably not necessary to put you on oral antibiotics after surgery, but if your surgeon may suggest it just to be on the safe side.

David R. Stephens, MD · Answer

Wow, it sounds like that was some kind of kidney infection! These are typically, but not always, caused by a different bacteria than that which causes infection following breast implant surgery. Also, it is now well over 6 months since this occurred and your body plumbing should have cleared this. If the workup did not reveal any anatomic problem with the kidneys and the urinalysis is normal than you should be good to go. Have there been any previous infections? Urinary tract infections can result in severe sepsis when not caught early or are from more virulent strains of bacteria. There should be no need for a catheter so surgery should not affect the risk of recurrence. Drinking lots of fluids and a little cranberry juice will also reduce the risk of problems. The risk of infection following breast augmentation is very low.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

If this was an isolated incident of sepsis then standard breast augmentation should be fine.  If there any questions your PS should consult with the physician who managed you septic event to get recommendations for any pre-surgical preparation.

	Dr. ES

Norman Bakshandeh Day, MD, FACS · Answer

A history of Past infections does not mean that you cannot have breast augmentation. Since you had a urinary tract/kidney infection a urinalysis prior to the surgery would be prudent.

Steven Wallach, MD · Answer

In general, sepsis per se if cleared and no longer an issue should not prevent you from the potential of having implant surgery. However, details of your sepsis problem is critical to know before considering offering a patient breast implants.

Herluf G. Lund, Jr, MD · Answer

Dear CheekyChick,

	Assuming your episode of sepsis was an isolated incident and your immune system is healthy and has returned to normal function, then you should be able to proceed with a breast augmentation procedure.  Your plastic surgeon will probably want to discuss your infection and its management with the treating doctor and will ask your permission to do so.  If there are no ongoing issues with your kidneys and urinary system, then  the normal antibiotic protocol will all that is needed with your surgery.

	Hope this helps and best of luck.

Peter E. Johnson, MD · Answer

A prior kidney infection is frightening and uncomfortable, yet it is unlikely related to a problem with your immunity, and you should not be at greater risk from infection during a breast augmentation. You can touch base with your primary and he too can explain the cause of the kidney infection and prevention of a recurrence.

Robert Whitfield, MD · Answer

There are several concerns with placing a medical device after a previous infection. Things I would want to evaluate are related to blood tests to evaluate signs of infection. If all of those parameters are normal and there are no other concerns then it is appropriate to be seen and evaluated for breast augmentation by a Board Certified Plastic Surgeon.

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