Can You Get Capsular Contracture from Dental Work or Surgery?

When having a deep dental cleaning or invasive dental work like a root canal or crown, you will have some of the bacteria from your mouth go into your blood stream.  It is possible then for the bacteria to settle around any foreign body, including breast implants, which can cause an inflammatory response leading to capsular contracture.  Similiarly, any time you have an infection that is not being treated, the bacteria can get into your blood stream and settle around your implants.  Surgery itself is not a risk factor, unless it is surgery in a non sterile environment, or in areas of the body where it is considered a "dirty" surgery; ie: rectal, vaginal, nose or mouth surgery.  In these instances, I inform my patients that they should take peri-operative or per-procedure antibiotics to decrease their risk of CC.

There is no specific cause related to developing a capsular contracture - but it is possible for bacteria to enter the bloodstream and cause you to enter the bloodstream and cause your body to react to the implants and form a contracture.  We take extra precautions for this by prescribing prophylactic antibiotics to take one hour before dental procedures, colonoscopies and vaginal scopes, but not surgical procedures.  Smokers or being exposed to second hand smoke do have a higher rate for developing capsular contractures.

There are many suspected causes of a capsular contracture but the most likely causes are implant contamination, bleeding and infection. Surgical technique is critical as prevention is the cure for capsular contracture. The risk of a capsular contracture when implants are placed above the muscle is in the 20 to 30% range. When the implant is placed either subfascial or sub muscular the risk is in the 4 to 7% range. The no touch technique was first described in 1991. This means avoiding any surface contamination of the implant during insertion. The no touch technique combined with irrigation with antibiotic and betadine solution as well as use of a funnel has greatly decreased the risk.

  There is at least a theoretical concern that any bacteria in the blood stream could potentially “seed” the breast implant  pocket/surface. Because there is no “science” documenting the effectiveness of prophylactic antibiotics  around the time of dental and/or other procedures, there is no “standard” recommendations are.  Best wishes.

Hello,

The idea behind dental work and capsule contracture is that dental work introduces bacteria into your blood stream.  This in turn can lead to undetected  or detectable contact between bacteria and the implant which can lead to capsule contracture.  It is hard to know what the right answer is, but what we do know is that the risk is very, very, small if at all.

All the best,

Dr Repta

Although there aren't many studies to support this, most surgeons do agree that there may be an increased risk of capsule contracture, or hardening  of tissue around breast implants, after dental work or really any surgical procedure that can result in bacteria in the bloodstream.  The thought is that the bacteria eventually goes to the breast implant and this leads to a "biofilm."  The body gets confused and tries to heal what it thinks is an infection, and the tissue starts to contract (think physics:  the maximum volume with least surface area is a sphere or ball) - the tissue starts to tighten and the result is a firmer harder breast, so called "capsule contracture."  Although there aren't hard studies (get it?!) to support it, I do admit to giving my breast implant patients a short course of antibiotics before any procedure that may result in a lot of bacteria in their system.

Dental work and surgery can cause bacteria to be released into the bloodstream.

Bacteria preferentially attach to foreign bodies (breast Implants, Heart Valves etc) and can cause infection or an inflammatory reaction.

Capsular Contraction around Breast Implants is an intense inflammatory reaction and infection does play a role in Capsule Formation around Breast Implants.

Many doctors recommend taking Prophylactic Antibiotics if you have Breast Implants when having Dental Work or other surgery

There are anecdotal reports of capsular contracture after dental procedures. This means it has been reported as a possible link. There is no science behind it. The idea of giving women with implants antibiotics twice a year for the rest of their lives is simply ridiculous. It is a practice that increases resistance of bacteria to antibiotics and should not be done. Capsular contacture has been shown to occur in the first 3-12 months in most cases and is related to the circumstances around the surgery to place the implants.