Capsular contracture and cavities? Would the bacteria from my cavity get in my blood stream causing CC after I get my BA?

Question

I'll be having BA in 2 weeks and I'm trying to understand the whole capsular contracture and avoiding it. So I understand you can't have dental work without antibiotics because of the bacteria, would that mean if I have a cavity right now would that bacteria from that cavity be getting in my blood stream and causing me a contracture after I have my BA done?

Robert L. Steely, MD, FACS · Answer

Good morning!Capsular contracture is still a not completely understood phenomenon.  It appears that the primary culprits are excess blood in the pocket after surgery and bacteria in the pocket - not so much bacteria that you get an infection, but a small amount that can cause an inflammatory cascade that results in the contracture.I have a large augmentation practice and am confident that poor dental hygiene and dental health can influence your chance of getting a contracture.  I have all of my patients be sure they do not have ongoing issues in their mouth before embarking on an augmentation, and I do have my patients take a single antibiotic pill the morning of going to have any dental work done- including a cleaning.  I have been doing this for several years and have had my contracture rates drop almost to zero.It is about doing several little things to minimize your chances of having a problem- having  dental issues does not guarantee that you will have an issue with your implants by any means- but we want to maximize your chance of having soft beautiful breasts for years after your augmentation.I hope this helps

Aldo Guerra, MD · Answer

Thanks for this question.No one in the world completely understands the exact mechanism that leads to capsule contracture. There is a lot of scientific evidence that the process begins with an inflammatory event. This event could be triggered by bacteria, but other factors are supported in other studies. Science has also taught us there is no way to kill all the bacteria in our body with antibiotics. All we can do is reduce the number of bacteria to such a low number that it reduces the risks of infection and other complications. We also understand now the most critical time to reduce the risks of capsule contracture is at the time of breast implant placement. These are the steps I take, in addition to using intravenous antibiotics, to reduce inflammation and reduce bacterial contamination. Use of a no touch technique for implant placement.Triple antibiotic irrigation of the breast pocket and breast implants.Covering the nipple on the patient to reduce bacterial exposure.Using a Keller Funnel to avoid having the breast implant touch the skin where bacteria live. Minimize bleeding in the breast pocket with a thorough dissection.Placing the breast implant under the pectoral muscle.Using textured breast implants when clinically indicated.After you leave surgery other events could expose the breast implant capsule to inflammation. An event like going to the dentist, a tattoo, a piercing, and any infection on your body could also do it. These events are not very common at all. However, if you have a cavity with infection you would probably be at higher risks of infection with surgery and also CC at the time of the operation.Speak with your plastic surgeon about these issues before proceeding with breast implants. Best wishes, Dr. ALDO

David Dellinger, DO, FACOS · Answer

A very interesting and controversial question. There is a definite correlation between increased bacteria in the bloodstream after dental procedures including dental cleanings. There are concerns that bacteria could enter a breast implant pocket, especially in the early weeks after augmentation, and cause problems including capsular contracture. Just having a cavity probably wouldn't make you any more likely to have bacteremia (bacteria in the blood), as we all have bacteria in our mouths. We place patients on antibiotics before, during and after surgery to prevent such problems. Once healing has occurred, we usually decide on a case by case, or if the dentist or patient would prefer to have the patient on antibiotics.

Capsular contracture and cavities? Would the bacteria from my cavity get in my blood stream causing CC after I get my BA?

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Capsular contracture and cavities? Would the bacteria from my cavity get in my blood stream causing CC after I get my BA?

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Everything you need to know about Breast Augmentation

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