My Doctor Thinks my Implant is Infected with Staph. How Can Staph Get Inside an Implant?

Question

Submuscular breast augmentation 10yrs ago, bottomed out, had 2nd surgery w/in 6mths(implants placed over muscle). 3yrs ago contracted internal staph infection(right breast), treated w/ antibiotics & cleared up. 8mths ago had surgery(same breast), removed papilloma. 1mth ago got 2nd staph infection(same breast), taking antibiotics, MRI & appt with disease specialist scheduled. Dr thinks implant is infected. How can staph get into a saline implant thru the silicone sack w/no apparent saline leak?

Gary M. Horndeski, MD · Answer

Hi,

	I am so sorry to hear about your complication. The staph infection is more likely in the 'pocket' that your PS made when the implant was placed and not IN the implant. I am glad you are seeing an infectious disease specialist. I would recommend removing the implant altogether until the infection has been irradicated completely. Best of luck to you.

	Sincerely,

	Dr. H

Miguel Delgado, MD · Answer

The inside of the implant doesnt get infected but the pocket around the implant. You have had significant issues with your implants and multiple surgeries, not to mention the expense. Some times it is best to take out the implants and let all the infection clear up and then replace them. I t is very difficult to clear an infection with a foreign body in human tissue. If you begin to have fevers and tendernous this is the saftest choice. good luck

Steven Wallach, MD · Answer

If you have an infection around the implant, it more than likely has to be removed.  Without an exam I can not be sure.

Scott E. Newman, MD, FACS · Answer

You seem to imply that the infection is 'within' the implant.  If so then you definitely need to provide more information.  Are you symptomatic?

Peter E. Johnson, MD · Answer

Infections with breast implants are not caused by bacteria inside the implant. Bacteria will set up in the breast capsule, or on the outside surface of the implant. The surface of the implant can from a place for the bacteria to 'hide' and antibiotics are not always able to fight off the infection, with a recurrence after the antibiotics are stopped. If antibiotics don't clear things up, infections rapidly respond when the implants are removed.

	Best of luck,

	peterejohnsonmd

Sugene Kim, MD, FACS · Answer

Sorry to hear that you have an infection after your surgery. Your recurrent infection is most likely due to colonization of bacteria around your implant/capsule. Our body is colonized with bacteria on our skin. During the surgery, bacteria on our skin (mostly Staph) might have gone into your implant/implant pocket. If you continue to have recurrence or infection does not clear up with antibiotics, you may need to get the implant out for awhile. Good luck to you.

Jeffrey D. Hoefflin, MD · Answer

I agree in that your capsule is most likely colonized. In addition, give your history of multiple procedures, a length of time between the procedures, and repeated infections, you most likely are colonized with a bacteria that has seeded the tissue surrounding the implant. These bacteria are often difficult to erradicate and can require either a different antibiotic choice, or ultimately, removing the implant, potentially the capsule, and letting your tissues heal together with the intention of staged procedure sometime in the future. I wish you all the best.

Glenn Vallecillos, MD, FACS · Answer

Hello and thank you for the question.

	As my colleague suggested, it is likely that the infection may involve the capsule surrounding the implant as opposed to the implant itself.  You may require a trial of explantation to allow your breasts to heal and the infection reside definitiively.

	Best of luck,

	Glenn Vallecillos, M.D., F.A.C.S.

Todd B. Koch, MD · Answer

Infection following breast augmentation is uncommon. The incidence is well below one out of 100. The infection occurs in the area around the implant between the capsule and the implant shell. There is never an infection inside the implant itself. These infections can be difficult to eradicate without removing the implant and then replacing it several months later. Depending on the severity of the infection a trial of antibiotics alone may work. If this fails returning to the OR is probably the best approach. Good luck.

Robin T.W. Yuan, MD · Answer

While your history is a bit confusing, the answer to your question is that bacteria can seed the implant either through the orginal surgery when the implants is inserted, through breasts ducts communicating the external world to the internal breast tissue amd the implant, or by the blood stream from another source such as a urinary tract infection of skin infection.

	Robin T.W. Yuan, M.D.

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