When Can I Have Implants Replaced After Removal for Infection?

Question

I had an infection in my left breast post implants. 5 weeks after surgery, I chose to have both removed. Can you explain how someone gets an infection? And does it look like it's healing properly? I had them removed 10 days ago. Should I still be on antibiotics? 
When can I have the implants put back in? Thank you. Also, the left breast is still feeling strange where my right one feels normal.

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

Tgutsbny,  
I am sorry that your implants got infected.  How someone gets an infection is complicated.  It depends on many factors such as your immune system, your overall health, the healing process just to name a few.  It is difficult to tell how you are healing with this picture and only one picture.  You should continue to follow up with your surgeon. This is extemely important so that he/she can direct your treatment successfully. I generally wait at least 3 months after removal to consider replacing the implants.  All signs/symptoms of the infection must be gone!  Good luck.  
Dr. ES

Armando Soto, MD, FACS · Answer

Hi there-
I would not want to second-guess your Board Certified Plastic Surgeon- but am happy to give you an understanding of how I would normally advise my own patients...
Implant infections are extremely rare, but they do happen, and when they do, it is appropriate to remove them. Most surgeons would recommend you wait at least 3 months before replacing them, and I think this is a good, conservative approach.

Otto Joseph Placik, MD · Answer

Your best source of information is your board certified plastic surgeon. My comments are only based on an impression and not the facts. According to my knowledge about 1 in 1000 implants gets infected. There are numerous causes. Antibiotics are typically prescribed for 10 days. Most surgeons advise waiting a minimum of 3 months before placing implants again but this recommendation will vary tremendously.

Steven Wallach, MD · Answer

The amount of time to take antibiotics depends upon what is being treated and how you respond. As to replacement, you should wait a minimum 3-4 months once you are completely healed.

Darryl J. Blinski, MD · Answer

3 to 6 months after the infection is TOTALLY cleared up. The reasons are many. From a break in sterile technique, to you getting a cold after surgery. We rarely ever know. I had a young patient after implants whose child had k. pnemoniae infection. She had to take him to ER to get treatment. Two days later she had a red swollen left implanted breast. On removal and culture, guess what bug she had? You got that right. 4 months later she has a new implant with great healing.

J. Vicente P. Poblete, MD · Answer

There is no specific timeline on when it is best for implants to be inserted after a prior infection and implants had to be removed. The tissues should be soft and no longer hardened (indurated) or swollen, no more redness (erythema) and it should be pliant. Generally, I recommend waiting at least 6 months or longer after explantation before re-insertion is done, but as noted, this is best determined by examining the patient. I wish you all the best.

Peter A. Aldea, MD · Answer

Breast Implants like ALL implants (heart valves. pacemakers, hip joints etc) may become infected because they lack the blood vessels and blood flow which can fight infection. Infections can happen just after surgery or months to years later at which time it may be an infection elsewhere in the body which SEEDS the implants.
If a trial of IV antibiotics does not cure the infection and its symptoms the affected implants are removed along with the smooth scar envelope (capsule) around them. Cultures of the pocket are obtained. Massive irrigation of the pocket(s) is carried out before closing.
I would be in NO hurry to place an implant back there. Besides wanting to allow your body to remove all the bacteria that may still be in the pocket(s) after the surgery, we like to have breast tissues which are soft, free of inflammation which behave normally and cover the implant(s) normally. It takes 4-6 months for the body to reach that state.
You really should discuss this with your Plastic surgeon and see how he / she feels.
Dr. P. Aldea

Nina S. Naidu, MD, FACS · Answer

It's a shame that you developed an infection, but we generally recommend waiting at least 3 months after your infection has cleared prior to replacing breast implants. It's hard to tell if you're healing well as your picture only shows some resolving bruising. I would suggest asking your surgeon about a possible cause for your infection and the recommended length of antibiotic treatment, as this is sometimes determined by the organism, if any, which was isolated after your implants were removed. Good luck and best wishes.

George J. Beraka, MD (retired) · Answer

Hi.
1) An occasional breast implant gets infected.  We almost never find the exact source of contamination.
2) The safest treatment is getting a wound culture, removing the infected implant, curetting (scraping) the implant capsule, inserting a drain, and taking the correct antibiotic (based on the culture) for at least two weeks.
3) Cannot tell how you are healing from picture, but you definitely have a rash that needs to be evaluated. Could be an allergic reaction.
4) It's safest to wait at least six months before replacing breast implants, because bacteria linger in the tissues.

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