Should my Implants Be Removed?

I recently had nipple reconstruction using a skin graph from my abdomen after a bilateral mastectomy. My left side took well but my right side did not take and the skin became infected, my breast became red and swollen. My surgeon removed the graph, put me on 2 weeks of antibiotics but the breast remains the same, the skin is sore and I am in pain with the swelling,and has a yellowish wound.How long do I follow this treatment before we decide the impant needs to be removed? Should it be removed?

Doctor Answers 10

Breast Enhancement Surgery

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I usually go step wise, if oral anti-biotics do not work I would go to IV, if that does not work than I would switch to a surgical option 

Breast Augmentation

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After you finish the antibiotics, you and your Board Certified Plastic Surgeon should discuss your options and evaluate whether the antibiotics were the correct choice, whether a culture and sensitivity were done, and if the drugs were effective in removing the bacteria.  If you had the correct antibiotic, and the implant is infected, very likely the implant will have to be removed if not resolved at the conclusion of antibiotic therapy.

Breast cancer and breast reconstruction

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You have answered your own question to some degree as you described an infected breast with a breast implant that is not responding to antibiotics- a clear case for implant removal. But from this side of the computer screen we do not have all the information your surgeon has including what this looks like, whether or not you had radiation and what medical specialists are involved in your care. If the infection only involves the skin sometimes all that is required is to change the antibiotic. An infectious disease specialist can help with this. We do not know what the status of your cancer is and sometimes advanced breast cancer can present this way. Your oncologist can help with this.

The breast cancer patient is best treated by a group or panel of specialists rather than a single plastic surgeon on a bulletin board.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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Breast Implant Infections

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Hello CWN22,

It is impossible to tell whether you have a superficial infection of the skin or an implant infection as well without direct physical examination.  If your doctor thinks your implant is involved with the infection, then it should be removed promptly.   When the implant has not been removed, I have never seen an implant infection get better without relapsing into another infection, no  matter how many antibiotics are used or how long a course taken.

See your doctor very soon and ask him if he thinks the implant is involved.  If he thinks it is, take them out or get a second opinion.  If not, your doctor should determine why after two weeks it's not getting better.  If he cannot give a clear understandible answer, get a second opinion. 

Best of luck!

Infected Breast Implants

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Breast implants which are infected almost always need to be removed.  It is impossible, given the information that you provided, to determine if your implants are infected or if you have a more superficial infection which does not involve your implants.  Your best bet is to follow the advice of your surgeon who should be acting in your best interests.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Should my Implants Be Removed?

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I agree that it is difficult to say without an exam; I would recommend asking your surgeon if he/she advises you to see an Infectious Disease specialist; also, have cultures been taken?  Discuss this with your surgeon!

Should my Implants Be Removed?

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Ty a change in antibiotics before removal, maybe hyperbaric oxygen therapy. Have a date in mind if you are not recovered than have implant removal, like a total of 4 weeks from infection. best of luck. 

Breast swelling

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Being that you had a skin graft for areola reconstruction, the redness may be directly related to the skin graft loss. Without an exam it is hard to say.  The best thing for you to do is follow closely with your surgeon.

Redness and swelling after areolar reconstruction

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You don't say whether the redness and soreness is just where the graft was or whether the whole breast is involved. If it is just the graft site, or just a narrow rim around it, then it may just be inflammation from the open wound and topical treatment may be sufficient. If the whole breast mound is red and sore, then an infection around the implant is more likely. Your surgeon is the best one to discuss your options with you--including removal of the implant. Although sometimes infections around implants can be cured with antibiotics, in my experience, once an implant becomes infected, it usually needs to be removed, the infection treated and then the implant can be replaced--usually at least several months later. Your surgeon can advise you best. Or if you are not happy with your surgeon, you should feel free to seek a second opinion.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon

Prolonged redness over an implant means an infected implant

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Your story worries me.  I presume that you are several months after your reconstruction.  Post mastectomy skin is thin, and it would be unusual but possible for nipple / areolar reconstruction in this operation to have created an infection around one of your implants.

No every infected implant needs to be removed--some can be saved with prompt, aggressive treatment with the right antibiotics.  I would follow up with your surgeon; if you are not getting good care, see another surgeon.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.