Infection After Breast Augmentation and Lift

Question

Does this look Normal for a second surgery? I had a major infection. Should I have been put on oral antibiotics to prevent infection? I originally had a lift and an augmentation - October, 08. Now, I just had them redone - April 08. 
The left one was the original problem and now seems to be again. I asked my PS to put me on oral antibiotics and he said that he doesn't recommend orals after surgery because he gave me a dose before and after my surgery. I insisted and he gave me Augementin 875mg 2x per day. Advice?

Jerome Edelstein, MD · Answer

The usual symptoms of bacterial infection include pain and tenderness, swelling, and erythema. Sometimes, there may also be a fever and purulent discharge (pus). If you are not experiencing any of these symptoms then it may just be prominent scarring. However, just in case please see your surgeon as it could be an infection that should be treated as soon as possible. Best of luck.

Richard J. Bruneteau, MD · Answer

Infection following breast augmentation is a serious
complication that can result in patients losing their breast implants. Signs of
infection include redness, swelling, drainage, pain, fever, and flu-like
symptoms. When these symptoms occur they should be investigated aggressively.
This may include laboratory studies, ultrasonography, and possibly fluid
aspiration from the breast pocket for culture.

Although your past history is concerning, your pictures
suggest a normal inflammatory response which is frequently associated with
wound healing. Although we don’t have the benefit of a physical exam, your
pictures suggest a normal postoperative course.

It’s important that your plastic surgeon closely
monitors your progress. It appears that your wound is slowly improving and
should continue to get better with time.

Asif Pirani, MD, FRCS(C) · Answer

The only way to really advise you correctly would be to examine you.  If you don't trust your surgeon, then you should get a second opinion from a board certified plastic surgeon in your area.

	Best,

Paul Vitenas, Jr., MD · Answer

The breast in the photograph does not appear to be infected but rather looks like there is some suture reactivity taking place. This can happen with Vicryl sutures and Monocryl sutures as well as others. At this time I would let the breast incisions settle down and then reassess at a later date.

Bhupesh Vasisht, MD · Answer

Based on the photographs, it seems that your redness is very focal to the area around the incision. The main portion of the breast appears to be uninvolved. Could it be that you may be reacting the sutures that are used for the internal dermal suturing? Sometimes, sutures like vicryl and monocryl can cause a reaction like the one around your incision. Please check with your surgeon for that possibility. Good luck with this issue.

Jason Hess, MD · Answer

An augmentation mastopexy is the reason for the most litigation of plastic all surgery cases. This indicates it is a procedure where complications of varying degrees are not uncommon. Based upon the pic provided, it does not appear to be infected. I give all breast augmentation patients antibiotics, but this is not mandatory. See your doctor and don't be afraid to ask questions. Good Luck!

Vincent N. Zubowicz, MD · Answer

Even though many plastic surgeons administer antibiotics to breast augmentation patients (me too), there is no evidence that they reduce the risk of operative infection. I would not disagree with your plastic surgeon.

Remus Repta, MD · Answer

Hello,

	Your photo appears to show incisions that have healed wide as opposed to infection.  If you did not have an infection during your recovery than not taking antibiotics had no affect.  Incisions can heal wide or visible secondary to many factors including technique, tension, genetics, and many others.  I would discuss this with your plastic surgeon regarding timing of re-evaluation and the decision of whether or not to proceed with scar revision.

	All the best,

	Dr Repta

Scott E. Newman, MD, FACS · Answer

It's difficult to give you advice based on your description and photo.  Oral antibiotics are not often an issue if there's a question of infection.

Grant Stevens, MD · Answer

I agree with the points made above.   Go to your surgeon and ask him or her.  Infections of breast implants are usually very obvious.  Hot, red, tender, fever, chills, eventuallly pus and exposure of the implant.  They are rarely subtle.................gs

Infection After Breast Augmentation and Lift

Answers (14)

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