Can Infection Appear Years After Implantation? Can It Be Inside the Scar Tissue?

In my opinion breast implant patients can get infections around the implants at any time after implant placement, even years later. The implants can get infected secondary to infections elsewhere in the body like the urinary tract or can even result from transient bacteria in the bloodstream from dental work. These infections can be mild and easily treated with antibiotics but never be completely cleared because there is foreign body material present. It depends on the type of bacteria, bacteria glycocalyx formation, capsule properties and patient immunity factors. The infections that never completely clear up can periodically return when the patient is stressed etc. Over time these lead to hardening capsular contracture of the breast. It is a difficult thing to treat because most patients are unwilling to remove the affected implants for 6 months followed by replacement. They would rather take antibiotics intermittently.

It is difficult to know exactly what is going on but to answer your question: Yes, it is possible to develop a breast implant infection years after the intial augmentation. It can be inside the scar tissue or develop from a remote site.

Without knowing your full clinical history, it would really be difficult to say whether or not you have an infection at this time.  While infections can certainly develop years down the road, they are much more common in the early period following your surgery.  It would be interesting to know how your other physicians diagnosed your intermittent implant infections and then successfully treated them with abx in the past since the gold standard is to remove your implant for a short period of time and then re-insert a new implant once the infection is cleared.

My recommendation is to visit a local Board Certified Plastic Surgeon and get a second opinion. 

I hope that helps!

What you may have developed is a pathologic biofilm.  There are theories our there that suggest that biofilms may harbor bacteria that could trigger signs of an implant infections years out from surgery.  In addition, there are theories out there that biofilms could precipitate capsular contracture. The good news - this is all very rare.  For a treatment plan, I would recommend a total capsulectomy and implant removal and placement of a new implant.  If a virgin pocket is available, I would place the implant there (such as transitioning from the subglandular position to a submuscle or dual plane position).  Please talk with your board certiifed plastic surgeon to review your options.

You may be experiencing a "subclinical" infection or an infection due to a bioflm. Unlike typical infections, these may just smolder along for a long time and are hard to treat with a short course of antibiotics. If you are going to have surgery, your surgeon may want to remove the implant and capsule, then obtain microbiology cultures (with stains, checked for 6 weeks). If you want to continue with breast implants, a new implant should be used and your surgeon may want to use antibiotic irrigation during surgery.