Timing of Breast Implant Replacement After Staph Infection?

Six months should be long enough to wait to replace an implant after infection.  In general, anywhere from 3-6 months should be safe in an unfortunate situation such as this one.  Luckily, infections are rare after a breast augmentation and when they do present, the implant can usually be salvaged with antibiotics.  But if the infection does not resolve, removing the implant is sometimes the only option.  When replacing the implant, care should be taken to minimize any risk of contamination (as with any augmentation).  The implant as well as the breast should be thoroughly irrigated with antibiotic solution.  Also, you may consider having the implant placed in a different position in the breast.  This decision should be made with your plastic surgeon and will depend somewhat on the details of your original infection. 

Unfortunately, we occasionally see patients who
develop infection following breast augmentation surgery.Although this complication is relatively
rare, it occasionally occurs and usually always requires removal of breast
implants.When
this situation arises, surgeons delay implant replacement for at least six
months following the eradication of the infection.This not only allows adequate time for the
body to eliminate bacteria, but also allows adequate time for swelling and
inflammation to resolve as well.This
helps soften the breast tissue and ultimately helps the aesthetic result
following re-augmentation surgery.When
patients undergo re-augmentation, it’s important that prophylactic antibiotics
be utilized.These antibiotics should be
specific to the cultured bacterial sensitivities.In addition, it’s important to involve
infectious disease consultants in the pre- and post-operative care of patients
who have lost implants secondary to infection.When
these steps are taken to optimize patient care, reinfection rates are
relatively low.Unfortunately, even when
these steps are taken, there still remains some risk of recurrent infection.

There is no hardfast rule to waiting, however, it would seem statistically fruitful to wait at least six months to ensure that your body has minimized the source of infection.  I would personally advise you to wait the full six months at the very least.

I would agree that 6 months is a reasonable amount of time.  In addition to waiting an appropriate amount of time, I am sure your plastic surgeon will take other measures to limit your risks of another infection.  Possible steps include:


Prophylactic antibiotics started before the incision

Bathing the implant in antibiotic solution prior to implantation

Avoiding handling the implant as possible

Layered wound closure to avoid implant exposure

Postoperative oral antibiotics.

Margaret- It is unfortunate that you contracted an infection after a breast augmentation. I’m sure none of that was expected. As far as getting your implants replaced, it is important to talk to your surgeon about your questions and fears. I would suggest waiting at least 6 months after the incision has healed before getting another augmentation. Your body has been through a lot and you want to make sure that you will heal properly. Discuss your options with your surgeon and ask questions.

Your story is unusual (fortunately), but does occur rarely.  The foreign body was removed (the implant) and the tissues have been given enough time to recover.  There is a chance you could have another infection but this chance is small.  I would consider placing the implant in an entirely different region.  If the infected implant was below the muscle, I would suggest placing the replacement above and vice versa.

Sorry to hear about your problems. this is a very rare complication in breast augmentation surgery, and I personally did not see one in 15 years. Since you are completely healed and I assume the breast tissue is soft with no tissue distortion or retractions, you should be ready for reaugmentation. Sometimes, after a bad infection like yours, the breast shape can change due to loss of fat which was dissolved by the infection. An implant alone might not be able to correct this fully and make you look symmetrical. If this is the case, you would benefit from fat injections after your augmentation to correct any residual asymmetry or tissue deficiency. Good luck!
George Marosan, M.D.

Hi there- I'm sorry to hear about your problems. Breast implant surgery is normally very low risk in healthy individuals, but unfortunately (as you understand) it's not a perfect science. I think the 6 month wait between complete healing and re-implantation is more than enough to lower your risk as much as possible.
In other words, there should be no benefit or further lowering of your risk associated with waiting longer than 6 months, as by 6 months, your body has had a lot of time to adequately clear any remaining bacteria (your wound would not have healed in the presence of a significant bacterial load that your immune system did not have under control).
I definitely understand your desire to avoid further problems, but I think your risk is as low as it will get, so go for it!

I'm sorry to hear about your explantation of the implant due to infection. Thankfully, this is an uncommon event. Staph infections do seem to be the primary culprit when an implant needs to be removed. The standard is to wait 6 months after explantation before replacing the implant. As with any surgery, there is always the risk of infection. My recommendations for my patients is to tailor the perioperative and postoperative antibiotics to the bacteria from the original infection. During surgery, cultures are obtained in case an infection does recur to identify any organisms present.

Another risk which should be discussed is the risk of subsequent capsular contracture. You are at a higher risk of capsular contracture given the previous infection as well as the scar tissue present. More aggressive massage may be necessary following reaugmentation. Your plastic surgeon will inform you of these risks.

All in all, the 6 months is an adequate amount of time to allow your body to clear the infection and for the inflammatory process related to the infection to subside. The majority of women who under a reaugmentation after a previous infection do just fine. Best of luck with your surgery!

It certainly sounds as if you have had a difficult experience so far. While your circumstance is quite rare, infections are to be taken very seriously. It sounds as if you were well cared for, having had the infected implant removed and then being placed on antibiotics. I agree that you should wait for a period of at least 6 months after appearing completely healed to replace your breast implant. With regard to your question- yes, it is possible that you can get another infection.

Your plastic surgeon will likely treat you with specific antibiotics around the time of your surgery, and will want to watch you very closely. He or she may use antibiotic irrigation during the operation as I do in Santa Barbara to provide further layers of safety. The odd are in your favor to have an event-free episode with this next operation, and so I would not fear getting your breast implant replaced and completing your breast augmentation.