Timing of Breast Implant Replacement After Staph Infection?

I had breast augmentation in August 2007 and had my right implant removed 5 months later. The cause of it was unknown at the time, but after months of my incision not healing, and numerous visits to doctors and countless cultures, an infectious disease specialist was able to pinpoint it to a particular staph infection. I was given antiobiotics which I took for 3-4 months.

My incision healed up in August and I've been given the green light for my redo in February. All doctors have recommended that I wait 6 months. Needless to say, I'm happy, yet fearful about getting my implant back in. Is it too early though? I certainly can wait if need be. Could I get another staph infection? I definitely do not want to repeat what I went through again. Is there anything I can do to prevent this from happening? Your advice and insight is greatly appreciated!

Doctor Answers 20

6 Months is Long Enough After Infection

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^ months is long enough to wait after complete healing has taken place and you have been off antibiotics.

Consult with your surgeon and your infectious disease specialist to be sure they agree and whether they want to do special cultures (like a nasal swab) before surgery to be sure you aren't host to certain kinds of staph.

Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Reaugmentation after infection

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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!

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Careful surgery is possible after an implant infection- but I would wait 6 months

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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.

Etiology is unclear

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If your question is can you have your implant surgery six months after clearing an infection, then I would say that is enough time as long as the tissues look and feel normal and pliable. One thing that is not clear from your statement is what started this whole process to begin with. Did your incision never heal? Was there a clinical infection that caused your incision not to heal? Was the culture really a pathogen or a contaminant? Was your infection secondary to a surgical or healing problem? Answers to these questions would put the culture that you obtain in better perspective. I don't know why it would take months and countless cultures to pinpoint a clinical infection. What kind of staph infection was is and are you are carrier for something called methicillin-resistant staph aureus or MRSA?

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

If you healed and the breast is soft then you are ready for surgery

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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.

Wait at least 6 months.

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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.

Breast implant infection

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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.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

Augmentation after an infection

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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. 

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

Talk about your options

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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.

6 months after breast infection is long enough for replacement.

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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.

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.