Follow-Up Question: Could this be an infection - 6 weeks post BA. (photos)

I posted a few days ago and received helpful answers suggesting a low grade infection 6 weeks post BA. My surgeon says that blood work would not help as infection parameters are always high:is this true? He now suggests to puncture looking for bacteria. I've been taking augmentan (3days) on my own request and the redness is fading. Unfortunately, it is impossible to get an appointment with a plastic surgeon earlier than a week from now (next Tuesday), while I'm unsure about what my surgeon says.

Doctor Answers 7

Get Checked Out As Soon As Possible

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At this point, your primary goal needs to be obtaining a proper diagnosis for the redness. That requires a personal visit, and if you cannot see your plastic surgeon for a week, I suggest scheduling an appointment with a primary care doctor. Based on the information you've posted, it appears that the condition is responding to the antibiotic, but that could be coincidental. You should closely monitor this and stay in contact with your plastic surgeon. Best wishes.

Breast augmentation post op, some advices:

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Thanks for the question. 

In my practice, after performing a BA I recommend to my patients to limit the movement of the arms for two weeks. After that, you can move your arms taking care and always with common sense.  In this regard, it's not advisable to carry heavy weights to prevent the implant out of position, and allow the formation of the physiological capsule around the implant, also to avoid pain and breast swelling. 

I recommend you to maintain the wound dry and clean and to follow your surgeon advices.

Kind regards 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 368 reviews

Follow-Up Question: Could this be an infection - 6 weeks post BA

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Thank you for sharing your question and photographs and I am sorry to hear of your recovery issues.  I would strongly recommend maintaining close follow up with your surgeon as they are ultimately responsible for your well-being and recovery, especially in the face of a possible infection.  Based on your pictures and narrative it is concerning that an infection may be present.  If the infection were to spread to your implant it would need to be removed to clear any residual bacteria.  I would not puncture the area, nor think blood work is necessary at this point in time, but if you start to manifest constitutional signs such as fevers, chills, nausea, etc, or breast specific symptoms like worsening swelling and pain, you need to see your surgeon in short order.  Best wishes.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Follow-Up Question: Could this be an infection - 6 weeks post BA.

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Without seeing a patient in person, specific advise is not possible. In general, superficial skin infections can be treated with antibiotics (and that may be the case based on the information provided). If the implant is infected, it may require more testing to make the diagnosis, including a needle puncture to test the fluid around the implant. If the implant is infected, it is usually removed. The redness in the picture looks like a skin problem (infection or rash) and may not mean there is a deeper problem. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Infection 6 weeks after breast implants?

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Thank you for asking about your breast augmentation.

  • If you are on augmentin and the redness is fading, you almost certainly have an infection.
  • It is not true that infection parameters are always high.
  • Doing a puncture to look for infection makes no sense to me - you are on antibiotics so you are unlikely to grow bacteria; a puncture is likely to damage the implant and if you do not have a deep infection now, the puncture could introduce infection. 
  • I strongly recommend that you stay on the augmentin and wait to see a plastic surgeon.
  • Your current surgeon does not seem the best professional to be involved with this surgery and most non-plastic surgeons are not trained to deal with breast implants and their complications. 
  • You are likely to need an ultrasound to see if there is evidence of infection around the implant.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Redness after BA

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When I see redness that's in a pattern with squared off margins such as I see in your picture, my first thought is a rash secondary to a sensitivity to tape or a tape like dressing that may have been placed over the incision. The better course of treatment if this is the case, would be a topical mild steroid. Your plastic surgeon will be your best bet in making a definitive diagnosis. Congratulations on your surgery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Low Grade infection? - Please visit your family doctor/surgeon

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Thank you for your question!

Redness is visible, but a correct diagnosis cannot be made from pictures. We want to play it safe, so if you are finding it hard to follow-up with your surgeon, then please visit your family doctor at the earliest. They may offer better antibiotics such as Cephalexin (Keflex) or Dicloxacillin (Dycil) that fight the endogenous bacteria within the breast.

A low-grade infection simply means that there may be mild inflammation without pus formation, but it is possible for the blood work to show an elevated white blood cell count relative to your baseline.

Please consult with either your family doctor or Surgeon as they are better informed about your medical and surgical history. Their instructions should take precedence over everything else you read here. Also, do not start any medications without first consulting your doctor/surgeon.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 519 reviews

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.