How do you know for sure if you have an infection in breast implant pocket? Is it likely to return after reimplanting? (Photo)

Infections with implantsyour case is confusing.   it is possible to have a subclinical or chronic low grade infection. treatment choices are difficult.. you can take the implants out for 3-12 months and then re -implant or try a protracted course of oral antibiotics for 2-3 months.  

Your story is confusing.  If your breasts are now soft, it is unlikely you have an infection, but with your history of response to antibiotics, and soreness, then a chronic low grade infection with a non aggressive bacteria must be considered.  I would consult with your surgeon, and describe your response. Your photo does not show deformation of the breast which would occur with a severe capsule.

Its pretty unlikely that you have an acute infection after a year, especially one that comes and goes as you describe.  It is possible that capsular contracture is caused by a more chronic low-grade infection.  The caue of all this is something you will need to explore with your plastic surgeon.

Infection can be diagnosed based on symptoms, and a definitive diagnosis can be made based on bloodwork and cultures. To get cultures from a capsule would require surgery

Thank you very much for your question. It does sound as if you have a low grade
infection in your breast.The cause of capsular contracture is not
100% known but is possibly related to low grade infection.This would tie in with the fact that your
condition does improve when you are on antibiotics.Interestingly breast implant infections are
more common in people who do have recurrent UTI’s as the bacteria from this can
spread in the blood and settle on a foreign object such as a breast implant.I think if you do have tender, painful
breasts with significant capsular contracture the best option may be to remove
the implants and the capsules so that your breasts are back to normal
tissue.You can then either leave the
implants out for a time to clear the infection or insert the implants during
the same operation.I would wish you the best of luck with this
in future.AR

Hello, I'm sorry to hear that you are having a difficult time with your breast implants. As others have said already,early hardening of breasts is usually not capsular contracture but would more likely be infectious in nature from a less virulent type of organism. The fact that redness and hardening comes and goes would once again point more toward partially treated infection.At this point thorough evaluation by your plastic surgeon, with possible imaging { MRI} would be best, and possibly an evaluation with an infectious disease expert.

A capsular contracture is rare to occur at 4 weeks.  WIth the way your breast have responded recently it could be that you have had an infection with one or both. Best to be seen in person to determine what the issues are.

Often tenderness and enlarged and or tender axillary lymph nodes is the only symptom with a chronically infected capsule.  The fact that it gets better with antibiotics is evidence that you have a bacterial infection.  In my experience, you also probably have mold and or yeast in the biofilm, so I would recommend a long course of an antibiotic combined with an antifungal.  If the pain recurs after that, you may need explantation with total capsule removal.

If your breast is swollen and/or sore this may be caused by several factors.  However, if the soreness seems to resolve with antibiotics following a UTI, you may have a chronic/intermittent breast infection.  Let your surgeon know about this situation.  They may what to get a white blood cell count which, if elevated, can be an indication of an infection.  They may also consider a breast ultrasound or CT scan which could look for any fluid accumulation around the implant. Best wishes, Dr. Lepore.