Can Implants Become Infected Years After Surgery?

Question

Is it true that implants can become infected sometimes years after surgery?  If so, what causes the infection and what can patients do to minimize the chances of infection?

Darrick E. Antell, MD, FACS · Answer

It is extremely rare for a breast implant to become infected years later. However, it is not impossible. You could have an infection in another part of your body and it could travel through your blood stream and cause an infection totally unrelated to the intial implant surgery. Sometimes you may never know the cause.
Fortunately, if this very rare event did occur, it is treatable.

Sam Jejurikar, MD · Answer

Breast implants can definitely become infected years after surgery.  Because implants are a foreign material, distinct from your body's own tissues, your body is able to deliver antibodies or antibiotics around the surface of the implant, but not into the implant itself.  If you get an infection elsewhere in your body, and the bacteria gets into your bloodstream, it can seed the implant.  In milder cases, this can result in capsular contracture (significant scar tissue buildup around the implant thought to be a sub-acute infection), or in more severe cases, this can result in a true infection.  If the infection is too advanced, your body has little ability to fight it, even with aggressive antibiotics, as the antibiotics can't be delivered into the implant itself.
For this reason, many of us recommend that our patients get on antibiotics if they have any bacterial infection, or if they have any procedure that could result in bacterial seeding into the blood (such as dental procedures or elective surgery).
Hope this helps.  Best of luck.

Scott E. Kasden, MD, FACS · Answer

I have had 2 or three cases where the patient had perfectly natural and aesthetic results but after years, spontaneously get infected.  To be fair, this is in perhaps a couple of thousand or more implants.  One woman had a dental abcess.  The other one may have been due to breast feeding/masitis.
It is VERY reare, and I am not sure it can be prevented.
sek

Peter A. Aldea, MD · Answer

Yes. They can.
Although this is not a common occurrence, it is not unheard of. In theory, any presence of bacteria or fungus in your blood (IE bacteremia - as seen with blood poisoning [sepsis], severe mouth or urinary tract infection etc) can literally seed an implant.
We have known for years that people with irregular or noisy heart valves (those having murmurs) or those with artificial valves are at a higher risk of getting them infected with bacteria from elsewhere (known as bacterial endocarditis). Similar issues can be seen with artificial vascular conduits, knee and hip joints etc.
In the case of breast implants, it is not unheard of for breast implants to become hard (capsular contracture) years later, a few weeks after an infection. Rarer yet, we have all seen a few cases of implant infections as verified by positive cultures of the implant obtained at the time of their removal.
Personally, with breast implants in, whenever you have an infection or have your teeth cleaned, I would recommend you consider taking antibiotics to lower such risks.
I hope this was helpful.

Steven Wallach, MD · Answer

Infections can develop in implants years after the procedure. But, I would have to say this is very rare. Unfortunately there really is not anything you can do to completely prevent this from happening.

G. Gregory Gallico III, MD · Answer

Any material in the body for any length of time can become infected. Certain procedures like dentalsurgery can release bacteria into the blood which can infect implants. Antibiotics can prevent this. Just be careful of all later surgery, take antibiotics, and rest assured, it's very rare.

Robin T.W. Yuan, MD · Answer

Implants can indeed become infected many years later. This is true of any implants whether they be breast, hip, or shunts. These are foreign material that do not have intrinsic blood supply. As such, bacteria that might be carried in the blood stream from distant or local infection, such as urinary tract infections, skin infection, tooth abscess,etc. may seed the implants and start an infection. For this reason, you must treat all bacterial infections promptly and also should prophylactically cover yourself with antibiotics if you to undergo procedures that might cause bacteremia, like bowel operations and dental procedures.

Tracy Pfeifer, MD · Answer

I have seen this twice. Once was in a patient who had her nipples pierced after breast augmentation. The second case was in a patient who "bound" her breasts after she delivered her baby to prevent her milk from coming in.
In the breast tissue there are ducts that connect the milk producing breast lobules to the nipple. Bacteria are in these ducts. In both cases it is possible the bacteria from the ducts infected the implants. In the tattooo case, it is also possible a non-sterile procedure contaminated the implants. Many surgeons also believe that implants can become infected during dental procedures, even routine teeth cleaning, and advise their patients to take antibiotics prior to the procedure.  
Hope this helps.

George J. Beraka, MD (retired) · Answer

Hi!
Do not worry about this.  I have done approximately 1500 breast augmentations, and I have seen only one very late (years) infection, that was caused by a fungus.  Nothing you can do to prevent this extremely rare complication.

John E. Gross, MD (retired) · Answer

Any of the devices that surgeons place in patients' bodies, e.g. breast implants, knee or hip prosthesis', heart valves etc can develop a late infection. this can happen when we have bacteria in our blood and the bacteria happen to end up on or around the implant. Since implants don't have a blood supply, if bacteria end up on the device an infection can occur. Most orthopedic surgeons recommend to their patients that have artificial joints to take an antibiotic for any procedure that can allow bacteria to enter the blood. The same may apply for patients with breast implants. Many breast surgeons will recommend one dose of antibiotics prior to a dental cleaning or colonoscopy. The science is not terribly clear on this, but when one looks at the risk or cost of one dose of antibiotics it seems the "trade off' is worth it.

Can Implants Become Infected Years After Surgery?

Answers (10)

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