Update: Breast implant exposed but not infected. (Photo)

Question

I got my pathology back and the infection I had in my left breast was MRSA. I work at Kaiser, and I went back to work 3 weeks post op. I am on antibiotic . My wound is the size of a quarter but already healing and getting small. My PS is wonderful and I'm seeing him weekly, he says he does not see the implant through my wound, but it was exposed but not infected, but when I ask him if I can save my implant he says he's not sure yet. I am not sure how me healing depends if I can keep my implant?

Gerald Minniti, MD, FACS · Answer

Hello,Regardless of culture results, the standard of care for an exposed implant is explantation.  It is by nature that the implant is contaminated when exposed, and antibiotics will not sterilize it.  Now that MRSA has been cultured, there really is no choice but implant removal.  You should plan to have both implants removed for at least 6 months, before replacing new implants. Best of luck!

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. The best option for you is following up closely/frequently with your Plastic Surgeon. Typically, once an implant has been exposed the safest plan is to remove it, heal completely and then replant in 6 months. Unfortunately, you should be prepared for this possibility.All the best

Farah Naz Khan, MD · Answer

Glad you are getting excellent care from your PS. At this point, only time will tell if your implant is salvageable. In my experience, once an implant is exposed, it is at higher risk of infection even if it does not initially appear to be grossly infected. This often necessitates its removal. Anyway, best to continue following up with your PS and good luck!

William Andrade, MD · Answer

Hello, if there is a wound over an implant there is a higher risk of implant infection.  Perhaps this is what your surgeon is explaining.  It sounds like they are following you very closely, which is important in cases of a wound healing issue or infection.

Benjamin Chu, MD, FACS · Answer

When there has been an infection of a breast implant especially with MRSA it has to be removed.  Leaving an exposed implant will allow the wound to fester and more of your tissues will become destroyed by the presence of the bacteria.  Its best to remove the implant allow the wound to heal and in 6 months or longer put a new implant in.  The fact that many women refuse to accept this will delay proper treatment and make it much more difficult to reconstruct the breast later.

Paul J. Leahy, MD · Answer

I'm very sorry to hear about your troubles healing after your breast surgery. MRSA is a tough bacteria to clear once it's around an implant (that means any implant: breast, knee or hip replacement, ports, pacemakers, etc.). Yes, it's possible that you will sterilize everything by taking your antibiotic, but it will be an uphill battle. I'm glad to hear that your surgeon is following you so closely; that's excellent care. Time will tell, and I wish you luck.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and I believe I answered this once before without the culture results.  With MRSA in the picture I would remove both implants and stay on antibiotics to ascertain you are clear of infection and then place them back in 4 to 6 months.Dr. Corbin

Arian Mowlavi, MD, FACS (license on probation) · Answer

Your only opportunity to save your implant is to be placed on a PICC line and receive IV antibiotics intended to eradicate MRSA (Vanco likely) and to have your surgeon revise your breasts to close your incision line; you cannot have an exposed implant if you are going to have it salvaged.

J. Michael Morrissey, MD (in memoriam) · Answer

I'm sorry for the experience you have had with your implants. This situation truly requires removal of the implant. The MRSA can not be effectively cleared with the implant still present.. The safe approach is to remove both implants, and wait 6 months before considering replacing them. As you can see, this is pretty much the consensus of all the surgeons who have responded. Good luck,

Brooke R. Seckel, MD, FACS (retired) · Answer

I am very sorry to hear what you are going through.  I am also very happy that your surgeon is following you closely.In my experience once a breast implant is exposed it is by definition exposed to bacteria.  In my experience once of breast implant is exposed  the best course of action  is removal of the implant, allowing it time to heal  and doing a reimplantation after 6-12 months.

Update: Breast implant exposed but not infected. (Photo)

Answers (10)

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