Dental work 1.5 years post breast augmentation - is it possible to develop capsular contracture?

Question

Hi! I had a breast augmentation in June 2023 and will have dental work done next week for the first time since surgery. My PS didn’t mention anything about antibiotics to prevent capsular contracture, but I’m reading that I should probably take a course before the appointment to be safe. Is it possible to develop cc almost 2 years post op from the dental work? Do I need antibiotics just in case? Thanks!

Donovan Rosas, MD · Answer

Dental work typically results in a transient bacteremia.

This is a risk of contamination of the implants in the early post operative period. Once the capsule is well established this is less of a concern (greater than 6 months).

That being said, I still recommend peri-procedural antibiotics out of an abundance of caution.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear ovirivahine,

every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Shlomo Widder, MD · Answer

Dear Ovirivahine,
    Thanks for your question, which I think is an important one. In my practice I  recommend to my patients who had  implant surgery of any kind - Breasts, Butt, Calf etc who are planning to have procedures like deep dental cleaning, dental extraction, colonoscopy etc to take antibiotics the night before, the morning of and 12 hours later. The theory behind it is that these procedures send bacteria into the blood stream and these bacteria sometimes  can land on the implant causing Biofilm and capsule contracture. I ask these patients to call my office if their doctor refuses to prescribe them the antibiotics and we do it for them. I had few patients who developed Biofilm and severe capsule contracture years after their breasts augmentation surgery  as a result of, most likely,  not complying with my policy.
                        Wishing you good luck,
                               Dr Widder
                      widderplasticsurgery.com

Chet Mays, MD · Answer

Thank you for your inquiry!!   Typically, an antibiotic is prescribed up to 6 months after the placement of breast implants.  Follow-up with your provider regarding their recommendations.

Connie Hiers, MD, FACS · Answer

Yes, you risk a capsule formation with exposure to bacteria, and lots of mouth bacteria are stirred up with dental cleaning and work. Ask your dentist to prescribe antibiotics prior to the procedure each time.

Camille Cash, MD · Answer

It is possible to develop capsular contracture any time when you have breast implants, but the risk is low.  The thought behind taking antibiotics before dental work is to prevent potential infection traveling to the implants which could lead to capsular contracture.  I encourage you to discuss this with your surgeon to decide what is right for you.

James Knoetgen, III, MD · Answer

It's great that you're being proactive about your health.
Capsular contracture (CC) can develop at any time after breast augmentation, but it's typically most likely within the first year after surgery. However, it is still possible, although less common, for CC to occur later. In your case, 1.5 years post-op, the risk is relatively low, but it's not entirely ruled out.
Regarding antibiotics, some surgeons recommend a preventive course of antibiotics for dental work to prevent infections, which can potentially trigger CC. If your surgeon hasn't mentioned antibiotics, it's likely because they don't see the need based on your specific situation. However, it's always a good idea to double-check with your surgeon or healthcare provider, especially if you’re concerned about the risk of infection from the dental procedure.
While the chance of developing CC from dental work alone is quite low, it's always best to follow the advice of your surgeon and your dentist to make sure you’re fully prepared.

Ralph M. Rosato, MD · Answer

The medical community is divided on this question. It stems from the idea that the scar tissue around you implant may be susceptible to infection.  Dental work can lead to temporary bacteria in the blood that potentially trigger a contracture.  I have a shoulder implant and take antibiotics before dental work. I ask my patient to do the same. Call you doctor.

Dental work 1.5 years post breast augmentation - is it possible to develop capsular contracture?

Answers (8)

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