Explant of 1 implant only? (Photo)

Question

I had reaugmentation nearly 3 years ago, no problems. 5 days ago I started with pain and swelling left breast, with a slight fever. 1 day later a small pinhole appeared on inner side L.breast which was leaking excessive liquid(slight yellow tinge). A&E diagnosed infection and started IV antibiotics. US showed implant intact with small amount fluid around it. Pain and swelling settling.Now on 7 day oral antibiotics. Do I need to have the implant out? Breast surgeon said not at this stage?????

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It sounds like you are dealing with a challenging situation. Based on what you have describe, it is good to hear that the initial pain and swelling are settling and that the implant appears intact. Keep a close eye on any changes in your symptoms, such as increasing pain, swelling, or the appearance of new symptoms. Also monitor the site of the pinhole to ensure it is healing properly. Removal of the implant may become necessary, do not hesitate to seek a second opinion if you have concerns or if your symptoms persist or worsen. Being proactive about your health is important. If you have further questions or concerns, feel free to reach out. I have linked my website for additional information about breast implant illness and implant removal, if you choose to proceed with that route.

Daniel Barrett, MD · Answer

Dear Sheenyrube,
I understand your concern. Generally speaking, implants should be removed in case of an infection. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hi @Sheenyrube, thanks for your question.  My recommendation is to remove both implants as quickly as you can, if you feel you can push sooner, do so. This will help alleviate symptoms and help regulate your body's autoimmune response. However, it is not only the implants that need to be removed, but also the capsules surrounding the prosthesis. It would be necessary to perform a preventive biopsy of each capsule. If you are considering breast explantation, consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. Best of luck! Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation of Adipose Therapeutics and Science (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Gary M. Horndeski, MD · Answer

Spontaneous opening and drainage with yellow fluid from the breast is an indication that you will most likely need the implant removed.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

If you still have a hole and are draining, the implant needs to be removed to avoid an infection.  If you do not have any open areas, a drain can be inserted to remove the excess fluid.

Camille Cash, MD · Answer

Based on your description and submitted photos it appears there is a high likelihood that the implant should be removed.  The other implant should also be examined to rule out capsular contracture or other concerns.  I encourage you to visit with another board certified plastic surgeon for a second opinion if you are unsure.

Mats Hagstrom, MD (license on probation) · Answer

Your situation is far too serious and complex for us to contemplate making an assessment or recommending a treatment plan.
I think most plastic surgeons would agree that a contaminated implant will need to be removed.
There have been reported implant infections that have been treated successfully without removing the implant, but attempting this is also potentially risky and potentially dangerous.
 Ongoing untreated infections can lead tissue destruction and creating illness, including sepsis and death.
Generally speaking if a foreign body is contaminated, it needs to be removed. As I mentioned earlier, there have been exceptions.
Being on antibiotics can cool off the symptoms, even if bacteria is still present.if you stop taking the antibiotics, the symptoms may come back quickly.
I don’t know if your implant is infected, but it sounds like it is.
If you have faith in your provider, then follow their recommendations.
If you don’t, then get a second opinion, sooner rather than later.
I would not rely on posting on the Internet to get the care you need.
Either continue working with your provider or get a proper second opinion.
when infections are involved, you don’t have the luxury of time.
Infections should be taken very seriously and can potentially be destructive and life-threatening.
In my opinion, patient safety comes before Aesthetic outcome.
Best,
Mats Hagstrom MD

Explant of 1 implant only? (Photo)

Answers (7)