By: Patrick Hudson

Date: Sat, 19 Feb 2000 06:44:28 EST

Infection after breast augmentation is unusual but can be a serious problem. It may occur up to a month or more after surgery. Cases of mycobacterial infection have developed over a year after breast augmentation. Infection seems more likely if there is bleeding and hematoma formation.

Infections are usually develop in only one breast. The most common infection is with staphylococcus aureus ("staph"). The breasts becomes red and tender. There may be a drainage of pus and the patient runs a high temperature. The treatment is to remove the implant and wash out the implant pocket with antibiotic. A new implant is reinserted about three months later after healing is complete. Some doctors have tried to reinsert the implant at the time of the irrigation or as soon as inflammation has resolved. This probably increases the risk of complications and is not generally recommended.

Not all infection is due to staphylococcus aureus. Staphylococcus epidermidis, which is a common bacteria in the nipple ducts, is thought by some doctors to cause a subclinical infection and perhaps cause capsule contracture.

When the patient has few clinical signs except severe pain it suggests that the bacteria may be pseudomonas. This bacteria seems to irritate nerve endings more than other germs. Another rare infection is caused by mycobacterium fortuitum. This causes inflammation around the implant but no symptoms in other parts of the body. Patients do not usually have a raised temperature but about one in three have drainage from the surgical site.

In almost all cases of infection around an implant the implant must be removed to cure the infection. Unfortunately infection may increase the risk of hardening of the capsule. If the implant is placed through an incision around the nipple it seems easier to save the implant.