Infection in breast implants

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Infection in breast implants

The Lancet Infectious Diseases, Volume 5, Issue 2, February 2005, Pages 94-106

Brigitte Pittet, Denys Montandon, Didier Pittet

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Summary

Infection is the leading cause of morbidity that occurs after breast implantation and complicates 2·0–2·5% of interventions in most case series. Two-thirds of infections develop within the acute post-operative period, whereas some infections may develop years or even decades after surgery. Infection rates are higher after breast reconstruction and subsequent implantation than after breast augmentation. Risk factors for infection associated with breast implantation have not been carefully assessed in prospective studies with long-term follow-up. Surgical technique and the patient's underlying condition are the most important determinants. In particular, breast reconstruction after mastectomy and radiotherapy for cancer is associated with a higher risk for infection. The origin of infection in women with implants remains difficult to determine, but potential sources include a contaminated implant, contaminated saline, the surgery itself or the surgical environment, the patient's skin or mammary ducts, or, as suggested by many reports, seeding of the implant from remote infection sites. Late infection usually results from secondary bacteraemia or an invasive procedure at a location other than breasts. Diagnostic and management strategies are proposed and the value of peri-operative surgical prophylaxis is revisited. The current hypothesis of the possible role of low-grade or subclinical infection in the origin of capsular contracture is also reviewed.

Article Outline

Historic overview of breast augmentation

Microbiology of the breast

Breast implants

Complications of breast augmentation

Incidence of infection

Risk factors for infection

Clinical features

Acute infection

Late infection

Diagnosis and management

Capsular contracture and silicone granuloma

Prophylactic antibiotics

Conclusions

Search strategy and selection criteria

Acknowledgements

References

ScienceDirect - Articles Related Silicone breast implants: Immunotoxic and epidemiologic issues

Delayed silicone breast implant infection with Mycobacterium avium-intracellulare

Aesthetic Surgery Journal, Volume 27, Issue 2, March-April 2007, Pages 167-171

Garrett A. Wirth, A. Brenner, J. Sundine

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AbstractAbstract | Figures/TablesFigures/Tables | ReferencesReferences

Mycobacterial breast implant infection is a rare complication after augmentation mammaplasty. A review of the literature demonstrates multiple examples of breast implant infection with Mycobacterium fortuitum, but only rare discussion of Mycobacterium avium-intracellulare (MAC). The authors report an unusual case of MAC breast implant infection in a patient with a complex surgical history.

Article Outline

Case presentation

Discussion

References

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