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Preventing Infections in Breast Augmentation

 

Breast augmentation is one off the procedures in plastic surgery in which the use of an implant is mandatory and is inserted into patients in large numbers. While there are numerous complications that can develop from the procedure, the most dreaded one is infection. Such a complication risks everything with the likely outcome of the need to remove the implant.

The most common reason any implant infection occurs is bacterial contamination and inadvertent inoculation of the implant. While the implant may be sterile in the packaging there are numerous opportunities for it to become inoculated between the box and the implant pocket. While most plastic surgeons use numerous safeguards to prevent infection there are no standards of practice amongst all of them.

In the June 2017 issue of the Annals of Plastic Surgery, an article was published entitled ‘Antimicrobial Prophylaxis Practice Patterns in Breast Augmentation: A National Survey of Current Practice’. In this paper, a surgery was sent to members of the American Society of Plastic Surgeons to assess their practice patterns of preventing infections in breast augmentation surgery. Of all the members solicited just over 250 responses were obtained. The results of the surgery showed that Chlorhexidine was used for surgery site prep in just about 50% of the respondents and a triple antibiotic solution was used for both implants soak (40%) and pocket irrigation (almost 50%) before implant placement. Interestingly over 40% of the surgeons used a no-touch funnel for implant insertion. After surgery antibiotics included a first-generation cephalosporin (Keflex) in almost 80% of respondents and was used up to one week after surgery in about half of the reported surgeon’s practices.

While there was no accompanying reporting of the respondent’s rates of infections, it is clear that an aggressive approach to breast implant infection is generally used that presumably creates a low risk of postoperative infection. Preventing bacterial contamination is being done at multiple levels from surgical site preparation, pocket and implant decontamination to after surgery systemic antibiotic prophylaxis.

In my breast augmentation practice, thus multi-level approach is used to prevent postoperative implant infection. While every level of infection prevention is important, the funnel insertion technique in which the implant is not touched by human hands is an invaluable part of the procedure.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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