Late infection following breast augmentation with textured silicone gel–filled implants

Basile, Antonio Roberto; Basile, F; Basile, Arthur

doi:10.1016/j.asj.2005.02.006

Cited by 28 publications

(15 citation statements)

References 16 publications

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“…Local debridement and implant salvage may be tried in many cases. In cases where perforation, systemic symptoms, and severe infection are present, we prefer to remove the implants and replace them when the process is resolved (3-6 months later) [16,24], as shown in Fig. 5.…”

Section: Discussionmentioning

confidence: 97%

“…Anecdotal information states that position problems may be more common when the axillary approach is used [8]. Some studies show that infection rates for the axillary approach may be lower when compared to the areola incision [16].…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of infection following breast augmentation may be a clinical challenge no matter which incision is used. Basile et al [16] extensively discussed their guidelines for infection treatment. Initially, clinical treatment with broad-spectrum antibiotics is tried.…”

Section: Discussionmentioning

confidence: 99%

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Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Basile

2011

Aesth Plast Surg

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Basile

2011

Aesth Plast Surg

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“…The onset time of infections is different for saline implants and silicone implants: saline implant infections occur within 8 weeks (on average 4 weeks), while silicone implant infections occur within 26 weeks (on average 13 weeks) [27]. The earlier onset of saline implant infections may be linked to contamination during implant filling [28].…”

Section: Late Infectionsmentioning

confidence: 99%

Infections in breast implants: a review with a focus on developing countries

Rubino

Brongo

Pagliara

et al. 2014

J Infect Dev Ctries

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The risk of surgical site infection is always present in surgery; the use of prosthetic materials is linked to an increased possibility of infection. Breast augmentation and breast reconstruction with implants are gaining popularity in developing countries. Implant infection is the main complication related to breast aesthetic and reconstructive surgery. In the present paper, we reviewed the current microbiological knowledge about implant infections, with particular attention to risk factors, diagnosis, clinical management, and antibiotic prophylaxis, focusing on reports from developing countries. After breast aesthetic surgery, up to 2.9% of patients develop a surgical site infection, with an incidence of 1.7% for acute infections and 0.8% for late infections. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53%. The clinical features are not constant, and bacterial culture with antibiogram is the gold standard for diagnosis and for identification of antibiotic resistance. While waiting for culture results, empiric therapy with vancomycin and extendedspectrum penicillins or cephalosporins is recommended. Some patients require removal of the infected prosthesis. The main methods to bring down the risk of infection are strict asepsis protocol, preoperative antibiotic prophylaxis, and irrigation of the surgical pocket and implant with an antibiotic solution.Key words: breast implant infections; acute infections; late infections; fungal infections; rare infections. EpidemiologyImplant infection is the main complication related to breast aesthetic and reconstructive surgery [1]. After breast aesthetic augmentation, up to 2.9% of women are affected by infection [2], with an incidence of 1.7% for acute infections versus an incidence of 0.8% for late infections, as confirmed by retrospective cohort studies with long-term follow-ups [1]. In developing countries, this problem is even more prevalent; surgery has a 50% rate of possible complications, of which infection is the main complication [3]. The rate of surgical site infection after post-mastectomy breast reconstruction is usually higher, ranging from 1% to 53% [4,5]. In breast reconstruction, a higher rate of infection was reported with expander implants compared to reconstruction with autologous tissue such as latissimus dorsi flaps [6]. The highest rates were found in women undergoing immediate reconstruction [4]. The reported number of infections after mammary augmentation and reconstruction is lower than the real incidence, because of the lack of a surveillance network of patients based on long-time follow-ups. The economic commitment for management of implant infections is significant. Kirkland et al. [7] reported an increase of hospital permanence for surgical site infection of 6.5 days, with related health care costs. In the United States, health care costs for surgical site infection after breast surgery were estimated to be about $4,091 [7], or $574 in the outpatient setting [9]...

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“…These conditions are also very rare. They include late infection (32), late capsular hematoma (33) and breast lymphoma (34). All of these diagnoses should be considered in patients with unilateral breast enlargement after breast augmentation.…”

Section: Cases 2 and 3 -Alteration Of Leaflet Valve Mechanismmentioning

confidence: 99%

Autoinflation of Saline-Filled Inflatable Breast Implants

Peters

2006

Canadian Journal of Plastic Surgery

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Spontaneous autoinflation of saline-filled breast implants is a rare phenomenon; only 20 cases have been reported in the world literature. Over the past seven years, three patients have presented with significant unilateral autoinflation of their smooth, single-lumen, round, saline-filled implants. This developed at various times: progressively over 23 years with a Simaplast implant; between the ninth and 10th year after augmentation with a leaflet valve implant; and slowly over the first four years with a leaflet valve implant. The etiology of the autoinflation was shown to be different for the two types of implants. The Simaplast implant had likely been injected with a hypertonic filling solution -one that was twice as concentrated as 'normal saline'. This would have created an osmotic gradient, which would have facilitated autoexpansion by diffusion. The implant solution remained clear and transparent. In addition, there were no detectable levels of glucose, uric acid or albumin in the fluid. By contrast, auto-inflation of the leaflet valve implants likely resulted from mechanical alterations of the valve mechanism. This type of implant is known to have a high deflation rate, with frequent partial deflations. It is interesting that one of the patients with the leaflet valve implants presented with an autoexpansion on one side and a partial deflation on the other side. Both implants were from the same lot number. The same mechanism that caused partial deflations may have also allowed fluid from the implant pocket to pass through the valve into the lumen of these implants. This could allow glucose, protein and cellular elements to enter into the lumen (these would not pass through an intact elastomeric shell) which would create an osmotic gradient, allowing water to enter the elastomeric shell by diffusion. The fluid in these leaflet valve implants was brownish yellow, very viscous and turbid. It contained elevated levels of glucose and uric acid which would not have passed through the elastomeric shell. Over the past 10 years, four different theories have been proposed in an attempt to explain the etiology of autoinflation. However, the findings of the present study indicate that there are only two mechanisms -a hypertonic filling solution and alterations of the valve mechanism.Key Words: Autoinflation; Saline-filled breast implants L'autogonflement des implants mammaires remplis de sérum physiologique L'autogonflement spontané des implants mammaires remplis de sérum physiologique est un phénomène rare, puisque 20 cas seulement ont été déclarés dans les publications mondiales. Depuis sept ans, trois patients ont présenté un autogonflement unilatéral important de leurs implants remplis de sérum physiologique ronds, souples et monolumières. Cette occurrence se déclare à divers moments : progressivement, sur une période de 23 ans, avec des implants Simaplast; entre la neuvième et la dixième année suivant l'augmentation mammaire avec des implants avec valve; et lentement, au cours des quatre premières années, avec...

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Late infection following breast augmentation with textured silicone gel–filled implants

Cited by 28 publications

References 16 publications

Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

Infections in breast implants: a review with a focus on developing countries

Autoinflation of Saline-Filled Inflatable Breast Implants

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