The Achilles heel of implant-based procedures is healing problems, which can lead to subsequent infection (or vice-versa). Ultimately, the salvage rate for exposed implants with re-exploration, washout, and exchange is not much higher than 50%.

Ultimately, your best chance for salvage is to strictly follow your current regimen and complete your prescribed antibiotic course. Be wary of the return of redness, pain, swelling or drainage as well as constitutional symptoms such as fever or generalized malaise.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

Yes, but I strongly recommend you take ACCOLATE 20 mg twice daily for 3 mos. START NOW! You have a 100% chance of capsular contracture.

Published on Jul 11, 2012

I would say no. Your surgeon is correct in telling you that the exposed implant, if reused, could lead to an infection and cause your body to reject it. It is best that a new, clean implant be inserted to reduce these risks.

Published on Jul 11, 2012

I personally would not put this implant back in; it is not worth the risk. Though infections are extremely rare in our practice, in the few instances we have seen them, we remove the implant, rinse out the internal pocket with a triple antibiotic irrigation and betadine irrigation, and place a drain. Once your body has healed, we would put in a brand new implant. Every surgeon is different, but that's our protocol.

Published on Jul 11, 2012

If an infection occurs, it is quite difficult for one's body to fight it because the breast implant is such a large foreign object. Sometimes, like your plastic surgeon said, you can try and do what he did and that may save it from being removed. I do wait less than six months to replace it if it does need to be removed. I hope it works for you for it is not pleasant to go through being without one implant!

Published on Jul 11, 2012

Since he removed the implant one day after the incision opened, and he took the existing implant out washed out the pocket and replaced the existing implants , I believe you actually have a good chance of saving the implants. This is a very reasonable approach. It was not infected to begin with. If however it does become infected at this point, then you would have to wait 6 months.

Published on Jul 11, 2012

I agree with your doctor the odds of saving the implant are low.
Follow your plastic surgeons instructions carefully and completely.

Published on Jul 11, 2012

Sorry to hear you are going through this.
It's difficult to say what will happen in the next few days / weeks.. just keep close follow up with your surgeon and allow him to take care of you.

Published on Jul 11, 2012

Keep in mind that the implant didn't just get exposed to bacteria when the incision opened; bacteria is what caused the incision to open in the first place. You can't clean off an implant. It's either sterile or its not, and once it's not, it will never be sterile again. So, I've heard of this being done and not having a subsequent infection, but I doubt you will be able to escape capsular contracture if you don't get an infection. I'm terribly sorry.

Published on Jul 11, 2012

The most conservative thing to do is to remove the implant and replace them at a later time when all potential sources of bacteria has cleared. However, there is a decent chance of salvaging the implant by washing out the breast pocket and implant and being on antibiotics. One thing to be consider however, is that there could be microseeding of bacteria that never completely clears from the implant, which can increase your chance of capsular contracture or possibly another infection in the future.

Published on Jul 11, 2012

I think it depends upon the reason that it opened up. If there was an infection that caused it to open then i'd say the chances are lower. If there was some sort of trauma against it that caused it to open then your chances are better.
But opening after 5 weeks i think it is more likely that there was an infection that caused it. I'm sure that your surgeon cultured it, but it is important to be sure that the specimen was sent for AFB smear and culture, as those are more typical causes for late infections, and sometimes surgeons don't think to order that test.
You may consider seeing an infectious disease doctor to manage your antibiotics and to follow your cultures carefully.
Each time something like this happens is highly individualized and as much as you want someone to tell you what your chances are, no one can do any more than guess, most of all those of us on line who haven't met you. It is important that you follow all the instructions your surgeon gives you and that you let him know if there is anything you want to show him. Perhaps you could bring up the AFB and infectious disease doc ideas, but it sounds like you are in good hands.

Published on Jul 11, 2012

Thank you for sharing. Sorry to hear about your situation. It's not possible to make an assessment in a forum like this one. Your PS seeing you will bat be able to guide you. Exposed implants are at significant risk. Follow your instructions to maximize your chances. Some times the formal operation is necessary for these situations. Good luck.

Published on Jul 11, 2012

Sorry to hear about your ordeal- implant exposure is thankfully a very rare occurrence after augmentation. implant salvage after exposure is a gamble- but studies have been done that is is possible. Depending upon the reason for your exposure (latent infection vs severe contracture) i would say you have around a 50 percent chance of keeping that implant.

Published on Jul 11, 2012

I am sorry you're having problems following your breast revision surgery.unfortunately, at this point it is difficult to say whether you will be able to salvage your implant. It depends on the infection and your bodies ability to fight it off with an implant. I would recommend continuing to followup with your surgeon since it sounds like they currently have a good game plan for your future treatment.best of luck.

Published on Jul 11, 2012

I'm sorry to hear that you've had complications. Your surgeon gave you good information. The chances are greater that the implant may have to be removed. But choosing to attempt salvage is what I'd recommend. Best of wishes.

Published on Jul 11, 2012

Breast implant exposure after one month is likely due to an infection around the breast implant signaling to the body to extrude the implant. Removing the breast implant and washing out the breast pocket is important. The chance of success is related to what caused the exposure in the first place which is likely a peri-prosthetic infection. That being said, it all depends on if there is continued infection but the most common scenario is that this will happen again and the implant will have to be removed.

Published on Jul 11, 2012

Sorry to hear about this. Infections can occur and fortunately are not common. It sounds as if your surgeon is communicating with you and providing advice and guidance. Because of the relative rarity of infections and exposure, it is difficult to prognosticate. Close follow up is your best course of action now. If infection recurs, removal will likely be recommended.

Published on Jul 11, 2012