I have read that capsular contracture is caused by bacteria. Can bacteria anywhere in your body affect this?
Talk to your surgeon. I certainly always check a urinalysis pre-op and will delay surgery until it is treated and several more days have elapsed. Most UTIs can be cleared within three days of taking antibiotics but your surgeon's policies may vary.
Published on Jul 11, 2012
I would postpone your breast augmentation if done at the time of a UTI or any other infection.
Michael Eisemann M.D.
Plastic Surgeon
Published on Jul 11, 2012
Yes it can. Treat the UTI immediately for 7-10 days or reschedule the surgery.
Published on Jul 11, 2012
You will need antibiotics now. You will be safe by surgery time.
Published on Jul 11, 2012
You should contact your plastic surgeon and let them know you have a UTI and how it is being treated. They may ask you to postpone your surgery.
Published on Jul 11, 2012
Unfortunately, there is no one single explanation or cause of capsular contracture. In fact, despite numerous detailed studies, capsular contracture remains poorly understood. However, all of the scientific research done over the past several decades has shed some light on capsular contracture and there are some theories to help explain why it sometimes happens. It is important to remember, as one reviews these theories, that many cases of capsular contracture can happen without any apparent cause.
One possible cause of capsular contracture is the presence of excess blood in the breast pocket. This usually occurs during the initial surgery. If there is an excessive amount of bleeding, or the blood that collects in the breast pocket is not removed or cleaned out prior to inserting the implant, this excess blood can stimulate the inflammatory process that leads to capsular contracture.
Capsular contracture may also be caused by a hematoma. A hematoma is a collection of blood that forms after surgery. When it occurs, the breast becomes very swollen and painful. Once this happens, surgery is required to remove the blood. Studies show an increased risk of capsular contracture if someone develops a hematoma after breast surgery.
If someone develops capsular contracture, it does not mean that they must have had excess bleeding or a hematoma. Capsular contracture is sometimes caused by unknown reasons. This is just one of many theories that may explain some cases of capsular contracture. Preventing bleeding during breast surgery through careful and meticulous operative techniques can help minimize this risk.
There are many studies that show that the presence of bacteria on the implant or in the breast can cause capsular contracture. The presence of even a few bacterial cells (which would not cause any infection) may lead to an inflammatory process that results in capsular contracture. This is called a "subclinical" infection because the amount of bacteria involved is so small ("sub") that there will not be any visible infection ("clinical"). The theory is that these few cells of bacteria in the breast pocket and on the implant produce a thin film of molecules on the implant surface called a "biofilm." The biofilm may be responsible for setting off the process that leads to capsular contracture.
There are many methods that can be done to prevent the chance of bacteria contaminating the breast pocket or breast implant during surgery. One is to use an inframammary incision (under the breast). This incision avoids the nipple and areola, as well as the underarm area, which are areas that are normally covered and filled with a large amount of bacteria. There are various other techniques that are utilized to minimize contamination such as using an antibiotic solution to clean the skin where the implant will be inserted, washing gloves with the antibiotic solution, and hands-free insertion method with a device called the Keller Funnel.
Taking the extra steps to prevent capsular contracture has decreased our capsular contracture rates to one of the lowest rates of any surgeon in the world.
Capsular contracture remains a poorly understood complication after breast surgery. Patients can develop capsular contracture even when there is no evidence of bleeding, bacteria, contamination or rough handling of tissues.
You should consult with your plastic surgeon regarding your UTI and having surgery.
Published on Jul 11, 2012
Thank you for your question.
It would be important for you to discuss this with your operating surgeon directly. In most cases, treatment for a UTI with antibiotics in advance of your procedure should be sufficient and should not be a reason to postpone your surgery, but you would need to discuss this with your operating board certified plastic surgeon.
Published on Jul 11, 2012
Yes. If you have an active infection, I don't recommend having elective surgery. Infection rates will be slightly higher and if I am putting in an implant, I'd like to have that risk as low as possible. The good news is that you should be able to clear up a UTI in three to four days with antibiotics. You may want to recheck your urine after taking the antibiotics to make sure the infection is gone. If you haven't already, let your surgeon know
Published on Jul 11, 2012