Inflammation and infection are two main adversaries of breast augmentation

Hello everyone. Today I would like to share about one of the most common theme in cosmetic surgery, the inflammation and infection with their results and further complications.

In science, we always ask “is that true?” and go through various stages in order to find out the opposite. Some people suffer because of what we try to change at present, but we cannot avoid these moments in order to find out the truth. The same applies to the medical field.

There are many surgeries that require implants. I am sure that there will be many products made in the future that could be used in the human body. Artificial tooth, ie. Implant (titanium), artificial knee, joint, artificial veins, pacemaker, etc are all these type of products. Silicone, artificial skin or ligaments and implants used to enlarge the breasts and buttocks are some common implants used today.



The reasons for using these implants are that the surgery can be quick, and we use already made products with perfect shape and features that make the overall result dramatic. It is much cheaper (due to mass production) than bone graft or cartilage transplant.

But an implant is a foreign substance. It is not made inside the body but in a manufacturing plant. People get suspicious about complications in using these products. Many complications do take place in reality.

The biggest problem in breast augmentation is the capsular contracture. We use implants for volume fulfillment but if they become hard and not smooth, there would be no meaning to using them. This is why all the doctors have been studying why capsular contracture is formed from the moment the implants are inserted.



Many studies show that the capsular contracture has been formed through contamination by germs. A lot of animal testing and clinical testing show such results.

Implants come with packaging with sterilization however we cannot say for certain that they are 100% hygienic. We also sterilize all the tools and equipment that we used during the surgery but can we say for certain that we killed all the germs? The surgeons use hygienic gloves and sterilize the operation room but there are always germs, bacteria in the air and there is no place around the world without them (except sterilization laboratory and immunity deterioration room). Therefore, there is a possibility that these germs get into and contaminate the implants and the pockets during the surgery.



If you have normal level of immunity then you can win certain level of germs that are acceptable and also recover properly. The same applies for breast augmentation patients. The human body makes the immune system active to kill and clean off the germs.

However, an implant is a foreign substance therefore it does not have the immune system. If the implant gets contaminated and there are much germs or if the surgery is too destructive and the tissue cells cannot have proper immune system, the germs will not disappear but live among the implant. These germs do not go away but make a wall for protection that leads to a thin film like structure around the implant.

We call this biofilm and this biofilm is resistant to sterilization and protects the germs therefore the germs can live for a long time causing worse level of inflammation on the body. Such inflammation works together fiboblast leading to severe case of capsular contracture. This is one of the most accepted theory.

Usually the patients cannot differentiate infection and inflammation. Infection refers to the allowing of outside germs to penetrate to the body and inflammation refers to the body reaction towards the germs.

If there is bad infection during the breast augmentation, you will have fever and also swelling on the breasts. When we say you have ‘inflammation’, it usually means that you are infected. Capsulation contracture is not a form of severe inflammation but a weak one. It is caused when there is minor inflammation that cannot be visually noticed that makes the body react with thick capsule leading to hard feeling breasts.

So what can we do to prevent such situations? Below is the 14 point plan that world known cosmetic surgeons around the world accept as capsular contracture preventing methods. I would like to clarify that massaging and taking prescription are not one of these.

1) Insert antibiotics during anesthesia
2) Avoid areola incision
3) Cover up the nipple during surgery
4) Be careful not to cause too much damage during the surgery
5) Careful hemostasis
6) Apply dual plane or form subfascial pockets
7) Use antibiotics or antiseptic solution to clean the pocket
8) Use sleeve (funnel, to avoid skin contact) to insert the implant
9) Change hygienic gloves before touching the implant
10) Reduce the time that the implant gets exposed (Unpack just before insertion)
11) Do not touch the implant a lot in order for proper placement
12) Stitch up layer upon layer
13) Avoid using drain tube (can be the cause of contamination)
14) Use antibiotics if additional surgeries are necessary
(There are some doctors who question No. 2, Avoid areola incision)

The conclusion is that the surgeon must conduct the breast augmentation properly. If there is severe case of capsular contracture after the breast augmentation, there is no reason for you to spend much money getting massages and taking medicine.



No matter how careful the experienced doctor is, he/she cannot completely avoid all the germs getting through. If the patient is unlucky, she might suffer from minor case (Grade 1~2) of capsular contracture. Such contracture does not require breast augmentation revision surgery.

There may be future implants that improve on this problem. There is a high possibility that texturing implant who disappear although it has been made to avoid the capsular contracture. There may be implant with sterilized or antibiotic coating. We expect there to be less cases of capsular contracture and inflammation once these products are in the market.

Thank you for reading.

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