Evaluating the Role of Postoperative Prophylactic Antibiotics in Primary and Secondary Breast Augmentation: A Retrospective Review

Abstract

The data suggest that there was no reduction in the overall rate of total complications, infection, or CC with postoperative prophylactic antibiotics for either primary or secondary cosmetic breast augmentation. This study provides Level 3 evidence in support of discontinuing prophylactic postoperative antibiotics following cosmetic breast augmentation.

Are Systemic Antibiotics Indicated in Aesthetic Breast Surgery? A Systematic Review of the Literature

“…9,11 From the included studies, two compared prophylactic antibiotics (either as a single preoperative dose, or as a preoperative and postoperative regimen) versus no antibiotics or placebo, and the remaining two studies compared different antibiotic regimens (preoperative antibiotics alone versus preoperative and postoperative antibiotics). In the single placebo-controlled study, the constituents of the placebo were reported, and this was given in a double-blinded manner, with the solutions being premixed by an independent pharmacist and supplied in a bottle the content composition of which …”

“…11 The operative approach was recorded in three of the studies 8,10,11 and was periareolar (51.5 percent), inframammary (47.6 percent), or transaxillary (0.9 percent). The plane of dissection was noted in all four studies and was dual-plane (47.4 percent), subglandular (39 percent), or submuscular (13.6 percent).…”

“…[1][2][3][4][5][6][7][8][9][10][11] In the United Kingdom, the National Institute for Health and Clinical Excellence only recommends systemic antibiotic prophylaxis, to reduce surgical-site infection, for clean surgery involving placement of a prosthesis or implant; clean-contaminated surgery; and contaminated surgery. 12 The American Society of Plastic Surgeons has recently published guidance to advocate the use of antibiotic prophylaxis for reduction mammaplasty, but not augmentation mammaplasty.…”

Povidone-Iodine Combined With Antibiotic Topical Irrigation to Reduce Capsular Contracture in Cosmetic Breast Augmentation

“…18 In group B (patients with irrigation), we also prescribed oral antibiotics postoperatively for 5 days, 9 although there is no clear evidence about the benefits of this practice. 42,43 Our mean (SD) follow-up was 24 (13) months in group A and 22 (3) months in group B, while the mean (SD) time of CC occurrence was 17.3 (12.2) months in group A. The single case of high-grade CC in group B occurred 26 months postoperatively.…”

Infections associated with body modification

“…In some studies, no benefits have been found after giving antibiotics for 3 postoperative days in primary or secondary breast augmentation, whereas other studies have advocated the use of more prolonged postoperative prophylaxis in breast reconstruction patients who required implants, especially in those who had received chemotherapy and/or radiotherapy after surgery. 94,96,97 Injectable permanent soft tissue fillers, such as polyacrylamide hydrogel, for breast augmentation was first used in Ukraine, subsequently gaining popularity in China. The polymer is considered to be nontoxic, nonbiodegradable, and nonteratogenic.…”