Protective Effect of Topical Antibiotics in Breast Augmentation

Abstract

The authors' data support the use of topical antibiotics in cosmetic breast surgery, because significant increases of both infections and seroma were seen in patients not treated with topical antibiotics compared with a cohort of similar patients where topical antibiotics were used.

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

“…1,19,22 Capsular contracture correlation with bacterial or subclinical (biofilm) infection has been reported in a number of studies. 3,6,[8][9][10]12,[23][24][25] Risk or causative factors include implant type, pregnancy, infection, and delayed hematoma. 1 Many other causative factors have been suggested for CC, such as silicone gel leaking from the implant or talcum powder from the surgeon's gloves.…”

“…The type and size of implant were selected by the patient and surgeon during a preoperative consultation several weeks before the procedure, at which time all patients also gave informed consent. [10][11][12][13][14][15] Preoperative markings were made immediately prior to the operation. All procedures were carried out under general anesthesia.…”

“…[4][5][6][7][8][9][10] In a retrospective study, Araco et al 4 showed that infiltrating the implant pocket with local antibiotics reduced the incidence of infections more than 4-fold compared with a nontreatment group (0.79% vs 2%, respectively); however, all patients in their study, including the nontreatment group, had their implant pockets washed with a povidone-iodine solution before implant insertion. Povidone-iodine irrigation is considered significantly more effective in preventing surgical infection compared with saline, water, or no irrigation.…”

“…[6][7][8] Adams et al 9 used a triple-antibiotic irrigation technique in a series of 165 cosmetic augmentation patients and found a rate of grade III/IV capsular contracture of 1.8% for patients undergoing primary breast augmentation. More recently, Pfeiffer et al 10 suggested that the use of topical antibiotics in cosmetic breast surgery reduces infections and seroma. However, no significant difference in the development of CC was detected in their study.…”

Is periareolar incision a suitable option for breast surgery? A mathematical comparison between periareolar and inframammary fold approaches

“…The argument that periareolar incision is associated with increased complications such as capsular contraction is commonplace but becomes debatable, if a correct and standardized protocol to keep the implant clean through the skin and the mammary gland is implemented. [22][23][24] To date, there are no reports in the literature of a diathesis favoring keloid formation. Even for racial factors, areolar and periareolar incisions are comparable to other adjacent skin areas such as the central sternum.…”