Gram-positive bacteria increase breast implant related complications: Prospective analysis of 100 revised implants

BACKGROUND: Breast implant-related complications can be reduced by strict antiseptic precautions during insertion, but bacteria can often be found on implant surfaces on the occasion of revision surgery. We prospectively analyzed the association of bacteria found on breast implant surfaces with implant-related complications in breast implant revision cases.

METHODS: We analyzed a total of 100 breast implant revisions in in 66 patients between August 2018 and January 2021. Capsular swabs and capsular samples were taken intraoperatively. Analyses upon the occurrence of bacteria and the occurrence of implant-related complications were performed. Additionally, correlations between bacterial contaminated breast implant surfaces and implant-related complications were performed.

RESULTS: Implant-related complications (perforation, rupture, capsular contraction) were observed in 42 implant sites; in eight unilateral and 34 bilateral cases. In total 16 swabs showed positive bacterial growth, 10 of which were associated with a breast implant-related complication (X2 = x.yz, p = 0.006). The most common implant-based complication at contaminated prosthetics was implant rupture. The association of contaminated breast implants and implant rupture was statistically significant.

CONCLUSION: We identified a correlation between implant complications and gram-positive bacteria found on breast implant surfaces. The most common implant-based complication seen at simultaneously positive samples was implant rupture in 50% of our cases. Here, no capsular contraction or other complications were seen.