How do I know if my body is rejecting my implant? How do I know if it is an infection?

I had a diep flap resection on 11/15. The flap failed on the right side, and a 750cc silicone implant was placed. When the stitches were removed from the right side there was an open area that had moderate amount of serous drainage related to a seroma. The area was clearly not healing on 12/14 I went back to the OR for a revision of the non healing area on the right breast and to have a drain placed. The right side became very tight. Skin under reconstructed breast pinkish, skin shiny. A lot of discomfort and pressure. Suture line has been red, but well approximated. Now...2 weeks later surgical line opening up. It started as one small area and then after a restless night the area grew. Wound is superficial, edges are red. Basically just looks like crap. I am getting so frustrated and I am worried that it is not going to heal. I am thinking that maybe I should just get the stupid implant taken out. It is extremely uncomfortable. I would have expected better healing at this
point in time. I had been on keflex for first 20 days. Then augmentin for 10 days after the revision. I have been off antibiotics for about 8 days.

Expert Answers

naturalbreastrecon (Physician - Surgery - Plastic (Verified) ) - 01 / 04 / 2012

Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.

Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.

Richard M. Kline Jr., M.D.
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