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New Antibacterial Solution May Reduce Complications From Breast Implants (dateline January 21, 2000)

Researchers at the University of Texas Southwestern Medical Center at Dallas have discovered that the use of a combination of three antibacterial agents during surgery may reduce capsular contracture, a common complication of saline breast implants.  Capsular contracture is a condition in which the scar around the implant begins to tighten and squeezes down on the implant, causing the breast to feel hard. According to the American Cancer Society, 93% of implant removals are the result of capsular contracture.

In several laboratory experiments, William Adams, Jr., MD, and his colleagues discovered that a combination of gentamicin, cefazolin, and a 10% solution of povidone-iodine killed every bacteria type they tested. In an ongoing clinical trial, 125 patients have been treated with the antibacterial agents during breast implant surgery. To date, none of the patients have developed capsular contracture, although the results of the trial will not be definitive for another three to five years.

It is estimated that more than 132,000 women undergo breast augmentation surgery each year to increase their breast size. Another 28,000 women undergo breast reconstruction after mastectomy—the surgical removal of a cancerous breast.  Presently, most plastic surgeons clean the breast-implant pocket with a variety of antibiotics before surgery to prevent infection. However, some antibiotic agents may interfere with the healing process.

Though the results of the new antibacterial combination will need to undergo several more clinical trials before its use becomes standard practice, Dr. Adams and his colleagues recommend that surgeons immediately begin using the agents during breast augmentation and reconstructive surgery to prevent capsular contracture. Nearly 44,000 breast implants are removed each year due to complications.

Besides causing pain and possible breast disfigurement if untreated, capsular contracture may interfere with mammogram readings that screen for breast cancer in asymptomatic women (women who have no signs of breast cancer). Presently, the most common treatment for capsular contracture is additional surgery to remove the scar tissue. Breast augmentation surgery or reconstruction do not increase a woman’s risk for breast cancer or cancer recurrence (return). It is important for women with breast implants to continue to receive yearly mammograms on both breasts. Women may wish to have mammograms performed at facilities where radiologists are experienced in special techniques required for imaging breasts with implants.

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