Acne After Breast Augmentation -

Skin issues are a common concern for patients undergoing breast augmentation surgery. One such skin issue that can arise post-surgery is Acne After Breast Augmentation, caused by the presence of the cutibacterium acnes bacteria. This bacteria is a natural resident of the skin, but can proliferate in the pores of the skin following surgery, leading to the development of acne.

Symptoms of Acne After Breast Augmentation may include:

– Redness and inflammation around the surgical site
– Small bumps or pimples on the skin
– Pain or tenderness in the affected area
– Itching or irritation

If you are experiencing these symptoms, it is important to consult with your breast surgeon for proper evaluation and treatment. Your surgeon may recommend the use of topical medications such as benzoyl peroxide or salicylic acid to help reduce inflammation and unclog pores. In some cases, oral antibiotics may also be prescribed to help combat the bacteria causing the acne.

In addition to medication, it is important to practice good skincare habits to help prevent and treat Acne After Breast Augmentation. This includes:

– Keeping the surgical site clean and dry
– Avoiding harsh or irritating skincare products
– Using non-comedogenic moisturizers and makeup
– Avoiding picking or squeezing acne lesions, as this can lead to scarring

There are also several products available on Amazon that may help in the treatment of Acne After Breast Augmentation. Some popular options include:

1. Neutrogena Rapid Clear Stubborn Acne Spot Gel: This gel contains benzoyl peroxide to help target and treat acne lesions quickly.
2. CeraVe Salicylic Acid Cleanser: This cleanser contains salicylic acid to help unclog pores and prevent new acne breakouts.
3. La Roche-Posay Effaclar Duo Dual Action Acne Treatment: This treatment contains benzoyl peroxide and lipo hydroxy acid to help clear acne and prevent new breakouts.

Overall, Acne After Breast Augmentation is a common side effect of surgery, but with proper treatment and skincare, it can be effectively managed. If you are experiencing acne after surgery, be sure to consult with your breast surgeon for personalized recommendations and treatment options.

In this guide, we review the aspects of Acne After Breast Augmentation, breast implant illness skin issues, what causes breast implant illness, and cutibacterium acnes symptoms.

Acne After Breast Augmentation

Acne is a common concern among women considering breast augmentation. Many worry about the potential for acne flare-ups from the incision sites or silicone implants, but these concerns are unfounded. Although there are no direct links between breast augmentation and acne, a range of factors are normally responsible for acne breakouts after surgery.

Acne is a common concern among women considering breast augmentation. Many worry about the potential for acne flare-ups from the incision sites or silicone implants, but these concerns are unfounded.

Acne is a common concern among women considering breast augmentation. Many worry that the incision sites or silicone implants will cause acne flare-ups, but these concerns are unfounded. Acne is caused by bacteria and inflammation in the pores of your skin, not by the presence of plastic materials in those pores. Your surgeon will make sure to use sterile materials during the procedure, including antibiotic ointment for any small cuts made on your body during surgery and sterile gauze dressings for all incisions afterward. In addition to this, breast augmentation does not cause inflammation: it only increases your breast volume without changing how much oil your glands produce or how sensitive they may be.

Breast augmentation does not cause acne; however, some people may experience acne flare-ups after their surgery if they were already prone to breakouts beforehand (which can happen even when nothing else is going on with their bodies). If you are concerned about this possibility before having any cosmetic procedures done on your face or body—including breast enhancement—then we recommend speaking with a dermatologist who specializes in cosmetics before making any decisions about whether you are suitable candidate for plastic surgery procedures at all!

Although there are no direct links between breast augmentation and acne, a range of factors are normally responsible for acne breakouts after surgery.

Acne is caused by bacteria, hormones, stress and other factors that make the skin’s oil glands work too hard. Acne can be treated with medication and topical treatments for as long as it takes for your body to balance itself out naturally again.

Acne is not caused by your breast implants. Make sure you know the causes so that you can prevent breakouts.

Acne is not caused by your breast implants. Make sure you know the causes so that you can prevent breakouts and get the best results from treatment.

Acne follows a specific pattern, which is why it’s so important to understand how it develops in order to fully treat and prevent it:

Acne is caused by a combination of factors, including genetics and hormones. If one factor changes (like your diet or exercise routine), another may change as well (like your skin). This means that there are multiple ways to prevent acne!
Acne is not caused by incision sites on the breast tissue or around the nipples; however, this area can become inflamed if bacteria gets inside of it after an operation like a lumpectomy or mastectomy due to poor post-operative care practices such as applying lotion too close together with other medications like antibiotics causing irritation leading into more serious complications such as ulcers forming over time due to chronic inflammation leading into scarring which could leave permanent effects even after seeking medical care immediately following surgery so please call right away because no one wants scars forever!

breast implant illness skin issues

Breast augmentation remains one of the most common and popular plastic surgery procedures performed in the U.S., and it has a low risk of complications – the most common being breast pain, changes in nipple and breast sensation, scar tissue formation, and rupture and deflation.

However, a small number of women experience a compilation of symptoms that has come to be known as breast implant illness, or BII. Though we are still learning about BII, and it is not a formal diagnosis, several new studies are investigating potential causes for the symptoms, which are wide-ranging and very real.

More than 100 symptoms have been associated with BII. Some of the most common include:

Breast implant illness has become more widely known in the last couple decades as patients have increasingly shared their stories on social media. In April 2022, retired race car driver Danica Patrick posted on Instagram about her struggles with BII and her decision to have her breast implants removed.

While it can be comforting to find a community of people with similar symptoms as you, unfortunately, sometimes these channels help spread misinformation or unnecessary fear.

Many patients with BII symptoms can find relief without having to remove their breast implants. In some cases, the cause of symptoms is an underlying condition that affects the immune system or hormone production.

If you develop unexplained symptoms that you suspect may stem from your breast implants, talk with a board certified plastic surgeon. We will listen to you and try to determine what the cause of your symptoms are and connect you with specialists if need be.

Determining the cause of your symptoms

Symptoms can occur with any type of breast implants and can start immediately after implantation or years later.

Because so many BII symptoms are associated with other conditions, it’s important to rule out causes unrelated to the breast implants. For example, many similar symptoms are associated with autoimmune conditions such as lupus, rheumatoid arthritis, scleroderma, and Lyme disease. Hypothyroidism, menopause, and fibromyalgia also can cause symptoms similar to those of BII.

Our goals in diagnosis are to determine the cause of your symptoms and to make a plan to resolve those issues at the source. In some women, the implants themselves prove to be the issue, such as if the implant or tissues surrounding it stiffen, or if the implant ruptures. For many more, an underlying condition is the culprit.

Diagnosis starts with a conversation about what triggers your symptoms and the extent to which they interfere with your quality of life. From there, we may refer you to a specialist in areas such as:

If the specialists find an underlying condition, unrelated to your breast implants, treatment for that condition should relieve or eliminate your symptoms. If no underlying conditions are found, we’ll discuss potential next steps, such as removing your implants.

Deciding whether to remove your breast implants

Choosing to remove your breast implants is just as big a decision as it was to get them, and yet more women made that decision in 2021 than in previous years. According to statistics from The Aesthetic Society, 148,000 women had implants removed and replaced (up 32% from 2020), and 71,000 had their implants removed and not replaced (up 47%), though it’s unclear what role if any BII played in the increase.

If you’re unhappy with the size or shape of your implants, or if you’ve developed a complication such as capsular contracture – the formation of hard, stiff scar tissue around the implant – the decision to remove them may reduce your symptoms.

But if you are satisfied with your appearance and your symptoms are systemic, rather than directly associated with the breasts, the decision can be more difficult. Even if BII symptoms resolve after implant removal, adjusting to changes in your appearance can be challenging.

Your plastic surgeon will discuss all options with you to help you make the best decision.

Clearing up common myths related to BII

There are many websites and social media groups dedicated to breast implant illness. And it’s not unusual for patients to tell us they read or saw something that worries them in one of these communities. We’d like to address a couple of the more common concerns.

Sagging skin after implant removal: There are a lot of people who post photos of themselves after having their implants removed. These photos are usually of women who had very large – 400cc or 500cc – implants removed, leaving excessive, sagging skin behind. Images like these can cause unnecessary anxiety.

Transferring fat to the breast from elsewhere in the body can help restore some volume after implant removal. Though your breasts likely will not be as full as they were with implants, this process can provide a pleasing appearance and a less dramatic transition.

“Only one right” way to remove implants: There are several methods to safely remove breast implants:

However, many social communities say that only specific procedures – notably en-bloc capsulectomy – will eliminate BII symptoms. This is untrue, and there are situations in which that procedure could cause more problems. For example, if the capsule is stuck to the chest wall, taking it all out could cause a pneumothorax, or air to leak into the space between the lungs and chest wall. In this case, we can take out most of the capsule and cauterize the patch that’s against the ribcage.

Additionally, removing the capsule and implant together (en-block) may require a longer incision, especially for women who have only had an augmentation and not a breast lift plus augmentation.

Current research and action related to BII

Research is under way to determine the degree to which certain symptoms are directly caused by breast implants and what effect, if any, removal has on those symptoms.

A study published in December 2021 found that the type of breast implant removal performed did not affect the reduction of breast implant illness symptoms.

Part two of this study investigated concerns, expressed on some BII websites, that the presence of heavy metals in silicone and saline breast implant capsules are a primary cause of systemic symptoms and health problems. More than 20 heavy metals were studied and some participants with BII symptoms had statistically higher levels of arsenic and zinc in their breast implant capsules compared with participants who didn’t exhibit BII symptoms. But the measured levels were all below what is considered acceptable exposure levels by regulatory agencies.

Also, the research confirmed that fewer heavy metals were detected in breast implant capsules than in breast tissue from patients who never had implants. Among participants with BII symptoms, there was a higher number of current or former smokers using tobacco and marijuana and a greater number of women with gluten allergies, suggesting that environmental exposure and personal choices related to cigarette smoking, marijuana use, tattoo pigments, and dietary sources may be the source of a BII patient’s exposure to heavy metals.

Based on this research, heavy metal toxicity should not sway a patient’s decision to remove her breast implants.

Finally, it’s important to note that a BII task force has been established within The Aesthetic Society to conduct research and follow new breast implant patients for more than 10 years in hopes of establishing more definitive data and finding more answers for patients and providers.

We understand it can be extremely frustrating to feel unwell without a specific diagnosis – especially after you’ve been through one or more major breast surgeries. Our breast plastic surgery and specialist teams work together, dedicated to providing you with evidence-based care that will get you to the ultimate goal of feeling better.

If you experience symptoms or complications that you suspect may be related to breast implants, call 214-645-8300 or request an appointment online.

A breakthrough in breast reconstruction at UTSW

When Renee Mallonee found out she was BRCA2 positive and her lifetime risk of breast cancer was high, she took the news very seriously. After 15 years of screenings and tests every six months, in 2020 she turned to UT Southwestern and became the first patient in the United States to receive a single port robotic nipple-sparing mastectomy.

what causes breast implant illness

More than 100 symptoms have been associated with BII. Some of the most common include:

While it can be comforting to find a community of people with similar symptoms as you, unfortunately, sometimes these channels help spread misinformation or unnecessary fear.

Determining the cause of your symptoms

Symptoms can occur with any type of breast implants and can start immediately after implantation or years later.

Diagnosis starts with a conversation about what triggers your symptoms and the extent to which they interfere with your quality of life. From there, we may refer you to a specialist in areas such as:

Deciding whether to remove your breast implants

Your plastic surgeon will discuss all options with you to help you make the best decision.

Clearing up common myths related to BII

“Only one right” way to remove implants: There are several methods to safely remove breast implants:

Additionally, removing the capsule and implant together (en-block) may require a longer incision, especially for women who have only had an augmentation and not a breast lift plus augmentation.

Current research and action related to BII

Research is under way to determine the degree to which certain symptoms are directly caused by breast implants and what effect, if any, removal has on those symptoms.

A study published in December 2021 found that the type of breast implant removal performed did not affect the reduction of breast implant illness symptoms.

Based on this research, heavy metal toxicity should not sway a patient’s decision to remove her breast implants.

If you experience symptoms or complications that you suspect may be related to breast implants, call 214-645-8300 or request an appointment online.

A breakthrough in breast reconstruction at UTSW

cutibacterium acnes symptoms

Infection is a rare but serious complication of shoulder arthroplasty. The most prevalent cause of patient infections is Cutibacterium acnes (formerly Proprionibacterium acnes), a commensal skin bacterial species. Its presentation is often non-specific and can occur long after shoulder arthroplasty, leading to delay in diagnosis. This bacterium is difficult to culture, typically taking 14 to 17 days for a positive culture and often does not exhibit abnormal results on a standard laboratory workup for infection (eg, ESR, CRP, and synovial WBC count). Male patients are at particularly high-risk due to having a greater number of sebaceous follicles than females. While it is difficult to diagnose, early diagnosis can lead to decreased morbidity, appropriate treatment, and improved clinical outcomes. Current options for treatment include antibiotics, one stage implant exchange, or two stage implant exchange, although success rates of each are not currently well described. A better understanding of the prevention, diagnosis, and treatment of C. acnes infection could lead to better patient outcomes from shoulder arthroplasty.

Introduction

Infection after shoulder surgery is a rare but potentially catastrophic complication. Patients that develop postoperative wound infections are 60% more likely to spend time in the intensive care unit and experience twice the mortality rate.1 Synovial joints are at risk for infection given both their relative absence of immune cells and the presence of nutrient-rich synovial fluid. Several species of commensal bacteria are known to cause the majority of shoulder infections. These include Staphylococcus aureus, Staphylococcus epidermidis, and Cutibacterium acnes (formerly Propionibacterium acnes).2

Recently, it has been noted that the common pathogen in shoulder infection post-arthroplasty is Cutibacterium acnes.3 C. acnes infection is also associated with arthroscopy, fracture fixation, injections, cuff repair, and Latarjet procedures.4 C. acnes is a gram-positive, anaerobic bacteria that normally occupies the hair follicles and sebaceous glands and colonizes the shoulder at increased rates compared to the knee and hip.5,6 Earlier studies reported a rate of C. acnes infection after shoulder arthroplasty presenting as a classical periprosthetic infection of 0%–15% of patients, but these studies recognized that this have been an underestimate of the true rate, as diagnosis of C. acnes can be difficult and unreliable.7 More recent studies, usually with longer durations of culture, have been positive at higher levels for C. acnes at the time of revision ranging from 16% to 70%4,7,8 with the most common estimates around 50%–60%.4,8,9 In one study, the total infection rate was 1.9% with 89% caused by C. acnes.10 Similarly, in a study of deep infection after rotator cuff injury, C. acnes was found to be the most prevalent cause of infection, causing 51% of the post-surgical infection cases.11

Cutibacterium acnes Biology

First described by Paul Gerson Unna in 1865, C. acnes is a slow-growing, facultatively anaerobic, non-spore forming grampositive rod-shaped bacterium.12 C. acnes is part of the normal flora of the skin, oral cavity, gastrointestinal, and genitourinary tract. There are three proposed sub-types of C. acnes (I, II and III).4 The production of propionic acid from lactose gave this species its prior name, Proprionibacterium. C. acnes has been shown to be implicated in the pathogenesis of endocarditis, endophthalmitis, septic arthritis, osteomyelitis, chronic prostatitis, sarcoidosis, synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome.13–20

In healthy skin, C. acnes plays a commensal role.5,21 It outcompetes other bacteria on the skin and colonizes the acidic, anaerobic environment of the sebaceous gland deep in the dermis. Through its digestion of the sebum, it produces free fatty acids which are secreted with the sebum onto the skin. This helps produce an overall acidic pH of the skin, which inhibits pathogenic bacteria such as Staphylococcus aureus and Streptococcus pyogenes, while favoring other commensal bacteria such as coagulase negative staphylococcus and corynebacteria.

The prevalence and burden of C. acnes has been found to be greater in the axilla and acromion than at the hip or knee.5 The prevalence and burden of C. acnes is also greater at the anterior and posterior acromion than the axilla in men, but not women. In general, men also have a greater prevalence and burden of bacteria than females.

Pathophysiologically, C. acnes bacteria feed on lipids and triglycerides producing fatty acids as a byproduct, as well as secrete cytotoxic chemicals and enzymes which can degrade the shoulder capsule.12 C. acnes uses antigens to adhere to cells, biofilms, and surfaces, which can initiate an inflammatory response on the inside of the joint.22,23 C. acnes forms biofilms within the body, which aids in micro-colony formation, evasion of macrophage engulfment, avoidance of phagocytosis.9,22 C. acnes may persist within macrophages for up to 8 months in vitro. Over half of C. acnes cultures now carry resistance to more than one antibiotic.24

Cutibacterium acnes Clinical Characteristics

C. acnes infection increases the risk of needing revision surgery, morbidity and mortality. The total cost to treat an infected shoulder prosthesis has been estimated at $46,745.25 Surgical debridement is often not sufficient alone to eliminate C. acnes infection and excess scar tissue from repeated surgery can lead to less functional outcomes.2,26 It is important to note that C. acnes infections do not typically elicit typical host inflammatory responses. Classic signs of swelling, erythema, drainage, tenderness, and sinus tract are less common. Rather, common presentations include unexplained pain, stiffness, and component loosening after an initially good outcome and the usual period for acute postoperative infection has passed. C. acnes may not present symptoms for two years or more post operatively. Good recovery of function and pain control followed by increase in pain and stiffness suggest C. acnes, particularly in males.24 A number of studies have pointed to C. acnes infection as a possible cause of prosthetic loosening.27,28 In established C. acnes infections involving a prosthesis, exchange of the prosthesis may yield the best clinical outcome.6

C. acnes may enter the surgical field via surgical incision through the pilosebaceous glands in the deeper layers of the skin.29–32 There has been no difference found in bacterial colonization for different types of pre-operative preparation including ChloraPrep (2% chlorahexidine gluconate and 70% isopropyl alcohol; Enturia, El Paso, Texas), DuraPrep (0.7% iodophor and 74% isopropyl alcohol; 3M Healthcare), or providone-iodine scrub and paint, (0.75% iodine scrub and 1.0% iodine paint; Tyco Healthcare Group, Mansfield, Massachusetts).29–31 Using a rigorous technique, Koh et al.30 demonstrated that use of 4% chlorohexidine gluconate showers only reduced the skin culture positivity rate to 40%, and even after the ChloraPrep had dried the skin positivity rate for C. acnes was 27%. At the end of the case, the skin culture positivity rate rose again to 43%.

Risk factors for C. acnes infection include male gender and surgery including a prosthesis or for treatment of trauma.24 Other factors in the development of C. acnes infections include the suitability of the joint for infection, the size of the bacterial inoculum, the patient’s immune response to the bacterium, and the relative proportion of pathogenic strains.4

Early treatment is important in treating C. acnes infection, even though it may not show symptoms for three or more years as it establishes a biofilm which is much more resistant to antibiotic therapy.3 Unfortunately, there is no established antibiotic regimen for treating C. acnes infection and consultation with an infectious disease specialist is recommended.11,33

Cutibacterium acnes Testing

Serological testing for infection may be unhelpful in laboratory evaluation for C. acnes infection—typical inflammatory markers, such as CRP and ESR, tend to be low or borderline while white blood cell count may be within normal limits.34 Traditionally, C. acnes was cultured with a tissue swab under anaerobic conditions and held for up to 7 days. It has been noted that this method is insufficient to rule out C. acnes infection, however.7

Matsen, et al,4,35 propose that testing for C. acnes in a failed shoulder should include more than 5 cultures including tissue and explant, sonication of explant, collection of revision specimens prior to antibiotics, sending cultures on both aerobic and anaerobic media, and holding the specimens for 17 days.

Intraoperatively, signs of inflammation are not usually seen. In some cases, cloudy fluid, osteolysis, a periprosthetic membrane, and component loosening may be present and are associated with increased likelihood of positive cultures, but absence does not preclude infection.35 Frozen section has poor sensitivity for infection in cases of C. acnes.

A new, more sensitive technique involves using PCR.36 This method utilizes restriction fragment length polymorphisms to create a clinically relevant assay that can detect C. acnes more easily, although controlling for false positives must be carried out carefully.36 This new method only requires 24 hours and can be carried out in the average pathology laboratory. As a PCR based assay, it can detect as few as ten C. acnes cells when it was tested in an artificial tissue system.

Controversy: Cutibacterium acnes and Arthritis

There are a number of controversies remaining in this field, including some questioning if C. acnes is present intraarticularly prior to surgery and if C. acnes may be responsible for some cases of arthritis.37 However, when carefully controlled for contamination, a cause and effect relationship between P. acnes and osteoarthritis was not supported in a separate study.38 Further study has found the bacteria only in skin tissue and not in the deeper tissues such as the rotator cuff and glenohumeral cartilage.39 This suggests the bacterium is a contaminant from the skin during surgery. Whether the data support a link between C. acnes and arthritis is still an area that requires more investigation.

Recent Developments and Future Directions

A number of strategies have been proposed as potential techniques to minimize infection and manage these infections. It has been suggested that a second change of gloves for the surgeon and re-draping, use of a skin barrier, along with hair removal by electric clippers or depilatories, could reduce C. acnes infection.2,10,40 Another preventative method being utilized is the application of vancomycin powder during shoulder arthroplasty to prevent C. acnes infection.25 This was found to be highly cost effective. Another technique under development is the disruption of the C. acnes biofilm by using calcium sulfate cement beads loaded with tobramycin, vancomycin, or a combination of the two to deliver high local concentrations of antibiotic; so far testing has only been in vitro.3 This was noted to be effective in eliminating both planktonic organisms and biofilms. Point-of-care testing could lead to improved outcomes for patients by informing decisions while still in the operating room. Changes in interleukin-6 (IL-6) levels, leukocyte esterase, and alpha-defensin are being investigated for correlation to C. acnes infection, although sensitivity and specificity have been lower.41–45 More recently, topical benzoyl peroxide has been investigated as a preventative agent for C. acnes.46–48 Presurgical treatment with topical benzoyl peroxide was found to be more effective than chlorhexidine gluconate in decreasing the skin burden of C. acnes, but was unable to completely eradicate it in any study.

Acne After Breast Augmentation