The word pseudomonas refers to a common bacteria found in soil, water and plants all over the world. It can also grow on human skin, most often found in more moist parts of the body such as the armpits or genital area. Pseudomonas can also be a breast implant associated infection, and unfortunately it can be a cause of surgical readmission after a breast implant surgery is infection. We spoke to Dr Justin Perron, Plastic, Reconstructive and Cosmetic Surgeon based in Brisbane, QLD to tell us more.
While pseudomonas is just one of a list of bacterial organisms that can cause infection relating to breast implants, it is one that can be difficult to eradicate. Pseudomonas is a type of bacteria that can secrete a matrix called a ‘biofilm’, in order to survive and protect itself. This biofilm can adhere to implants and prevent antibiotics from properly working. Once it is present on an implant, it can not be removed, and usually means the implant needs to be replaced.
Any breast implant infection should be treated seriously and there are several warning signs or symptoms that you should be aware of just in case you show any signs of them after a breast augmentation. These are:
- Redness
- Swelling (above and beyond what is normally expected after a breast augmentation)
- Itchiness
- Pain
- Fatigue or tiredness
- Body aches or pains
- Fever
- Breasts that are hot to the touch
You definitely shouldn’t freak out if you have any of these symptoms as many of them can be associated with the recovery process of a breast augmentation recovery. However, redness that does not go away, a change in pain, or discharge should prompt a phone call to your plastic surgeon.
Why does the infection occur and can you reduce your risk?
Many Australian surgeons prescribe antibiotics for their breast augmentation patients as part of their recovery to reduce any risk of infection. Sometimes these antibiotics do not cover ALL types of bacteria, and can mean that some infections can occur. In rare circumstances, especially with complicated or revisional surgery, the tissues may not have enough blood supply to normally block, or otherwise prevent infection from bacteria like pseudomonas. The best prevention is to ensure excellent nutrition, stop smoking before and after your operation (6-8 weeks on either side of the operation day), watch your incision areas and report any changes to your plastic surgeon.
What is the treatment for pseudomonas or any other breast implant infection?
You should contact your surgeon immediately if you suspect you may have any infection! There are a few treatments available, but usually antibiotics are often able to treat the issue. However in very rare cases you may require hospital admission and receive IV antibiotics, and in very, very, rare cases, you may need to have the implants removed.
In any case, if you have any doubts or concerns, you should always contact your surgeon in the first instance.
We’d like to thank Dr Perron for helping us provide accurate and the most up to date information on this subject. You might also want to check out the podcast with Dr Perron on patient safety, more on infections, wound safety and more – it’s a wealth of information on how to minimise your chances of infection.
FAQs about Pseudomonas
How does pseudomonas behave differently from other common surgical bacteria?
Pseudomonas has a unique ability to survive in harsh environments, including low-oxygen and moist conditions often found around surgical sites. Unlike many bacteria, it can rapidly adapt and resist multiple antibiotics, which makes infections more persistent and harder to treat.
Why is pseudomonas more likely to affect breast implants than some other devices?
Breast implants provide a smooth or textured surface that allows pseudomonas to attach and form a protective biofilm. This biofilm shields the bacteria from both the immune system and antibiotics, making implants a particularly vulnerable surface compared to natural tissue.
Can pseudomonas live on healthy skin without causing problems?
Yes, pseudomonas can exist on the skin without causing symptoms, especially in moist areas such as the armpits or under the breasts. Problems usually arise when the bacteria enter the body through a surgical incision or weakened tissue.
What makes pseudomonas infections harder to detect early after surgery?
Early symptoms of pseudomonas infection can mimic normal post-surgical healing, such as mild redness or swelling. This overlap can delay diagnosis, especially if symptoms progress slowly rather than appearing suddenly.
Is pseudomonas infection always linked to poor hygiene or surgical error?
No, pseudomonas is widespread in the environment and infections can occur even with excellent surgical technique and hygiene. Factors such as individual healing capacity, immune response, and tissue blood supply also play a significant role.
Why does pseudomonas sometimes cause a greenish discharge?
Pseudomonas can produce pigments, including one called pyocyanin, which gives a green or blue-green colour. This is a distinctive clinical clue that can help surgeons identify the type of infection early.
Can pseudomonas spread from one implant to the other?
While less common, it is possible for infection to spread, particularly if bacteria enter the bloodstream or if both implants were exposed during surgery. Prompt treatment reduces the risk of bilateral involvement.
How does biofilm formation change the treatment approach?
Once a biofilm forms on an implant, antibiotics alone are often insufficient because they cannot penetrate the protective layer effectively. This is why, in some cases, removal or replacement of the implant becomes necessary.
Are certain patients more at risk of pseudomonas infection after breast augmentation?
Patients who smoke, have diabetes, or have compromised blood supply to tissues are generally at higher risk. Revision surgeries and longer procedures may also increase susceptibility due to added stress on the tissues.
Can water exposure increase the risk of pseudomonas infection after surgery?
Yes, pseudomonas thrives in water environments such as pools, hot tubs, and even poorly maintained showers. Patients are usually advised to avoid soaking wounds until fully healed to minimise exposure.
Does pseudomonas infection always require hospitalisation?
Most cases can be managed with oral antibiotics if detected early. However, more severe infections may require hospital admission for intravenous antibiotics and closer monitoring.
Can pseudomonas infection occur months or years after breast implant surgery?
Although less common, late infections can occur, particularly if bacteria enter the bloodstream from another source and seed onto the implant. This highlights the importance of ongoing health and infection prevention.
Why might standard antibiotics fail against pseudomonas?
Pseudomonas has intrinsic resistance mechanisms and can quickly develop additional resistance during treatment. This means that targeted antibiotics based on culture results are often required.
Is pseudomonas infection more common with textured or smooth implants?
There is ongoing discussion about implant surface and infection risk, but pseudomonas can adhere to both types. The key factor is the presence of a surface where biofilm can develop, rather than the texture alone.
Can early intervention prevent implant removal in pseudomonas infections?
In some cases, early detection and aggressive antibiotic treatment may control the infection before a biofilm fully establishes. However, once the biofilm is mature, implant removal is often the safest option.
What role does nutrition play in preventing pseudomonas infection?
Good nutrition supports immune function and tissue healing, which helps the body resist infection. Adequate protein intake and micronutrients are especially important in the recovery phase.
Can pseudomonas infections recur after treatment?
Yes, recurrence can happen if the bacteria are not fully eradicated or if a biofilm persists. This is why follow-up care and monitoring are essential after treatment.
Is there a specific smell associated with pseudomonas infection?
Pseudomonas infections can sometimes produce a distinct, sweet or fruity odour due to bacterial metabolites. While not always present, this can be another clinical clue.
How do surgeons confirm a pseudomonas infection?
Diagnosis is usually confirmed through wound swabs or fluid samples that are sent for microbiological testing. This allows identification of the bacteria and determination of the most effective antibiotics.
Can lifestyle changes before surgery reduce pseudomonas risk?
Yes, stopping smoking, improving nutrition, and managing chronic conditions can significantly reduce infection risk. These steps help optimise tissue health and immune response before surgery.
Taking Action and Implementing
Understanding pseudomonas is essential for both patients and surgeons, particularly in the context of breast implant surgery. Early recognition, proactive prevention strategies, and prompt communication with your surgeon are the most effective ways to reduce risk and manage complications successfully.
If you’d like to find a Specialist Plastic Surgeon near you, here’s a link to our directory.
Angela’s breast reduction and tummy tuck with Dr Justin Perron
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