u/Time-East3793

Anyone deal with an infection after direct-to-implant reconstruction? Did you end up losing your implants?

I had a double mastectomy with direct-to-implant reconstruction on 7/21, so I’m coming up on four weeks post-op. The first week was honestly great—I had almost no pain and felt like recovery was going incredibly well.

Then around 8–9 days post-op, I developed a pretty awful infection and ended up hospitalized for three days on IV antibiotics. When I was admitted, they were very upfront that if imaging showed an abscess or fluid collection around the implants, I might need surgery and potentially have the implants removed. Thankfully, my CT didn’t show a collection, so I was discharged on a 21-day course of Keflex.

My plastics team has continued to be very transparent that I’m not necessarily out of the woods. The antibiotic could end up not covering whatever bacteria caused the infection, and even if the infection clears, the inflammation could potentially lead to significant capsular contracture and another surgery down the road. Basically, there’s still a chance I could end up losing these implants.

At my three-week follow-up, they removed my right drain because it had stopped functioning. When they pulled it, what felt like a RIVER of milky fluid came out—easily ~50 cc. 🤢 They left the left drain in because it was still draining similar milky fluid.

Fast-forward to this weekend, almost four weeks post-DMX, and my left drain started falling out. I spoke with the on-call plastic surgeon, who told me I could remove it at home. My husband pulled it, and again, a ton of brown/milky fluid poured out.

Now both breasts are significantly red, hot, swollen and have a burning sensation. The swelling has increased enough that I had to go buy a larger zip-front bra. I don’t currently have a fever.

I called the on-call line again tonight, and the conversation honestly left me with more questions than answers. He initially didn’t realize I had implants, despite being the same doctor I had spoken with earlier about removing the drain. Based on the symptoms, though, there’s obviously concern that the current antibiotic may not be adequately treating whatever is going on.

I’m calling my actual plastic surgeon first thing tomorrow and hoping he can see me, repeat imaging to look for a fluid collection, and give me some clarity on whether we’re reaching the point where these implants need to come out.

The added complication is that I’m supposed to start my next cancer treatment by around 9/1, so getting this infection under control and being healthy enough to continue treatment is my biggest priority.

Has anyone here dealt with an infection like this after direct-to-implant reconstruction? Did antibiotics eventually clear it? Did they aspirate/wash out the area, exchange the implants, or did you ultimately have to have them removed? If they were removed, how long did you have to wait before reconstruction again?

I think I’m mostly looking for experiences so I have some idea of what the possible paths forward might look like. I’m so upset and just desperately want to feel like I have some control over my body again.

Six rounds of TCHP before surgery somehow felt like a cakewalk compared with this. 😩

Hi-

EDITING POST - thank you all for the comments. To clarify some things, I am 36, my husband is 45. My husband lost his job in May 2022 and i supported us financially until April of this year (I am still primary income; even through chemo I worked) . We also went through 7 rounds of IVF. our marriage has been no cake walk. We went to a therapist last year but he did not take it seriously. I have asked him throughout the past 5-6 months of my diagnosis to go again. I started individual therapy but he has not helped to schedule couples therapy.

I think two things that hurt me the most- one, he lied. He didn’t tell me what he was truthfully leaving me for.
Two- I’m tired of being the person holding us together again. I’m tired of teaching a man-child how to be a man and a husband. I’m also tired of constantly keeping the boundaries up with my in laws whose own toxic marriage is seeping in to ours (they hate each other and use their kids for their relationship).

Also - I was to stay overnight, my husband was to supposed to stay till 8pm with me.

I really appreciate the insight from the husbands/caregivers. One thing about me is - I over communicate. I have tried to voice my needs but I think he is either terrified or just overwhelmed or a combination of wtf has my life become. The morning of my surgery, driving to the hospital, he turns to me and says “I’m so over driving to hospitals, by the way.” Huh?!?? I have supportive family members and friends who have taken me to chemo treatments and appointments. My BFF took me to my colonoscopy. His words and actions are both screaming “I don’t want to be here anymore.” I have asked him point blank if he needs to / wants leave/take a break/etc, but he always says no.

You won’t be shocked to learn this isn’t our first argument during this journey. I once left a cereal bowl in the sink on the way to chemo (my dad drove me). I received the nastiest, most hurtful text message from him that I’m so disrespectful for not cleaning up after myself. I could go on. Just the blatant lack of empathy is something I don’t think I can come back from. And instead of ever getting an apology, he thinks he deserves an award for how supportive he’s been. My therapist says it’s classic DARVO behavior.

——————
I was diagnosed with Stage 1 breast cancer (er+\her2+, pr-) in February. I did 6 cycles of neoadjuvant chemo & immunotherapy and just had my double mastectomy last week.

My surgery could not have gone better (confirmed no lymph nodes and DTI), but my husband literally left me at bedside to get dinner with his mom. I had been up for 13 mins and he texted her to come get dinner with him and our son????

The plan was always for me to be admitted over night and for my sister to watch our son while Charlie stayed with me. I expected my husband to stay with me until bedtime. I even mentioned in recovery room ordering DoorDash for dinner.

To paint the scene- my surgery started around 11. I was rolled out and reunited with him by 2:30/3pm. It was so quick! He sent his mom a text with a picture of me sleeping in the OR recovery bays around 2:58. She said “sleep well” (meanwhile MY mom got no sort of reassuring text that I had surgery). I have no recollection of any conversations in the OR recovery bays. They take me to the overnight hospital rooms. I’m trying to sleep and I feel this anxiety rolling off of him that it wakes me up from my nap. I stupidly/in my anesthesia state assume he’s worried about our dogs. I tell him he can go walk our dog if he needs to but leave our son at my sisters since he’s having fun. He jumps at the chance to leave saying “I have a lot on my mind. I’m going to walk the dogs and go to the gym”

I fall back into my stupor. I wake up around 5:30?6 ish? I Check my phone, text my sister to see how my son is doing. No response. I text my husband to let him know I’m okay and that I’m awake. I see that his location says he’s at a restaurant/bar in town. As this is happening my sister texts to let me know my husband had picked our son up right away.

I go on our doggo nanny cam and see that flowers in the kitchen and by stomach drops because I finally understand that he left me for my MIL!!!!

I call my sister and she says she didn’t want to tell me bc she didn’t want me to get upset.

I just cannot imagine seeing your wife after getting life saving surgery and leaving her for your mom?? His parents have a history of crossing boundaries and were asking how they could help out two days before my surgery but I said that I had it covered. We tried to see them for breakfast but it didn’t work with my FILs padel schedule. (He belongs to a country club and it takes precedence over everything). My mil is obsessed with being the favorite grandma (her relationship is ruined with my BIL/sil).

Things between my husband and I have been rocky for a few years (he lost his job and I became the sole breadwinner) once I started chemo he magically found a job though.

He is not built for being in a marriage in the trenches. I have realized that I am over teaching him how to be a man/husband. I’m so hurt. I don’t think I can forgive this. I’m sure I’m missing a few key details but it’s disgusting and horrifying and disappointing.

Any advice for finding grace in this please!!

I should note he has been awful this whole experience. I told him he’s making me so independent that he’s obsolete.