Post augmentation erythema

Hello, I had breast augmentation - silicon gel - (plus mastoplexy) done on 20 July this year (areolar approach, above the muscle). On 5 August periareolar erythema developed bilaterally. I feel burning and tightness at the top of my breasts. I have no fever, no pain, no evident swelling, normal CBC, ESR, CRP. Ultrasound did not reveal free fluid, only thickenning of the skin on the left. I am on 5th ATB since, last two days added Sporanox tbl. There is no improvement, but it is not worsenning either. I have seen two specialists with contradicting opinion. One is suggesting removal of implants 2nd to infection, other one is against it and recommending to wait as it is not an infection. My surgeon is far away and has seen only pictures, suggesting it could be allergy to stitching material or rejection of implant; however, he has never seen anything like that. It seems it is not only me who is confused. Please, could you give me your opinion and suggestion what to do? To stop ATB or to continue, to do massage or not, to remove implants or not? What is my prognosis? Thank you.

[Howard Rosenberg, MD]

In the absence of a direct examination, and (to my knowledge) never having seen a similar problem in literally thousands of cases, I am at a loss to make a specific recommendation.  In the absence of serious symptoms, I might wait this out before considering implant removal.  Certainly suture reaction would be a likely candidate and should resolve with time.  If the condition or symptoms get worse, then I would remove the implants as a last resort.