breast infection after nipple reconstruction

I recently had nipple reconstruction using my own skin from the abdomen after a bilateral mastectomy.  I have silicone implants.  My left side took just fine but the skin never took on my right side.  It became infected and my surgeon cut the nipple out.  My breast is completely swollen and the skin is red, the area where the nipple was is kind of yellowish.  I have saline soaked gauze on the wound and silvadene cream on the outer skin.  I am on my second week of antibiotics with no improvement.  Will the implant need to be removed?  The swelling is very painful and the skin is sore. How long does this need to go on?

[Michael B Wolfeld, MD]

It is hard to give you an answer without a physical exam.  In these situations, sometimes oral antibiotics or IV antibiotics may treat the infection and salvage the implant.  At times, however, the implant may need to be removed in conjunction with antibiotics for proper treatment of this infection.