A few situations can compromise the presence and aesthetic appearance of breast implants. Infection, bleeding, and capsular contracture can all negatively affect the appearance of breast implant surgical results. A rare yet real risk to breast implant patients is a spider bite from the brown recluse spider. We just saw a patient with this condition – who is seeking another revision surgery ( who developed necrosis and infection 2 days after she was bitten).Although usually, they don’t come into contact with humans occasionally they do. And if the spider bites a woman’s breasts who has implants serious complications can arise. This spider has a painless bite. However, it has a type of venom that is toxic to skin and subcutaneous tissue. There is no antivenom and there is no antibiotic that will prevent the potentially toxic effects of this bite.
If untreated a breast with an implant could develop significant tissue necrosis. And, a possible subsequent infection may require the removal of the implant temporarily or permanently depending upon the severity of the tissue damage. Initial treatment is essential and involves opening and debridement of the blistered site,
antihistamines, and local wound care. This is to minimize the spread of the necrotic tissue. It’s questionable whether or not prophylactic antibiotics are helpful. If the debridement and wound care are adequate initially
the implant pocket could be spared and removal of the implant avoided. However, if the necrotic tissue
spreads into the pocket area then implant removal would be required.
Once the area heals up re-insertion of a new implant may be indicated. However significant anatomic changes may have occurred to the extent that the best aesthetic result can no longer be achieved.
Check clothing and bedding that has not been most recently used by shaking to eliminate or minimize
the risks of the Brown recluse spider lurking in these garments or bedding. Prevention and avoidance is the best policy.
THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
