Antibiotics in cosmetic surgery

Cosmetic surgeries are extremely common in our society. These days, people are having buttock augmentations, tummy tucks, and breast augmentations, among other procedures. Surgeons examine anecdotal studies and peer-reviewed studies to figure out better ways to minimize complications. One of the things that surgeons do prior to the surgery itself is to give patients prophylactic antibiotics. So, what are prophylactic antibiotics? These are antibiotics that are given an hour before the patient goes to sleep. Studies have demonstrated that this decreases the likelihood of having a postoperative infection.

Infection after a cosmetic procedure is not very common. Cosmetic procedures are classified as a clean surgery, an elective not emergent surgery where there is no break in sterile technique and there are no organ fluids entered during the procedure. The risk of infection in this type of procedure is about 2%. However, there are certain arguments in favor of giving antibiotics prior to surgery in this category. For specific clean procedures, infection may be unlikely, but the morbidity and cost of even infrequent infection can justify the use of prophylaxis. Also, clean procedures constitute approximately 60% of all surgical procedures and account for approximately 40% of all wound infections. It is estimated that prophylaxis for clean procedures will reduce the overall incidence of wound infection by 17%.

Typically, antibiotics are provided through IV, and depending on the situation and location of the surgery, these antibiotics can be given to cover broad spectrums of different bacteria. The most common bacterium that causes infection is called Staph aureus. There is a rising trend of bacteria becoming more resistant to antibiotics; I am sure you have heard about MRSA, which stands for methicillin-resistant Staphylococcus aureus. Even though you cannot see the bacteria on your skin, they are everywhere in the body. If we culture any part of your body, it is going to grow bacteria. Nevertheless, good sterile technique, prepping the patient before surgery, and providing IV antibiotics have made elective surgery possible. It is a standard of care to provide you with IV antibiotics before surgery, and I do that every single time I perform a cosmetic surgery.