Commentary on: Microbiologic Safety of the Transareolar Approach in Breast Augmentation.

Abstract

The authors of this article systematically evaluate the bacteria present in the surgical field of a breast augmentation procedure in an attempt to dispel the notion that periareolar augmentation mammaplasty yields a higher rate of capsular contracture than do other approaches.1 The goal is to refute the notion that the breast harbors endogenous bacteria, which are here strictly defined beyond the scope of their original description.2 The concept of endogenous breast bacteria defines bacterial colonies present in significant concentrations and residing within the breast tissue, as opposed to being skin contaminants in the field. As originally described, these bacteria are present in the presumed-sterile surgical field (after skin sterilization) and are consistently identified across sample subjects. Although their exact location has yet to be proven, it is reasonable to imagine that they reside in the ducts, paths that are in fact exposed to the outside world in a similar fashion to the gastrointestinal and urogenital tracts. Even if the ducts harbor similar bacteria to that found on the skin, if that flora is remote from routine skin preparation, then the …