Breast surgery is becoming more common around the world. For women who've been diagnosed with cancer, the operation is a medical necessity. But more and more women are choosing to have cosmetic surgery to either increase or decrease the size of their breasts.

Researcher Margaret Olsen from Washington University in St. Louis was investigating infections after all kinds of surgeries when she noticed something: women had an unusual number of infections after breast surgery.

"Breast surgery is the type of surgery that we don't expect to have a lot of infections occurring after the surgery because it's an area of the body that doesn't normally have a lot of bacteria there," Olsen explains. "It's not something like operating in the mouth or the colon where we have a lot of normal bacteria, and so you would expect to have a lot of infections after those surgeries."

To do her study, Olsen and her colleagues reviewed case histories for close to 1000 women who had either cosmetic breast surgery or reconstructive surgery after having a mastectomy to treat cancer. She found the women who had breast cancer surgery, plus reconstruction, had a higher risk of post-operative infection than the women who had purely cosmetic procedures. That risk increased even more if the cancer patients had artificial implants put into their breasts.

Olsen says the two populations of women are quite different. Those who are having implants placed for cosmetic reasons or breast reduction, are more often young women who are healthy, with very little in the way of any underlying diseases. "Maybe a little bit of obesity, but that's about it," Olsen adds.

In contrast, cancer patients tend to be older, and so are more likely to be obese, or have diabetes or other conditions that make them less-than-ideal candidates for surgery. Many cancer patients also receive chemotherapy or radiation treatment to fight the cancer. This may have made them more debilitated and more susceptible to infection.

But, despite the extra factors, Olsen says most infections could be avoided. She says what happens when a woman is discharged from the hospital is important. "Often times (women) are sent home with home health nurses to help them out," she points out. "Well, maybe the obese patient needs more frequent home health (care visits)."

Olsen says patients are "very careful when they're taking care of their wound to make sure that it's very clean, that they use all of the appropriate wound care techniques."

But, Olsen says the most important thing for a woman to do is to sit down with her surgeon before she has surgery and explore what risks she brings to the procedure before making a decision.

Olsen's research is published in the journal Archives of Surgery.