The 14 point plan puts together proven strategies for surgeons to use when they are inserting breast implants. It was first published in 2013 and has since been adopted all around the world.

The 14 steps target bacteria, which have been shown to cause capsular contracture – hardening, pain and deformity following breast implant surgery. By using the 14PP, the number of bacteria attaching to implants is reduced and the risk of breast implant complications are minimised.

Using the plan ensures that all patients are given the benefit of proven research to combat infection and the best chance of a stable, long lasting and successful outcome.

Biofilm infection – not your usual infection

Bacteria exist in two forms – a free floating (or planktonic) and sessile (adherent) forms. Bacteria that come into contact with implants become adherent and quickly secrete a thick sticky coating that binds them onto the surface irreversibly. The combination of bacteria and their protective coating is termed biofilm. Biofilms are now recognized as the leading cause of implant failure in medicine and can infect not just breast implants but orthopaedic implants, cochlear implants, contact lenses, catheters and heart valves.

Process of biofilm attachment and dissemination

Biofilm on the surface of a breast implant