It is estimated that, globally, more than four million women undergo breast implant surgery for either aesthetic or reconstructive purpose. Breast implant surgery involves the creation of a breast pocket followed by insertion of a breast implant. There may be complications associated with the procedure. There is potential for development of capsular contracture, which may be due to chronic subclinical infection around the implant. Capsular contracture is progressive and disfiguring and frequently results in reoperation. Also, implanting a foreign material is associated with risk of infection. The potential for bacterial infection, and the correlation between capsular contracture and biofilm formation, prompted the perioperative use of antimicrobial agents for soaking implants and for breast pocket irrigation. These agents include several antibiotics (e.g., cefuroxine, cefazolin, gentamicin) and antiseptics (e.g., povidone-iodine [PVI]). In 2000, the US Food and Drug Administration (FDA) recommended against the direct contact of PVI with implants, due to concerns about PVI causing implant deflation. Subsequently, Jewell and Adams, reported that in 2017, the US FDA approved a request by one of the manufacturers of breast implants for removal of the warning regarding the use of Betadine (povidone-iodine 10% solution). There appears to be some uncertainty regarding the use of PVI for pocket irrigation and implant soaking, in breast implant surgery. The purpose of this report is to review the clinical effectiveness of PVI for pocket irrigation and implant soaking in breast implant surgery. Additionally, this report aims to review the evidence-based guidelines regarding the use of povidone-iodine for biofilm mitigation and prevention of infection during and after breast implant surgery.