Background Implant-based breast reconstruction or augmentation may lead to significant complications, including infection, capsular contracture and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). As such, it is now common practice to utilise antimicrobial irrigation intraoperatively to improve outcomes. In the literature and in practice, there is a wide range of agents and concentrations of antibiotics used. This review aims to identify types and concentrations of antimicrobial agents used in breast implant irrigation solutions and their impact on outcomes and complications postoperatively. Method A search on Ovid Medline was conducted, identifying 84 relevant studies. Studies that were included involved adult females who underwent breast implant insertion as a primary procedure. Outcomes including infection rate, capsular contracture, BIALCL and reoperation were assessed. These studies were reviewed by two authors with 16 studies remaining after review. Results A wide variety of concentrations and combinations of antimicrobial agents have been presented in the literature. Currently, there are no clinical studies examining the impact of concentrations of antimicrobial irrigation solutions and the development of complications. It was identified however, that a solution of 10% povidone-iodine, 160mg gentamicin and 1g cefazolin in 500ml sterile saline produces the optimal outcomes. Conclusion There are limited studies comparing different concentrations of irrigation solutions. Further clinical studies are required to identify the efficacy of varying additive concentrations in breast implant irrigation.