Complications after breast augmentation with polyacrylamide injection: a case report

Pham Thi Viet Dung, Truong The Duy

Main Article Content

Abstract

 A 42-year-old female patient who had breast augmentation using polyacrylamide hydrogel
injection 18 years ago was admitted to the hospital because of pain and swelling in both breasts.
The right breast had a large firm mass, causing severe deformity. The left breast was slightly
swollen with a small mass that was discovered after careful examination. Polyacrylamide hydrogel
is a non-biodegradable filler that used to be popular in China and Eastern Europe and has now
been banned for breast augmentation due to many serious delayed complications. Breast MRI
showed the fibrous capsule containing hypersignal fluid located in front of the chest wall muscle.
The patient was treated with total capsulectomy through the incision in the lower half of the areola.
The fluid in the fibrous capsule was slightly viscous, pale milk-like yellow liquid, with many small
yellow residues. Partial mastectomy was performed due to an infiltration of artificial material.
Histopathology revealed a foreign body granulomatous inflammatory reaction. After surgery, the
patient was pain-free. After 2 months, the breast shape on both sides was relatively symmetrical,
and the breasts was soft to touch. Residual fluid or recurrence of fluid was not observed.

Article Details

References

1. Cheng NX, Wang YL, Wang JH, Zhang XM, Zhong H. Complications of breast augmentation with injected hydrophilic polyacrylamide gel. Aesthetic Plast Surg. 2002;26(5):375-382. doi: 10.1007/s00266-002-2052-4.
2. Xu L ying, Kong X quan, Tian Z xiong, Qiu D sheng. Magnetic resonance imaging on complications of breast augmentation with injected hydrophilic polyacrylamide gel. Chin Med J (Engl). 2006;119(15):1311-1314.
3. Xiaoling F, Yi C, Zhang Y, et al. Analysis of the complications induced by polyacrylamide hydrogel injection. Plast Reconstr Surg. 2004;114(1):261-262. doi: 10.1097/01.prs.0000 127232.07433.b7.
4. Peters W, Fornasier V. Complications from injectable materials used for breast augmentation. Can J Plast Surg. 2009;17(3):89-96. doi: 10.1177/229255030901700305.
5. U S Food and Drug Administration. Soft tissue fillers: Dermal fillers. MD: U. S. Food and Drug Administration. 2015.
6. Khedher NB, David J, Trop I, Drouin S, Peloquin L, Lalonde L. Imaging findings of breast augmentation with injected hydrophilic polyacrylamide gel: patient reports and literature review. Eur J Radiol. 2011;78(1):104-111. doi: 10.1016/j.ejrad.2009.09.021.
7. Polyacrylamide gel injections for breast augmentation: management of complications in 106 patients, a multicenter study. PubMed. Accessed December 7, 2021. https://pubmed.ncbi.nlm.nih.gov/21932147/.
8. Lin WC, Hsu GC, Hsu YC, et al. A late complication of augmentation mammoplasty by polyacrylamide hydrogel injection: ultrasound and magnetic resonance imaging findings of huge galactocele formation in a puerperal woman with pathological correlation. Breast J. 2008;14(6):584-587. doi: 10.1111/j.1524-4741. 2008.00652.x.
9. Leung KM, Yeoh GPS, Chan KW. Breast pathology in complications associated with polyacrylamide hydrogel (PAAG) mammoplasty. Hong Kong Med J. 2007;13(2):137-140.
10. Berthe JV, Van Geertruyden JP. Osmotic instability of hydrogel-filled breast implants. Br J Plast Surg. 2001;54(5):465-466. doi: 10.1054/bjps.2001.3614.
11. Benediktsson K, Perbeck LG. Fluid retention in Bioplasty Misti Gold II breast prostheses with development of capsular contracture. Scand J Plast Reconstr Surg Hand Surg. 2000;34(1):65-70. doi: 10.1080/02 844310050160196.
12. Adams TST, Crook T, Cadier MAM. A late complication following the insertion of hydrogel breast implants. J Plast Reconstr Aesthet Surg. 2007;60(2):210-212. doi: 10.1016 /j.bjps.2006.01.012.
13. Cheng NX, Zhang YL, Luo SK, et al. Late hematoma, seroma, and galactocele in breasts injected with polyacrylamide gel. Aesthetic Plast Surg. 2011;35(3):365-372. doi: 10.1007/s00266-010-9617-4.
14. Kang G, Ong Y. Large Unilateral Breast Autoinflation After Breastfeeding Linked to Polyacrylamide Hydrogel Injection Augmentation Mammaplasty. Aesthetic Plastic Surgery. Published online 2010. doi: 10.1007/s00266-010-9550-6.
15. Ghasemi H, Damsgaard T, Stolle L, Christensen B. Complications 15 years after breast augmentation with polyacrylamide. Journal of Plastic Reconstructive & Aesthetic Surgery. 2015;37. doi: 10.1016/j.jpra.2015.04. 002.