Clinical and Histologic Evaluation of a New Injectable Implant:

Abstract

Hydrophilic polyacrylamide gel is a new, jellylike transparent implant that consists of 95% water and 5% polyacrylamide, and it has been applied in many countries for many years as a sort of injectable implant. However, there are no data regarding human tissue reaction to hydrophilic polyacrylamide gel to date. Thirty-one patients who had undergone the injection of hydrophilic polyacrylamide gel for soft-tissue augmentation from September 1998 to November 2001 wanted to remove the implant. Hematoxylin-eosin-stained sections from each cyst of tissue sample were investigated and analyzed with light microscopy. The tissue slices of 12 patients who had received an injection of silicone from 1988 to 1994 were reviewed. The difference in histologic features was assessed. The inflammatory reaction of hydrophilic polyacrylamide gel was characterized by the presence of more foreign body giant cells. The cellular response ranged from moderate or marked (4 to 18 months) to mild (>18 months). The difference was statistically significant (P <0.05). Little lymphocyte infiltration was shown in all slices of hydrophilic polyacrylamide gel. There were clusters or diffuse lymphocyte infiltration on histologic observation of the liquid silicone. The difference was significant (P <0.001). In summary, hydrophilic polyacrylamide gel may evoke a human tissue inflammatory response similar to other foreign materials. Lumpy subcutaneous nodules, mastodynia, and difficult removal may limit its application in breast augmentation.

Polyacrylamide hydrogel injection for breast augmentation: Another injectable failure

“…Thus, the infection may invade the loose connective tissues and fat layer in the armpit, chest wall and abdominal wall along the submammary space, which is the main cause of systemic infection. Statistics show that the severe chronic infection following PAAG injection accounts for 2% of patients, which demonstrates the clinical importance of infection as a complication [1,2]. Moreover, some clinicians in primary care settings pay less attention to the complications of PAAG injection and then usually conduct improper treatment among these patients, which results in delayed wound healing and spread of infection or even more complex and severe complications.…”

“…Polyacrylamide hydrogel (PAAG) injection was developed in 1980 as a minimally invasive technique for breast augmentation; it has been used in many women and is widely applied in more than 30 countries in Europe, Canada, USA, New Zealand, Australia, South America and Asia [1,2]. In Ukraine, Russia, China and Iran, as many as 300 000 women have received PAAG injection for augmentation mammoplasty.…”

Brusterhaltende Therapie des Mammakarzinoms nach Augmentation mit injiziertem hydrophilem Polyacrylamidgel und Literaturübersicht

“…Die operativen Eingriffe zur Entfernung des Gels reichen von Punktion mit Saug-Spül-Drainage über partielle Mastektomie, subkutane Mastektomie und Entfernung von angrenzenden Muskelanteilen [4][5][6] .…”

“…Zhao et al [6] beschreiben, dass Befunde in der Mammographie durch das hyperdense PAAG maskiert werden können. Ausserdem wird von falsch positiven Mammographien durch reaktiv entstandenen Mikrokalk berichtet [6] .…”

“…Ausserdem wird von falsch positiven Mammographien durch reaktiv entstandenen Mikrokalk berichtet [6] .…”