Complications 18 years after polyacrylamide hydrogel augmentation mammoplasty: a case report and histopathological analysis

Abstract

Polyacrylamide hydrogel (PAAG) is a synthetic substance previously used as an injectable material for augmentation mammoplasty. Current literature has demonstrated that the average time from PAAG injection to the onset of complication ranges from 6 to 39 months. We present a unique case report describing the onset of complications 18 years after PAAG augmentation mammoplasty. To the best of our knowledge, the presentation of a healthy female who experienced unprovoked expansion of breast tissue >15 years after polyacrylamide injection has not been previously reported in surgical literature. This suggests that serious complications of PAAG injection may occur later than the literature has previously described. Importantly, this case is the first demonstration of the successful surgical removal of polyacrylamide 18 years after injection. Additionally, this case also provides a histopathological analysis of breast capsules which showed evidence of an extensive chronic inflammatory reaction to polyacrylamide, consistent with previous reports.

Durability of Implanted Low-Density Polyacrylamide Hydrogel Used as a Scaffold for Microencapsulated Molecular Probes inside Small Fish

“…Polyacrylamide gel with 2.5% monomer concentration was applied as a cosmetic filler in the 1990s; therefore, there are a number of studies of its tissue biocompatibility and long-term effects [ 44 , 45 , 46 , 47 ]. Studies of these hydrogels were mainly focused on cases of medical complications (mainly chronic inflammation and fibrosis), and their results were often controversial, with little discussion of the short-term consequences of the administration of 2.5% PAAH [ 48 ].…”

“…Studies of these hydrogels were mainly focused on cases of medical complications (mainly chronic inflammation and fibrosis), and their results were often controversial, with little discussion of the short-term consequences of the administration of 2.5% PAAH [ 48 ]. However, the time between PAAH injection and health complaints in humans was reported to be from six months to decades [ 44 , 46 , 47 ]. Such a period is mostly sufficient for application of implantable optical sensors in physiological research on fish and even for some potential tasks in aquaculture.…”

Breast Augmentation with Autologous Fat Grafting Immediately after Removal of Polyacrylamide Hydrogel and Fibrotic Capsule in 162 Patients

“…By the time the approval was withdrawn in 2006, 300,000 or more female injected with PAAG in breast augmentation were complaining about the complications associated with PAAG, such as infection, pain, hematoma, multiple induration and lumps, breastfeeding difficulties, breast autoinflation, displacement of the injected material, as well as non-negligible psychological problems [ 2 , 3 , 4 , 5 ]. Delayed complications have also been reported recently, including a long-lasting autoimmune reaction with general complications [ 6 , 7 ]. The only way out for patients with these complications is to remove the PAAG as much as possible.…”