Polyacrylamide Gel Injections for Breast Augmentation: Management of Complications in 106 Patients, a Multicenter Study

Abstract

Injections of PAAG can cause irreversible damage to the breast necessitating complex debridement procedures, even mastectomy and breast reconstruction. Despite numerous surgical interventions, gel remnants are still found on subsequent breast imaging. Although PAAG is prohibited in many countries, different types of injections with unknown long-term effects are currently being used. Making the public aware of the problems of injectables for breast augmentation is warranted.

Polyacrylamide gel breast augmentation: report of two cases and review of the literature

“…There is a tendency for PAAG to form globules, which may present as a palpable mass on physical examination and be A B seen on imaging as a discrete mass [10]. In a study of patients undergoing surgery following PAAG augmentation, breast pain was the most common indication for surgery, followed by breast hardening and breast deformity [2]. Rarely, late complications such as hematomas, seromas, and galactoceles can result from PAAG breast augmentation [11].…”

“…The silicone is known to migrate to axillary lymph nodes, skin, pectoral muscle, and even the lungs, spreading via hematogenous or lymphatic systems [13][14][15]. In the workup of palpable abnormalities in these patients, mammography and ultrasound are often performed first [2]. On mammography, the density of PAAG is similar to that of breast parenchyma and may be difficult to distinguish.…”

“…Although PAAG is banned in most countries, patients may present with symptoms related to PAAG augmentation, which may mimic malignancy clinically and radiographically [2]. Because of this, it is essential for health care providers to be cognizant of the signs and symptoms PAAG breast augmentation.…”

“…Though PAAG was first introduced in the 1970s, it was not popularized for breast augmentation until 1997 by China and the Soviet Union [2]. Soon after, the Russian ministry prohibited PAAG injection for fear that it may lead to glandular atrophy [3].…”

“…Its high water content allows PAAG to be readily integrated within surrounding connective tissue and fat. When hydrated, PAAG forms a gel, which is commonly exploited in everyday items such as contact lenses, food packaging, and water purification [2].…”