Polyacrylamide hydrogel injection for breast augmentation: Another injectable failure

Abstract

SummaryBackgroundIncreasing complications of polyacrylamide hydrogel (PAAG) augmentation mammoplasty, such as chronic persistent infection, have recently caught the attention of both the medical field and the general public.Material/MethodsA total of 96 patients with severe chronic infection following PAAG augmentation mammoplasty were treated in the present study including 63 cases with infection confined to the breast and 33 with systemic infection. Endoscopy and surgery were performed to completely remove the materials and clear the infected tissues followed by drug-irrigation and vacuum-assisted closure for several days.ResultsIn patients with severe infection there were large amounts of PAAG, fibers and infiltration of numerous neutrophils and macrophages. The infection-inducing materials were extensively dispersed in the mammary and subcutaneous tissues, pectoral fascia and intermuscular space. In addition, there was scattered distribution of PAAG materials in the armpit, chest wall and abdominal wall, which were mixed with necrotic tissues and surrounded by lymphocytes, giant cells, macrophages and other inflammatory cells, forming chronic granulomatous and fibrous lesions. Infection was controlled following surgical intervention. No residual infectious foci or recurrent infections were noted among these patients. Although the severe infection did not result in mastectomy, patients had breast atrophy and various degrees of deformation.ConclusionsChronic infection following PAAG augmentation mammaplasty usually causes systemic infection and other devastating adverse reactions. This study confirms PAAG augmentation mammaplasty is another failed attempt. More attention should be paid to the injection of large doses of liquid filler.

The Complications of Polyacrylamide Hydrogel Augmentation Mammoplasty

“…Given the hydrophilicity of PAAG, the wound should be repeatedly irrigated with antibiotics in normal saline until the fluid in the drainage is clear, and PAAG granules and pus are not observed. 5 …”

“…4 As many as 300 000 women have been treated for PAAG injections. 5 Polyacrylamide hydrogel injections have been used in both legal and illegal institutions, such as beauty parlors by non-medical professionals. 2 Aquamid is a representative of PAAG.…”

“…Approaches to surgical treatment and subsequent breast reconstruction are not defined primarily because of the limited knowledge about this group of patients. 5 This article aims to summarize complications and the risks associated with PAAG through a case report and review of the literature.…”

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

“…Soon after, the Russian ministry prohibited PAAG injection for fear that it may lead to glandular atrophy [3]. The Chinese State Food and Drug Administration followed suit in 2006 and also banned PAAG sale, production, and use.…”

“…Atraumatic aspiration of PAAG is accomplished by a blunt tip cannula that has an orifice on a taper [3,4]. Saline irrigation and breast massage can facilitate the removal of all PAAG.…”