The Complications of Polyacrylamide Hydrogel Augmentation Mammoplasty

Abstract

The use of polyacrylamide hydrogel (PAAG) as an injectable filler for breast augmentation has fallen out of popularity since its first use in the 1980s but has produced an increasing patient population presenting with complications related to PAAG injections. Polyacrylamide hydrogel use was popularized most notably in China, Russia, and Iran. However, given immigration trends and medical tourism, PAAG-related complications have become increasingly more common in North America. These complications can be difficult to treat, often necessitating complex surgery that includes gel removal, debridement procedures, and often breast reconstruction. Approaches to surgical treatment and subsequent breast reconstruction are not universally defined primarily because of the limited knowledge about this group of patients. This article presents the option of autologous free flap reconstruction for a patient with extensive muscular involvement and aims to summarize complications and risks associated with PAAG through case report and a review of the literature. Résumé L'hydrogel de polyacrylamide (PAAG) utilisé comme produit de remplissage injectable pour l'augmentation mammaire a perdu toute sa popularité depuis sa première utilisation dans les années 1980, mais est responsable d'une population croissante de patientes ayant des complications liées aux injections de PAAG. L'utilisation de PAAG a surtoutété popularisée en Chine, en Russie et en Iran, maisétant donné les tendances d'immigration et le tourisme médical, les complications qui s'y rapportent sont de plus en plus courantes en Amérique du Nord. Ces complications peuventêtre difficiles à traiter, exigent souvent des opérations complexes qui comprennent l'extraction du gel, des interventions de débridement et, dans bien des cas, une reconstruction mammaire. Les approches au traitement chirurgical et la reconstruction mammaire subséquente ne sont pas universelles en première ligne, en raison des connaissances limitées au sujet de ce groupe de patientes. Le présent article présente la possibilité de reconstruction autologue par lambeau libre chez une patiente ayant une importante atteinte musculaire. De plus, les complications et les risques associés au PAAG y sont résumés dans le rapport de cas et une analyse bibliographique.

Construction of Tough Hydrogel Cross-Linked via Ionic Interaction by Protection Effect of Hydrophobic Domains

“…17 local toxicity and inflammation at the site of implantation have been observed in several cases. 18,19 These issues underscore the crucial need for developing hydrogels that not only exhibit enhanced mechanical strength but also are biocompatible and devoid of potentially harmful components, making them safer for desired tissue engineering applications. Considering the importance of nontoxicity and biocompatibility in biomaterials, there is a way to fabricate hydrogels based on natural polymers.…”

“…This involves covalently cross-linked hydrophilic PAAm networks physically associated with poly­(vinyl alcohol) (PVA) crystallites, as reported by Li et al Despite the improvement achieved by both systems, concerns remain regarding the presence of nonbiodegradable components, specifically the synthetic polymers PVA and PAAm . Moreover, the potential neurotoxicity and teratogenic properties of residual acrylamide are concerning, and local toxicity and inflammation at the site of implantation have been observed in several cases. , These issues underscore the crucial need for developing hydrogels that not only exhibit enhanced mechanical strength but also are biocompatible and devoid of potentially harmful components, making them safer for desired tissue engineering applications. Considering the importance of nontoxicity and biocompatibility in biomaterials, there is a way to fabricate hydrogels based on natural polymers. , We have previously reported the construction of a highly stretchable hydrogel based on the conjugation between a biodegradable polymer, poly­(γ-glutamic acid) (γ-PGA), and an ionic cross-linked functional group, alendronic acid (Aln), resulting in γ-PGA-Aln .…”

3D printed dual macro-, microscale porous network as a tissue engineering scaffold with drug delivering function

“…As with other implanted devices, these scaffolds are prone to post-surgery complications such as surgical site bacterial infections or bacterial biofilm formation on the scaffolds. In the case of patients receiving these scaffolds following tumor removal, cancer can recur because some cancer cells were incompletely removed [7][8][9][10][11]. Therefore current standard treatments still involve systemic administration of antibiotics or chemotherapeutic agents post-surgery.…”