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Late Hematoma, Seroma, and Galactocele in Breasts Injected With Polyacrylamide Gel

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Abstract

Late hematoma or seroma and galactocele caused by augmentation mammaplasty have been reported in patients with silicon breast prostheses but are extremely rare in patients injected with polyacrylamide gel (PAAG). In a retrospective survey, the incidence, clinical manifestations, and management of late hematoma, seroma, and galactocele in 28 of 2,610 patients who underwent breast augmentation with PAAG injection were investigated, and 5 typical cases are presented. The diagnostic and managing methods for this complication have been assessed. The incidence of late hematoma or seroma was 0.65% and that of galactocele was 0.35% among patients with PAAG-injected breast augmentations. The clinical onsets of such late PAAG complications were of two types: rapid enlargement in 17 patients and progressive expansion in another 11 patients. Aspiration, ultrasound, and magnetic resonance imaging (MRI) are useful and sensitive tools for diagnosis. Foreign body reaction, PAAG-related tissue necrosis and fibrosis, and granuloma were shown, and the bacterial cultures in all 12 cases were negative. Needle aspiration with pressure dressing has been advocated as a reliable method for small diseases, and surgical exploration with irrigation-vacuum drainage and evacuation with capsulectomy have been considered more effective for recurrent, large, and long-term cases. In conclusion, these late complications rarely present after large-volume injections of PAAG for breast augmentation. The PAAG-related pathologic inflammatory tissue changes are suggested as the pathogenesis for the complication. Trauma and breastfeeding are considered to be stimulating factors.

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Acknowledgment

We thank Lian-Tang Wang, Department of Pathology, Medical College of Zhongshan University, Guangzhou, China, for his support in pathologic observation, and Lie Zhu, Department of Plastic Surgery, The Third Affiliated Hospital of Zhongshan University, Guangzhou, China, for her help with the ultrasound data.

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None.

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Authors and Affiliations

  1. Department of Plastic Surgery, First Affiliated Hospital, College of Clinical Medicine, Guangdong Pharmaceutical University, Nonglinxialu 19, 510080, Guangzhou, China

    Ning-Xin Cheng, Li Hui, Yuan-Liang Chen & Ping Li

  2. Section of Aesthetic Plastic Surgery, Guangzhou Shuguang Aesthetics and Plastic Hospital, Jichanglu 15, 510030, Guangzhou, China

    Yuan-Long Zhang

  3. Department of Aesthetic and Plastic Surgery, Guangdong Second Peoples’ Hospital, Shiliuganglu 1, 510317, Guangzhou, China

    Sheng-Kang Luo & Hai-Bin Wang

  4. Department of Medical Image, Guangzhou First Municipal People’s Hospital, Guangzhou Medical College, Panfulu 1, 510180, Guangzhou, China

    Xiao-Man Zhang & Dai-Hong Wu

  5. Section of Cosmetic Surgery, Guangzhou Huamei Cosmetic and Plastic Surgery Clinics, Huangpudadaoxi 493, 510620, Guangzhou, China

    Shao-Yong Sheng

Authors
  1. Ning-Xin Cheng
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  2. Yuan-Long Zhang
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  3. Sheng-Kang Luo
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  4. Xiao-Man Zhang
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  5. Li Hui
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  8. Dai-Hong Wu
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  9. Hai-Bin Wang
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  10. Ping Li
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Corresponding author

Correspondence to Ning-Xin Cheng.

Additional information

N.-X. Cheng, Y.-L. Zhang, S.-K. Luo, X.-M. Zhang contributed equally to this work.

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Cheng, NX., Zhang, YL., Luo, SK. et al. Late Hematoma, Seroma, and Galactocele in Breasts Injected With Polyacrylamide Gel. Aesth Plast Surg 35, 365–372 (2011). https://doi.org/10.1007/s00266-010-9617-4

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  • DOI: https://doi.org/10.1007/s00266-010-9617-4

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