Abstract
Since 1994, a new filling material (polyacrylamide 5% hydrogel, composed of acrylamide, methylenbisacrylamide, tetramethylendiamine and distilled water) has been used by several surgeons in Bulgaria. The indications for the use of hydrogel as recommended by the manufacturer are as follows: treatment of depressions and wrinkles of the glabella, malar and upper lip region, lip augmentation, augmentation mammaplasty, phalloplasty, atrophy or paralysis of the vocal cords, Romberg syndrome and many other similar conditions. Despite good immediate results, numerous long-term complications have been observed. The hydrogel diffuses into areas with minimal resistance and moves downward with time. The most serious problems arise after injection of hydrogel to augment breasts. The injected hydrogel disseminates in all directions into tissues of the gland and the muscles; this has been confirmed histologically. Early diagnosis of mammary tumors is made impossible in such women because it is very difficult to differentiate between the injected hydrogel and a possible neoplastic process. Other complications which have been encountered are necrosis of the skin and tissues of the breast and migration of the hydrogel causing functional disruption of the penis and eyes, etc. The hydrogel changes its position and diffuses throughout the tissues. Removal of the injected hydrogel is extremely difficult and frequently may not be possible. In conclusion, the use of this type of material is dangerous; it requires further research, and it is recommended that its use be discontinued at this moment.
Similar content being viewed by others
References
Cheng NX, Wang YL, Wang JH, Zhang XM, Zhong H (2002) Complications of breast augmentation with injected hydrophilic polyacrylamide gel. Aesth Plast Surg 26(5):375–382
Lopatin VV (2000) Polyacrylamide gels for endoprostheses and their place in the family of polymeric materials for medicine. Ann Plast Reconstr Aesth Surg 3:57–60
Mengjun Cao (2001) The clinic application of polyacrylamide hydrogel in plastic surgery. Abstracts of the 9th Congress of ESPRAS. Rome. September 16–20, 2001 (paper not presented on the congress)
Milanov NO (2000) Plastic contour correction with polyacrylamide gels. Myths and reality. Ann Plast Reconstr Aesth Surg 4:63–69
Nerobeev AI (2000) Short communication: apropos of the article “Evaluation of the efficiency of polyacrylamide hydrogel used to correct soft tissue contour of lower limbs” by V.A. Vissarionov, et al. Ann Plast Reconstr Aesth Surg 3:67–70
Shehter AB, Lopatin VV (1977) Injectable polyacrylamide gel “Formacryl” and the tissue reaction by its implantation. Ann Plast Reconstr Aesth Surg 2
Vissarionov VA, Yakimets VG, Karpova EI (2000) Evaluation of polyacrylamide hydrogel used to correct soft tissue contour of lower limbs. Ann Plast Reconstr Aesth Surg 3:61–66
Wintsch W, Smahel J and Clodius L (1978) Local and regional lymph node response to ruptured gel-filled mammary prostheses. Br J Plast Surg 31(4):349–352
Author information
Authors and Affiliations
Corresponding author
Additional information
An Editor's comment and 3 invited commentaries on this paper are available at http://dx.doi.org/10.1007/s00238-006-0056-z http://dx.doi.org/10.1007/s00238-006-0057-y http://dx.doi.org/10.1007/s00238-006-0058-x http://dx.doi.org/10.1007/s00238-006-0059-9.
Rights and permissions
About this article
Cite this article
Evstatiev, D. Late complications after application of polyacrylamide hydrogel. Eur J Plast Surg 29, 127–132 (2006). https://doi.org/10.1007/s00238-006-0055-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-006-0055-0