European Journal of Plastic Surgery

, Volume 35, Issue 1, pp 65–71 | Cite as

Macrolane™ complications after breast augmentation: treatment and prevention

  • Mario GoisisEmail author
Original Paper


Macrolane™ (Q-Med AB, Uppsala, Sweden), an injectable preparation of stabilised hyaluronic acid-based gel of non-animal origin (NASHA-based gel), is used for breast augmentation. Here, we describe how our experience of changing injection techniques for NASHA-based gel reduced the rate of complications and increased successful treatment of any remaining complications. A total of 320 patients were treated with NASHA-based gel injected through a single injection site as multiple or single deposits, with or without ultrasonographic guidance. Complications were reduced when injecting the gel into the space between the deep fascia and pectoralis muscle, or in the submuscolar plane or into the pectoralis muscle, using a single injection technique under ultrasonographic guidance. Complications such as lumps were easily treatable with aspiration or hyaluronidase injection. One woman experienced a mild infection, which was resolved using antibiotics. Our clinic’s experience shows that when using our preferred injection technique, complications are reduced for this effective and minimally invasive treatment for breast augmentation.


Macrolane™ NASHA-based gel Breast augmentation Injection technique Complications and treatment 



Dr Goisis would like to thank Dr A. Casale, the radiologist from the National Cancer Institute, Milano, and Dr. G. Savarè, the senologist from the Macrofiller Study Group. Editorial assistance for the manuscript was provided by Fishawack Communications Ltd and supported by Q-Med, Uppsala, Sweden.


  1. 1.
    Gomez-de la Fuente E, Alvarez-Fernandez JG, Pinedo F, Naz E, Gamo R, Vicente-Martin FJ, Lopez-Estebaranz JL (2007) Cutaneous adverse reaction to Bio-Alcamid implant. Actas Dermosifiliogr 98(4):271–275. doi: 13102006 PubMedCrossRefGoogle Scholar
  2. 2.
    Klein AW, Elson ML (2000) The history of substances for soft tissue augmentation. Dermatol Surg 26(12):1096–1105. doi: 10.1046/j.1524-4725.2000.00512.x PubMedCrossRefGoogle Scholar
  3. 3.
    Hedén P, Sellman G, von Wachenfeldt M, Olenius M, Fagrell D (2009) Body shaping and volume restoration: the role of hyaluronic acid. Aesthet Plast Surg 33(3):274–282. doi: 10.1007/s00266-008-9303-y CrossRefGoogle Scholar
  4. 4.
    McCleave MJ (2010) Is breast augmentation using hyaluronic acid safe? Aesthet Plast Surg 34(1):65–68. doi: 10.1007/s00266-009-9450-9, discussion 69–70CrossRefGoogle Scholar
  5. 5.
    Broder KW, Cohen SR (2006) An overview of permanent and semipermanent fillers. Plast Reconstr Surg 118(3 Suppl):7S–14S. doi: 10.1097/01.prs.0000234900.26676.0b PubMedCrossRefGoogle Scholar
  6. 6.
    Fumihiko I, Toshiya H, Kazuaki S (2006) Hyaluronic acid breast augmentation. Jap J Plast Reconstr Surg 49:1335–1341Google Scholar
  7. 7.
    Goisis (2010) Is hyaluronic acid gel a good option for breast augmentation? Aesthet Plast Surg. doi: 10.1007/s00266-010-9603-x Google Scholar
  8. 8.
    McCleave MJ, Grover R, Jones BM (2010) Breast enhancement using Macrolane: a report of complications in three patients and a review of this new product. J Plast Reconstr Aesthet Surg. doi: 10.1016/j.bjps.2010.02.021 PubMedGoogle Scholar
  9. 9.
    Mir-Mir Caragol S (2010) Is breast augmentation using hyaluronic acid safe? Aesthet Plast Surg 34(1):69–70. doi: 10.1007/s00266-009-9451-8 CrossRefGoogle Scholar
  10. 10.
    Toole BP (2009) Hyaluronan-CD44 Interactions in cancer: paradoxes and possibilities. Clin Cancer Res 15(24):7462–7468. doi: 15/24/746210.1158/1078-0432.CCR-09-0479 PubMedCrossRefGoogle Scholar
  11. 11.
    Hedén P, Olenius M, Tengvar M (2010) Macrolane(TM) for breast enhancement: 12-month follow-up. Plast Reconstr Surg. doi: 10.1097/PRS.0b013e318200ae57 Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Macrofiller Study GroupMilanItaly
  2. 2.Doctor’s EquipeMilanItaly

Personalised recommendations