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Complications and Treatment Strategy After Breast Augmentation by Polyacrylamide Hydrogel Injection: Summary of 10-Year Clinical Experience

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  • Breast Surgery
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Abstract

From 1997 to 2006, polyacrylamide hydrogel (PAAG) was approved for use in China as a permanent filler for breast augmentation, and it is estimated that 200,000 women have undergone PAAG injection since then. After injection, complications such as pain, mass, hematoma, asymmetry, migration, infection, and even cancer continue to emerge. Because of the potential toxicity and unstable nature of the material and the nonstandardized injection layers, complications after PAAG injection breast augmentation are often complex and difficult to treat. The only treatment for these complications is debridement surgery, which includes PAAG evacuation, capsule remove, lesion excision, and mastectomy. Currently, although there are a variety of surgical methods for complications after PAAG injection, there is a lack of consensus regarding the diagnosis and treatment. We systematically review the literature and summarize our experience of diagnosis and treatment of complications after PAAG injection in our hospital over the past 10 years. To date, this is the first attempt to propose a diagnostic classification for PAAG injection breast augmentation and to set out a treatment strategy based on this classification. Although the China Food and Drug Administration withdrew its approval in 2006, PAAG is still being used illegally in some areas, and the patient population is widespread. This study aims to provide a more comprehensive understanding of PAAG complications to drive the standard diagnosis and treatment based on clinical classification, and to provide references for the future development of safer injectable products.

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Author information

Author notes

  1. Rui Jin and Xusong Luo contributed equally to this work.

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People’s Republic of China

    Rui Jin, Xusong Luo, Fei Liu, Qun Yang, Jun Yang & Xi Wang

  2. Department of Medical Aesthetic Surgery, Weihai Central Hospital, Weihai, People’s Republic of China

    Xiaoke Wang

  3. Department of Plastic and Reconstructive Surgery, Shanghai First People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

    Jie Ma

Authors
  1. Rui Jin
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  2. Xusong Luo
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  3. Xiaoke Wang
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  4. Jie Ma
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  5. Fei Liu
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  6. Qun Yang
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  7. Jun Yang
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  8. Xi Wang
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Correspondence to Xi Wang.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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266_2017_1006_MOESM1_ESM.jpg

Sup. Figure 1. Preoperative photographs of case 1. A. Preoperative anterior view; B. Preoperative lateral view; C. MRI showing that the injection layer is mainly under the breast, and the capsule is intact (JPEG 34 kb)

266_2017_1006_MOESM2_ESM.jpg

Sup. Figure 2. Pre and postoperative photographs of case 2. A, B are preoperative anterior and lateral views and C, D are postoperative anterior and lateral views (JPEG 54 kb)

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Jin, R., Luo, X., Wang, X. et al. Complications and Treatment Strategy After Breast Augmentation by Polyacrylamide Hydrogel Injection: Summary of 10-Year Clinical Experience. Aesth Plast Surg 42, 402–409 (2018). https://doi.org/10.1007/s00266-017-1006-9

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  • DOI: https://doi.org/10.1007/s00266-017-1006-9

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