Treatment of breast injection with polyacrylamide hydrogel with infiltrated fascia capsule removal: report on 104 cases.

[BACKGROUND] Complications of polyacrylamide hydrogel injection for augmentation mammaplasty have captured the attention of both medical experts and the general public in China. Increasing numbers of patients are seeking to have the polyacrylamide gel removed from their breasts regardless of whether they suffer from symptoms. Blunt aspiration, which is widely performed but removes only free hydrogel, leaves residual hydrogel in the breast. We report and discuss our ideas and techniques for the treatment of polyacrylamide hydrogel-injected breasts.

[METHODS] Between February 2005 and December 2010, 104 women who had undergone injection of polyacrylamide hydrogel for breast augmentation presented to us for treatment. A periareolar incision was made on the lower border of the areola, followed by dissection to the outer surface of the infiltrated fascia of polyacrylamide hydrogel. The fascia was dissected away as completely as possible and the free polyacrylamide hydrogel was removed from the cavity.

[RESULTS] All of the patients were satisfied with the surgical results, except for three patients who complained about the flat appearance of the breast. Preoperative symptoms such as breast lumps, pain, uncomfortable upper-extremity movement, and breast firmness were relieved and disappeared after removal of the free polyacrylamide hydrogel and infiltrated capsule.

[CONCLUSION] The removal of as much of the infiltrated capsule and free polyacrylamide hydrogel as possible may be successful in removing breast lumps, pain, and uncomfortable upper-extremity movement due to breast firmness. To remove as much polyacrylamide hydrogel as possible, the removal of the infiltrated fascia and capsule together with the free polyacrylamide hydrogel is recommended.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article.