Classification and Management of Polyacrylamide Gel Migration After Injection Augmentation Mammaplasty: A Preliminary Re
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ORIGINAL ARTICLE
BREAST SURGERY
Classification and Management of Polyacrylamide Gel Migration After Injection Augmentation Mammaplasty: A Preliminary Report Jinguang He1 • Tao Wang1
•
Jiasheng Dong1
Received: 28 March 2020 / Accepted: 3 August 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Polyacrylamide gel (PAAG) migration after esthetic breast injection is clinically variable and complex, and thus, the rate of incomplete removal after debridement is high. Objectives We aimed to describe a practical classification system for PAAG migration after breast injection and evaluate the outcome of our management. Methods A retrospective review of medical records was conducted for patients who presented to our institution for the management of PAAG migration after injection augmentation mammaplasty from June 2013 to November 2018. PAAG migration was evaluated by MRI examination and classified based on the migrating direction outside the breast contour. Surgery was performed to remove the material completely through different incisions. Results Seventy-eight women met the study criteria, with 106 breasts identified as showing PAAG migration. Patients were classified as having superior (22%), lateral (25%), inferior (34%), medial (10%) or complex (9%) PAAG displacement. The mean follow-up was 9 months (range 3–18 months). Postoperative complications included seroma (n = 3), delayed wound healing (n = 2), occasional breast pain (n = 5) and paresthesia or numbness at the migrated site (n = 2). MRI re-examination revealed
& Tao Wang [email protected] & Jiasheng Dong [email protected] 1
Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi Zao Ju Rd., Shanghai 200011, People’s Republic of China
that most of the injected material was removed, and no patient needed a secondary debridement operation. Conclusion PAAG migration after injection augmentation mammaplasty can be clinically characterized into different types based on the migrating direction. It is helpful to perform MRI examinations preoperatively to fully evaluate PAAG migration. Under the guidance of our classification system, the injected material could be effectively eradicated with an acceptable complication rate. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Injection mammaplasty Polyacrylamide gel migration Classification Treatment
Introduction As a nonbiodegradable soft-tissue filler, polyacrylamide gel (PAAG) was once used for esthetic breast augmentation in China [1, 2]. Since increasing complications were observed after PAAG injection, the procedure was legally banned for clinical application in 2006 [3, 4]. However, for patients w
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