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Classification and Management of Polyacrylamide Gel Migration After Injection Augmentation Mammaplasty: A Preliminary
Jinguang He1, Tao Wang2, Jiasheng Dong3
1Department 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.
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 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 .
