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09.11.2017 | Original Article | Ausgabe 2/2018

Aesthetic Plastic Surgery 2/2018

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

Aesthetic Plastic Surgery > Ausgabe 2/2018
Rui Jin, Xusong Luo, Xiaoke Wang, Jie Ma, Fei Liu, Qun Yang, Jun Yang, Xi Wang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00266-017-1006-9) contains supplementary material, which is available to authorized users.
Rui Jin and Xusong Luo contributed equally to this work.


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.
Level of Evidence IV 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.

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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)
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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