Clinical Research Of Removing Polyacrylamide Hydrogel From Breast And Reconstructing The Breast At One Stage

Objective: To explore the method and feasibility of removing the injected polyacrylamide hydrogel(PAHG) from the breast and reconstructing the breast at one stage.Methods:19 women who had undergone injection of PAHG for breast augmentation in other hospitals and clinics were admitted to our hospital from November 2013 to January 2016. All patients were scanned before the operation by magnetic resonance imaging(MRI) to ascertain the distribution of PAHG and the integrity of the fibrous capsule. An inframammary incision was made on each breast, followed by dissection to the surface of the capsule. The capsule was dissected away as completely as possible and the free PAHG was removed from the breast. Irrigating the cavity with a large volume of saline, then implanting a suitable silicone prosthesis under the gland. Some patients with mild or moderate breast ptosis after prosthesis implantation required breast lifting.Results:Of the 19 patients, 10 patients with breast ptosis after gel removing were underwent bilateral breast lifting. One patient did not receive the silicon prosthesis after gel removing, and 18 patients underwent implant-based breast reconstructions after removing the injections. All of the patients were satisfied with the surgical results, except for one patient who’s left breast occurred recurrent infections and subcutaneous seroma that did not responde to conservative treatment, we had to take out the implantation from her left breast at last. Preoperative symptoms such as breast lumps, deformity, ptosis, and gel migration were modified and disappeared, the appearance and size of the breast was satisfactory.Conclusion : The complications of polyacrylamide hydrogel injection for breast augmentation mammaplasty were various and complex. We choose the patients without breast infections, and those the MRI shows the PAHG has intact fibrous capsule to surgery. Inframammary incisions were made in all of the patients, reconstructing the breast with silicone prosthesis or breast lifting after the gel removing at one stage was accessible and showed favorable effects. Redesign the position of the new inframammary fold and nipple is benefit to use the expander to calculate the required size of the prosthesis accurately and is the key to reconstruction the breast.