In the past, biomaterials have been utilized for volumetric augmentation in many parts of the human body. In aesthetic surgery, it is not rare to observe complications related to the inappropriate use of these materials. Formacryl®, an injectable hydrophilic gel of polyacrylamide, was proposed as the ideal material for volumetric modeling and improvement and even for augmentation mammoplasty. As is frequent with injectable substances, this gel was supposed to be fully biocompatible without complications. It was withdrawn from the market and its use was forbidden because of the early and later complications that appeared after implantation. The present case report describes the complications and the subsequent reconstruction of a patient who presented to us after an augmentation mammoplasty performed with Formacryl® (polyacrilamide) in Bulgaria 10 years before. Over time the patient developed bilateral granulomatosis with severe symptoms consisting of constant and sensitivity. Instrumental analysis (MRI; ECO) showed a significant and uneven distribution of the polyacrilamide not only within the breast parenchyma but also in the subdermal layer, the axillae, and in the pectoralis major intramuscularly. We surgically debrided the polyacrilamide in three stages due to the difficulty in removing all of the polyacrilamide gel followed by reconstruction of the breasts. In a follow-up after 4 years since the original surgery, the clinical picture has significantly improved, along with an aesthetic result that is satisfactory.
European Journal of Plastic Surgery – Springer Journals
Published: Oct 1, 2010
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