Fan Zhang1, Xiaojie Wang1, Hailing Guo2. 1. Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China. 2. Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China. guohailinpumch@163.com.
Abstract
BACKGROUND: Polyacrylamide hydrogel (PAAG) was once used as an important injection for breast augmentation though it has been banned in China for more than 10 years. Secondary breast deformity after removing PAAG poses a challenging problem. The aim of this article is to introduce types of breast deformity induced by two types of PAAG based on MRI examination and corresponding treatment strategies. METHODS: From 2008 to 2017, 300 patients with the history of injectable PAAG were reviewed. From their medical history, two types of PAAG injections were imported Interfall and domestic Amazingel, 182 patients received Interfall injection and 118 patients received Amazingel injection. MRI was used as a regular examination preoperatively. According to MRI examinations, breast deformities were classified into nodular type, flow type and mixed type. RESULTS: All of them underwent PAAG removal operations. In the 182 patients with Interfall injection: There were only 5 cases of nodular type, 3 cases received immediate breast augmentation and 2 cases received second-stage breast augmentation, and none of cases received breast augmentation; there were 170 cases of flow type, 165 cases received immediate breast augmentation and 5 cases received second-stage breast augmentation, and none of cases received breast augmentation; there were 7 cases of mixed type, 5 cases received immediate breast augmentation, 1 case received second-stage breast augmentation and 1 case did not receive breast augmentation; in the 118 patients with Amazingel injection: There were 111 cases of nodular type, 20 cases received immediate breast augmentation, 51 cases received second-stage breast augmentation and 40 cases did not receive breast augmentation; there were 4 cases of flow type, 2 cases received immediate breast augmentation, 1 case received second-stage breast augmentation and 1 case did not receive breast augmentation; there were 2 cases of mixed type, 1 case received second-stage breast augmentation and 1 case did not receive breast augmentation, and none of cases received immediate breast augmentation . CONCLUSIONS: Breast deformity induced by two types of PAAG can be classified into three types based on MRI examinations, which is very critical for preoperative evaluation and classification. Each type of deformity has its own characteristics, which serves as a guide for whether a first-stage or a second-stage prosthesis implant can be implemented. The proportion of patients who can have breast augmentation in the first or second phase after injection of Interfall is significantly higher than that of patients who have injections of Amazingel. 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.
BACKGROUND: Polyacrylamide hydrogel (PAAG) was once used as an important injection for breast augmentation though it has been banned in China for more than 10 years. Secondary breast deformity after removing PAAG poses a challenging problem. The aim of this article is to introduce types of breast deformity induced by two types of PAAG based on MRI examination and corresponding treatment strategies. METHODS: From 2008 to 2017, 300 patients with the history of injectable PAAG were reviewed. From their medical history, two types of PAAG injections were imported Interfall and domestic Amazingel, 182 patients received Interfall injection and 118 patients received Amazingel injection. MRI was used as a regular examination preoperatively. According to MRI examinations, breast deformities were classified into nodular type, flow type and mixed type. RESULTS: All of them underwent PAAG removal operations. In the 182 patients with Interfall injection: There were only 5 cases of nodular type, 3 cases received immediate breast augmentation and 2 cases received second-stage breast augmentation, and none of cases received breast augmentation; there were 170 cases of flow type, 165 cases received immediate breast augmentation and 5 cases received second-stage breast augmentation, and none of cases received breast augmentation; there were 7 cases of mixed type, 5 cases received immediate breast augmentation, 1 case received second-stage breast augmentation and 1 case did not receive breast augmentation; in the 118 patients with Amazingel injection: There were 111 cases of nodular type, 20 cases received immediate breast augmentation, 51 cases received second-stage breast augmentation and 40 cases did not receive breast augmentation; there were 4 cases of flow type, 2 cases received immediate breast augmentation, 1 case received second-stage breast augmentation and 1 case did not receive breast augmentation; there were 2 cases of mixed type, 1 case received second-stage breast augmentation and 1 case did not receive breast augmentation, and none of cases received immediate breast augmentation . CONCLUSIONS: Breast deformity induced by two types of PAAG can be classified into three types based on MRI examinations, which is very critical for preoperative evaluation and classification. Each type of deformity has its own characteristics, which serves as a guide for whether a first-stage or a second-stage prosthesis implant can be implemented. The proportion of patients who can have breast augmentation in the first or second phase after injection of Interfall is significantly higher than that of patients who have injections of Amazingel. 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.
Entities:
Keywords:
Amazingel; Breast deformity; Interfall; PAAG