Challenging Gluteal Augmentation Due to Late Complication of Permanent Filler: Case Report and Literature Review

Abstract

Polyacrylamide hydrogel (PAAG) has been used for more than two decades as a permanent injectable for facial and soft tissue augmentation. With the advent of so-called "minimally invasive" techniques, permanent injectables became popular with both patients and physicians. However, several late complications have been reported worldwide.Here, we present a 43-year-old female patient who experienced late complications 8 years after buttock augmentation with PAAG injections with a difficult reconstruction of the gluteal region.We also reviewed the literature on clinical management issues and available reconstructive options for this problem. The search in the clinical key using the term polyacrylamide hydrogel yielded 169 results in various fields of medicine, limiting the search in plastic surgery yielded 67 results, 14 in facial rejuvenation, 9 in breast augmentation, 7 in buttock augmentation, 2 literatures on the use of u/s in the diagnosis of PAAG complications, and 35 literatures on the composition, histologic analysis, and general complications from the use of PAAG.Searching for the term gluteal augmentation after excluding augmentation modalities other than PAAG ends at 7 literatures, however, the total number of these clinical reports on complications of PAAG use for buttock augmentation is striking, accounting for more than 50% of the studies.All literatures conclude that the PAAG filler is easy to inject, but once complications occur, they are difficult to manage.