Complications and management of breast augmentation using two different types of fillers: a case series

Abstract

An advantage of breast augmentation with injectable fillers is that the desired size can be determined and achieved under local anesthesia with a short recovery time. However, a high complication rate is a critical disadvantage. Some fillers are challenging to remove, resulting in breast deformity and scarring. Five patients who underwent surgery to manage a foreign body in the breasts in 2021 were enrolled in this study. Two had copolyamide filler injections, while the other three had polyacrylamide hydrogel filler injections. A physical examination was performed, and preoperative and intraoperative photographs were obtained. Two patients underwent subcutaneous mastectomy because most of the filler had infiltrated into the normal breast tissue. In contrast, the other patients underwent filler removal and debridement because most of the filler had remained separate from the normal breast tissue. All patients who had a subcutaneous mastectomy and one who underwent only filler removal underwent immediate breast reconstruction with cohesive gel implants. The other patients rejected immediate reconstruction, and only filler removal was performed. All patients recovered without complications. We propose an algorithm for diagnosis and treatment based on our cases, which we hope can help clinicians manage the complications of filler injections for breast augmentation.

Distant migration of copolyamide breast filler following mammography: a case report

“…Various complications associated with the use of copolyamide fillers have been increasingly reported across numerous countries. These complications include induration, masses, pain, firmness, contour irregularities, migration, and mastitis [4][5][6][7][8]. Notably, such issues do not typically present in the early stages following injection but often emerge later, complicating their management.…”

“…However, safety concerns have arisen due to reported complications associated with copolyamide fillers, including induration, masses, mastalgia (breast pain), firmness, asymmetry, migration, infection, and dimpling, which are attributed to the copolyamide component [4][5][6][7][8]. Consequently, the Korean Academic Association of Aesthetic and Reconstructive Breast Surgery has recommended against the use of copolyamide fillers for breast augmentation until their long-term safety can be established [2].…”

Breast filler granuloma mistaken for implant rupture: A case report

“…Based on this, Choi et al proposed a diagnostic algorithm. [24] MRI is recommended as the primary diagnostic tool in this algorithm, and immediate reconstruction is possible if the preexisting capsule is healthy; however, it is based on careful judgment of the surgeon. In our patient case, there were no abnormal laboratory findings, and a healthy capsule was identified; therefore, we immediately performed reconstruction using silicone implants.…”