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Objective: To explore the relationship between mammaplasty and results after polyacrylamide hydrophilic gel (PAHG) removal from breast., Methods: From Feb. 2003 to Aug. 2009, 130 patients with bilateral breast augmentation by PAHG injection were treated. Preoperative ultrasound examination and MRI were performed to know the distribution of PAHG and infiltration at the surrounding tissue. According to the conditions after removal, the patients were received implant augmentation immediately, or at the second stage, or no implant., Results: The patients were followed up for 3 months at the most with a very satisfactory rate of 63.84% (83/120), a satisfactory rate of 31.53% (41/120) and a unsatisfactory rate of 4.63% (6/120). Slight capsular contracture (Baker I) occurred in 5 cases with 6 breasts in satisfactory group. All the patients in unsatisfactory groups who selected unsuitable implants by themselves were re-operated to take out the implants. 3 cases with much residue PAHG insisted to receive breast implants. Among them, 2 cases achieved acceptable results even the surface of the breasts were not smooth. No other complication happened., Conclusions: The breast reaugmentation after PAHG removal should be performed based on the deformity and condition of breast. Both cosmetic result and psychological relief could be obtained after mammaplasty.

Objective: To investigate the correction of secondary breast deformities after removement of injected polyacrylamide hydrophilic gel (PAHG)., Methods: From March 2003 to March 2008, 100 patients with bilateral breast augmentation with injected PAHG underwent operation to remove the PAHG. The age of patients ranged from 35 to 50 years. Ultrasound and MRI were performed before operation to show the distribution of PAHG and the muscle infiltration around the PAHG. According to the PAHG distribution, muscle infiltration, skin elasticity, infection and PAHG residue, the patients were treated respectively with breast implants at the same stage or at the second stage, or without implants., Results: The patients were followed up for 3 months to 3 years. The percentage of satisfactory, median satisfactory and dissatisfactory was 90%, 9%, and 1%. In the median satisfactory group, 3 breasts in 3 cases showed slight capsular contracture (Baker II), 8 implants in 6 cases were palpable on the lower pole of the breasts. The middle-aged patient in dissatisfactory group was not satisfied with the high-projected implants shape which were chosen by herself and placed at the second stage. Then implants were removed. There was no complication of implant hernia, infection, wound disruption, or asymmetry., Conclusions: The secondary breast deformities could be corrected by breast augmentation with implants. Both breast appearance and the psychological affection can be improved.

Objective: To discuss the complications of breast augmentation with injected polyacrylamide hydrophilic gel (PAHG) in order to avoid further injury by taking treatment at the right moment., Methods: 90 patients with some side-effects after breast augmentation with injected polyacrylamide hydrophilic gel had been undergone the treatment in our hospital from 1999 to 2006. Their clinical data were analyzed., Results: The major complaints of the patients were feeling pain, multiple indurations, secondary deformity, PAHG displacement, low-grade fever of unknown reason, limitation of upper limb activity, spillage of milk and blood, ulceration and sinus tract of breast, inversion of nipple, infection. All patients were treated by surgical operations to remove the injected PAHG., Conclusions: The complications are might not only related to the injected material but also caused by incorrect manipulation during operation. To do suction several times may cause the injected material distributed diffusely and the tissue was badly injured. Operation can remove the PAHG as completely as possible. It is a better treatment for the complications of PAHG injection for augmentation mammaplasty.

Objective: To analyze the clinical manifestations and explore suitable treatments for the complications induced by polyacrylamide hydrogel(PAHG) injection for augmentation mammoplasty., Methods: The symptoms, physical signs and treatments of the 118 cases were analyzed and summarized., Results: The complications included in nodule formation (54.2%), pain (33.9%), PAHG migration (7.6%) and acute mastitis in lactation (4.3%). Satisfactory clinical treatment results have been obtained after suitable treatments., Conclusions: The complications induced by PAHG injection for augmentation mammoplasty have increased following its widely use, the re-evaluation for this technique should be made, and more effective treatment should be considered.

Objective: To analyze ultrasonographic features for the complications of breast augmentation with polyamide hydrogel injection., Methods: Clinical study was made for 101 patients who had received the polyamide hydrogel injection for augmentation mammoplasty by using the ultrasonographic examination., Results: The 195 treated breasts in 98 patients suffered from injectable layer disorder, 1 breast for hematoma, 7 breasts in 5 patients for abscess (infection), 2 breasts in 2 patients for cancer and 3 breasts in 3 patients for fibroadenomas., Conclusions: Ultrasonography may be of great diagnostic value for the complications of breast augmentation with polyamide hydrogel injection.

Objective: To search for the perfect therapy for the complications of breast augmentation by injecting polyacrylamide hydrogel., Methods: 15 patients whose complications were severe after hydrogel injection were included in this study. Open suction and irrigation of cavity were performed in all patients and all received immediately dual-plane augmentation mammaplasty with silicon gel prostheses., Results: 12 patient were followed up for 3 months to 1 year (mean 6.8 months) and no malposition or deformation occurred. 10 patients (20 breasts) had satisfactory results. The edges of the implant shell could be felt in 2 patients (3 breasts). 1 patient (1 breast) with breast firmness ranked Baker II ., Conclusions: The dual-plane breast augmentation is a valuable technique to treat the complications of polyacrylamide hydrogel injection.

Objective: To inquire into the reason why the postoperative complications of augmentation mammaplasty by injecting polyacrylamide hydrogel took place and to find the best method to deal with the complications., Methods: 12 patients who accepted polyacrylamide hydrogel injection for augmentation mammaplasty were included in this study. Operations were performed to remove the polyacrylamide hydrogel., Results: All patients didn't argue with the result, but the outside shape of mamma was not good post-operation., Conclusions: So-called standard injection method can't avoid the postoperative complications. The considerable therapy for the complications of polyacrylamide hydrogel was removing it by operation.

Objective: To analyze the complications induced by polyacrylamide hydrogel injection for augmentation mammaplasty, explore the reason of the complication., Methods: Twenty three patients with complications after polyacrylamide hydrogel injection were classified by signs and symptoms, ultrasound and pathologic examinations were made., Results: The main complications were pain, hard nodule, asymmetry and breast deformation. The injected material was distributed diffusely behind gland, in gland, in muscles subcutaneous, even out of breast, caused some pathologic changes and it's hard to be cleaned completely from normal tissue., Conclusions: The complications were caused mainly by incorrect manipulation during operation, others might be relative to the injected material. The reliability of this injection method for augmentation should be cautiously observed.

Objective: To investigate the clinical and histological features of the complications after hydrophilic polyacrylamide gel injection., Methods: Fifty-two patients were included in this study, who had undergone hydrophilic polyacrylamide gel injection in other units from 1998 to 2003 and later came to our department for removal of the injected gel. The tissue samples taken from each cyst were sectioned and stained with hematoxylin and eosin. The sections were investigated and analyzed under light microcopy. The tissue sections of 12 patients who had ever received liquid silicone injection from 1988 to 1994 were used as the control group. The difference in histological features was assessed., Results: The inflammatory reaction of the hydrophilic polyacrylamide gel was characterized by an increased number of foreign-body giant cells. The mild lymphocyte infiltration was shown in the slides of hydrophilic polyacrylamide gel. On the contrary, there were much more clusters or lymphocyte infiltration in the slides of liquid silicone. The differences between the hydrophilic polyacrylamide gel and liquid silicone were significant in terms of thickness of the fibrous capsule., Conclusions: The security of hydrophilic polyacrylamide gel injection for soft tissue augmentation is in doubt.

Objective: To observe the immunologic changes in patients who have complications after polyacrylamide hydrogel (HPG) injection., Methods: To compare the patients in the HPG injection group and the control group, the expressions of immunoglobulin IgG, IgM, IgA and complement C3, C4 of serum were measured by immunoturbidimetry., Results: The expressions of IgG and C3 in the injection group were lower than the control group with extremely significant difference (P < 0.01). The expressions of IgM were higher than the control group with significant difference (P < 0.05). The expression of IgA and C4 had no significant differences between the two groups. The immunologic changes had no relation to the injection doses., Conclusions: Clinical application of HPG as a soft tissue filling material may cause foreign-body rejection reaction. The long-term immunologic effect of HPG needs further observation in more cases.

Objective: To evaluate the possible side-effects after injecting hydrophilic polyacrylamide gel for augmentation of the soft-tissue., Methods: Fifteen patients with some side-effects after injecting the hydrophilic polyacrylamide gel had been undergoing for the treatment in our unit from 2000 to 2001. Their symptoms were analyzed and the specimen of the tissue was also removed for pathologic examination., Results: The major complaints of the patients after injecting hydrophilic polyacrylamide gel were feeling pain(60.00%), uncomfortable (13.33%), no cosmetic improvement results (33.33%), secondary deformity (20.00%), long-lasting swelling (6.67%), and nodules (80.00%). The pathologic examination was showing the capsule formation (53.33%), macrophagocyte infiltration (60.00%) and granuloma producing (20.00%)., Conclusion: Clinical application of the hydrophilic polyacrylamide gel may result in some serious side-effects. It should be cautious to the physicians who may apply the product for clinic use.

Objective: To investigate the causes of complications of polyacrylamide hydrogel injection for facial plasty and reliable treatments., Methods: Eight patients were included in the study. Some of them were examined by MRI. All the patients received surgical treatments., Results: The injected polyacrylamide hydrogel was found in the superficial layer of the superficial temporal fasica, the loose connective tissue below the deep temporal fascia, the subcutaneous tissue or the orbicularis muscle. Polyacrylamide hydrogel injected into the superficial layer of the superficial temporal fascia could spread to the face along the SMAS. Polyacrylamide hydrogel injected into the loose connective tissue below the deep temporal fascia could spread down to the cheek. The patients' symptoms were relieved with the operation. Satisfactory results were obtained., Conclusion: Polyacrylamide hydrogel injection does not adapt to facial plasty. The reliability of polyacrylamide hydrogel injection for facial plasty is in doubt.

Objective: To search for a simple and non-invasive method to assist the treatment of the complications of breast augmentation with polyacrylamide hydrogel injection., Methods: High-frequency ultrasound was used to examine the breast and observe the distributions of the injected polyacrylamide hydrogel. The operation procedure was predetermined according to the ultrasound information. The ultrasound results were compared with what was seen during the operation., Results: 40 patients (80 breasts) were examined. The ultrasound results were coincident with the outcomes of surgery. The results of postoperative follow-up were coincident with the predicted., Conclusion: Ultrasound is an accurate method for examining the augmented breast with polyacrylamide hydrogel injection. It is helpful in predetermining the operation procedure, predicting postoperative results.

Objective: To explore the reasons for the complications of polyacrylamide hydrogel injection., Methods: 39 patients were included in this study, who had complications after polyacrylamide hydrogel injection in the breasts, nose, temproal area or depressed locus. The clinical manifestations of the complications were analyzed., Results: Postoperative infection occurred in 5 cases, induration in 23, pain in 25, ulceration of the puncture points in 9, displacement in 6, galactostasis in 1, skin necrosis in 1, breast deformation in 3, bilateral asymmetry in 4, aseptic inflammation in 10, and skin-acne-like changes on the face in 4., Conclusion: Some complications were caused mainly by incorrect manipulation and others were relative to the injected material. The applications of polyacrylamide hydrogel as a clinical implant material need further investigations. Polyacrylamide hydrogel injection should be cautiously used.

Objective: To investigate the complications in 16 patients who had breast augmentation with polyacrylamide hydrogel injection. The distribution and late changes of the injected material was observed., Methods: The physical signs and symptoms of the 16 patients were classified. Ultrasound and infrared examinations or MRI were used in some cases., Results: Two patients had operations for extraction. The injection material was distributed in the muscles diffusely, or existed in the breast and subcutaneous tissue as many masses., Conclusion: The reliability of this injection method for breast augmentation is in doubt.