Fig 5 - available via license: Creative Commons Attribution-NonCommercial 4.0 International
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MRI image of a 40-year-old female who underwent breast augmentation with PAAG for 16 years. The marks in the image were PAAG, fibrotic capsule, and induration, respectively.
Source publication
Objective:
In this study, we investigated the feasibility and efficacy of immediate breast augmentation with autologous fat grafting after removal of polyacrylamide hydrogel (PAAG) and fibrotic capsule.
Methods:
A retrospective study was conducted on 162 female patients who underwent removal of breast filler PAAG and the fibrotic capsule which p...
Context in source publication
Context 1
... The average body mass index was 21.59 (range 16.92-28.83). Pain and all other symptoms belonged to the PAAG injection were the cause for the operation. The average time of postoperative follow-up was 17.6 months (6-30 months). All the patients were categorized into ASA Class I and Class II (Table 1). 146 patients (90.12%) complained about pain (Fig. 5). 16 patients (9.88%) had displacement of the injected material and distortion of the breast. 74 patients (45.68%) complained of induration and lumps in breast areas. Abnormal breast enlargement occurred in 23 patients (14.20%). Bilateral breast asymmetry was found in 89 patients (54.94%). Fifty-seven patients (35.19%) suffered from ...
Citations
... Six studies (20,22,25,30,35,42) (n= 510) recorded patient satisfaction after AFG over a 1-year follow-up period with an average of 92% satisfaction (range; 83.2-97.5%). Seven studies used questionnaires to assess patient satisfaction (22,25,26,30,33,42) with four using BREAST-Q questionnaire for this purpose, (26,30,35,42) one (35) ...
... Six studies (20,22,25,30,35,42) (n= 510) recorded patient satisfaction after AFG over a 1-year follow-up period with an average of 92% satisfaction (range; 83.2-97.5%). Seven studies used questionnaires to assess patient satisfaction (22,25,26,30,33,42) with four using BREAST-Q questionnaire for this purpose, (26,30,35,42) one (35) ...
Background:
Autologous fat grafting (AFG) is a breast augmentation method for treating volume and contour abnormalities. This systematic review aims to summarize complications, radiological safety, volume retention, and patient satisfaction associated with AFG.
Methods:
PubMed, EMBASE, Google Scholar, Cochrane CENTRAL, Wiley library, clinical key/Elsevier, and EBSCO databases were searched for relevant studies from Articles describing AFG for breast augmentation were selected based on predetermined inclusion and exclusion criteria. PRISMA guidelines were adhered to, and the study was registered on PROSPERO. The ROBINS-I assessment was used to assess the quality of studies and the risk of bias was measured using the ACROBAT-NRSI.
Results:
Total of 35 studies comprising 3757 women were included. The average follow-up duration was 24.5 months (range, 1-372 months). The overall complication rate was 27.8%, with fat necrosis making up 43.7% of all complications. Average fat volume injected was 300mls (range: 134-610ml) and average volume retention was 58% (range: 44-83%). Volume retention was greater with the supplementation of fat with plasma-rich-protein (PRP) and stromal vascular fractioning (SVF). The most common radiological changes were fat necrosis (9.4%) and calcification (1.2%). After follow-up of one year, patient satisfaction was on average 92% (range; 83.2-97.5%). The included studies were of good quality and consisted of a moderate risk of bias.
Conclusions:
AFG was associated with an overall complication rate of 27.8%, and additional supplementation of fat with PRP and SVF may improve graft survival. Despite poor volume retention being a persistent drawback patient satisfaction remains high.
Once a popular injectable filler, polyacrylamide hydrogel (PAAG) has been banned in China since 2006 due to its unclear safety and long-term complications. However, it is still being used worldwide because of its huge commercial profit, leading to emerging complications and an urgent need for standardized clinical management. This review aimed to assess the properties, safety, and complications of PAAG and treatment strategies for its removal.
