Department of Plastic and Reconstructive Surgery, Fatemeh Zahra Hospital, Iran University of Medical Sciences, Street No. 21, Seyed Jamaladin Asad-Abadi Avenue, Tehran, Iran.
Aesthetic Plast Surg. 2010 Aug;34(4):413-22. doi: 10.1007/s00266-009-9359-3. Epub 2009 May 19.
Polyacrylamide hydrogel, considered a safe and biocompatible soft tissue filler, is widely used in cosmetic procedures. Its use for facial contouring and breast augmentation in Iran has increased dramatically in recent years. Most patients and many doctors are unaware of possible and reported adverse effects related to its administration.
This study enrolled 98 patients experiencing unsatisfactory results and complications of polyacrylamide hydrogel. Adverse effects related to gel administration were documented for all the patients. Lab values were requested together with related medical care and surgical treatments, and gel was extracted by incision, milking, and irrigation.
The most common findings at the time of presentation were inflammation (n = 51), asymmetry (n = 31), irregularity (n = 18), infection and abscess formation (n = 11), and gel migration (n = 8). In one patient, severe anaphylactoid reaction was observed 1 week after gel injection, which led to significant complications for the patient. Histologic findings showed granuloma formation (n = 17), fat necrosis (n = 9), and fibrosis (n = 17). Macroscopic gel-related complications resolved after extraction of the injected material, except for skin necrosis and hyperpigmentation, which remained unchanged. For eight patients, the gel could not be extracted by squeezing and irrigation entirely. Three patients experienced gel reaccumulation after seemingly complete removal of the gel.
A wide range of complications seen among our patients showed that polyacrylamide hydrogel may not be as safe and biocompatible as it was thought previously. Both patients and physicians must be aware of the potential side effects of polyacrylamide hydrogel before gel administration.
聚丙稀酰胺水凝胶，被认为是一种安全且生物相容的软组织填充剂，被广泛应用于美容手术。近年来，在伊朗，其用于面部轮廓塑造和隆胸的使用量急剧增加。大多数患者和许多医生都不知道与注射相关的可能和已报告的不良反应。
本研究纳入了 98 名经历聚丙稀酰胺水凝胶治疗效果不佳和并发症的患者。所有患者的凝胶注射相关不良反应均有记录。要求进行实验室检查并提供相关医疗和手术治疗，通过切开、挤奶和冲洗提取凝胶。
就诊时最常见的表现为炎症（n = 51）、不对称（n = 31）、不规则（n = 18）、感染和脓肿形成（n = 11）和凝胶迁移（n = 8）。1 例患者在注射凝胶后 1 周出现严重类过敏反应，导致患者出现严重并发症。组织学检查发现肉芽肿形成（n = 17）、脂肪坏死（n = 9）和纤维化（n = 17）。除皮肤坏死和色素沉着外，注射材料取出后，与肉眼可见凝胶相关的并发症均得到解决，这些皮肤病变仍未改变。对于 8 名患者，无法通过挤压和冲洗完全提取凝胶。3 名患者在看似完全清除凝胶后出现凝胶再积聚。
我们的患者中出现的各种并发症表明，聚丙稀酰胺水凝胶可能不像以前认为的那样安全且生物相容。在注射凝胶之前，患者和医生都必须了解聚丙稀酰胺水凝胶的潜在副作用。
