Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Plastic Surgery, SMG-SNU Boramae Medical Center, Seoul, 07061, Korea.
Aesthetic Plast Surg. 2019 Feb;43(1):46-52. doi: 10.1007/s00266-018-1242-7. Epub 2018 Oct 4.
We describe the first case of a patient who received AQUAfilling gel (Biomedica, Prague, Czech Republic) after augmentation with Poly Implant Prothèse (PIP) breast implants and later developed breast deformity with bilateral implant rupture.
A 49-year-old Korean female patient who received breast augmentation with PIP implants 18 years ago and subsequent insertion of AQUAfilling gel 1 year ago visited our center with a chief complaint of pain and decreased implant sizes in both breasts. Breast implant and foreign body removal operation was performed for both breasts under general anesthesia. Intraoperative gross findings, pathologic findings, and tissue culture results were analyzed.
Our diagnosis included rupture of the implants in both breasts with leakage of injected material resulting in inflammation of the pericapsular area and pectoralis muscle. The intraoperative gross findings and results of the pathologic report showed that the implants were exposed with massive leakage of AQUAfilling gel in the pericapsular space, and the pectoralis major was mixed with AQUAfilling gel-like liquid and tissue with an inflammatory reaction.
Surgeons should be careful in performing AQUAfilling gel injection for breast augmentation, especially when combined with breast implant insertion. AQUAfilling gel itself is not yet proven safe in the long term, so more research on this topic is warranted. Additionally, surgeons should be aware of the comparatively high risk of implant rupture and foreign body reaction with PIP implants, and warn patients accordingly.
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我们描述了首例接受 AQUAfilling 凝胶（Biomedica，布拉格，捷克共和国）治疗的患者，该患者在接受 Poly Implant Prothèse（PIP）乳房植入物隆胸后出现乳房畸形，并伴有双侧植入物破裂。
一位 49 岁的韩国女性，18 年前接受了 PIP 乳房植入物隆胸，1 年前接受了 AQUAfilling 凝胶植入，因双侧乳房疼痛和植入物缩小来我院就诊。在全身麻醉下对双侧乳房进行了乳房植入物和异物取出手术。分析了术中大体所见、病理检查结果和组织培养结果。
我们的诊断包括双侧乳房植入物破裂，注射材料泄漏导致包膜下区域和胸大肌炎症。术中大体所见和病理报告结果显示，植入物暴露，包膜下空间大量 AQUAfilling 凝胶泄漏，胸大肌混合 AQUAfilling 凝胶样液体和有炎症反应的组织。
外科医生在进行乳房增大的 AQUAfilling 凝胶注射时应小心，尤其是与乳房植入物插入结合时。AQUAfilling 凝胶本身在长期内是否安全尚未得到证实，因此需要对此类话题进行更多的研究。此外，外科医生应该意识到 PIP 植入物破裂和异物反应的风险相对较高，并相应地告知患者。
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