Kim Hyeon Jo, Lee Seong Joo, Lee Ju Ho, Shin Se Ho, Kim Seong Hwan, Kim Jae Hyun, Suh In Suck
Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2020 Aug 14;99(33):e21516. doi: 10.1097/MD.0000000000021516.
Breast filler injections are less commonly used due to their associated complications, such as pain and foreign body reactions. Yet, these fillers are often administered illegally, resulting in aesthetic or life-threatening complications. These are treated by removing the foreign material, and the breasts are reconstructed using silicone implants or autologous tissue/fat injection.
Case 1. A 45-year-old woman with polyacrylamide gel injections in both breasts visited our clinic for breast pain and tenderness. Grade I ptosis was observed in each breast, without skin necrosis and discoloration. Case 2. A 51-year-old woman, with unknown breast filler injections, visited our clinic for painful masses. Intraoperatively, massive amounts of foreign material had severely infiltrated the nearby tissues; thus, an immediate breast reconstruction could not be performed. Three months later, severe deformities including shrinkage and irregular breast skin surfaces were observed.
Case 1. Multiple cystic lesions, fluid collection in the retromammary spaces, and diffuse infiltration were observed on mammography, computed tomography, and ultrasonography. Case 2. Multiple cystic lesions, calcified areas, and diffuse infiltrations in the axillae and retromammary spaces were observed on mammography, computed tomography, and ultrasonography.
Case 1. The foreign material was removed and the breasts were reconstructed using silicone implants into subpectoral pocket with acellular dermal matrices (Alloderm, Lipocell Corporation). Case 2. A delayed reconstruction was undertaken using silicone implants covered by latissimus dorsi muscle flaps, 3 months after the foreign material removal.
Case 1. The foreign material was removed and there were no complications such as foreign body reaction, capsular contracture. Ptosis was corrected and both breasts were symmetric with proper projection. Case 2. Residual foreign material was removed and there were no complications such capsular contracture, implant malposition.
Massive injections of foreign materials into the breast can cause severe infiltration and associated foreign body reactions. By a near-complete removal of the foreign materials and breast reconstruction using silicone implants, we achieved satisfactory results, without complications such as wound disruption, capsular contracture, and implant malposition.
由于隆胸填充剂注射存在疼痛和异物反应等相关并发症，其使用不太普遍。然而，这些填充剂常常被非法使用，导致美学问题或危及生命的并发症。治疗方法是取出异物，然后使用硅胶植入物或自体组织/脂肪注射对乳房进行重建。
病例1。一名45岁女性，双侧乳房注射了聚丙烯酰胺凝胶，因乳房疼痛和压痛前来我院就诊。每侧乳房均观察到I级下垂，无皮肤坏死和变色。病例2。一名51岁女性，乳房注射填充剂情况不明，因乳房肿块疼痛前来我院就诊。术中发现大量异物严重浸润了附近组织，因此无法立即进行乳房重建。三个月后，观察到严重畸形，包括乳房萎缩和皮肤表面不规则。
病例1。乳房X线摄影、计算机断层扫描和超声检查显示多发囊性病变、乳腺后间隙积液和弥漫性浸润。病例2。乳房X线摄影、计算机断层扫描和超声检查显示多发囊性病变、钙化区域以及腋窝和乳腺后间隙的弥漫性浸润。
病例1。取出异物，将硅胶植入物置于胸大肌下间隙，并使用脱细胞真皮基质（Alloderm，Lipocell公司）对乳房进行重建。病例2。在取出异物3个月后，采用背阔肌肌皮瓣覆盖硅胶植入物进行延迟重建。
病例1。异物被取出，未出现异物反应、包膜挛缩等并发症。下垂得到纠正，双侧乳房对称且有适当的隆起。病例2。残留异物被取出，未出现包膜挛缩、植入物移位等并发症。
大量向乳房注射异物可导致严重浸润及相关异物反应。通过近乎完全取出异物并使用硅胶植入物进行乳房重建，我们取得了满意的效果，未出现伤口裂开、包膜挛缩和植入物移位等并发症。
