Toyama Shota, Akiyama Goh, Ono Shimpei, Nukaga Sawako, Yokobori Shoji, Ogawa Rei
From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2025 May 8;13(5):e6798. doi: 10.1097/GOX.0000000000006798. eCollection 2025 May.
Aquafilling is a hydrophilic gel composed of 98% physiological saline and 2% polyacrylamide gel, introduced in Japan in 2015 for breast augmentation. Despite its initial popularity, it has been associated with severe complications, including delayed infections, abscess formation, material migration, and fibrosis. In 2019, the Japanese Society of Aesthetic Plastic Surgery banned its use for breast augmentation due to safety concerns. However, cases of late-onset complications continue to emerge. Here, we report a case of sepsis caused by an abscess at the injection site 6 years after Aquafilling injection. A 34-year-old woman with a history of methamphetamine addiction underwent breast augmentation with Aquafilling. Six years later, she developed erythema, swelling, and fever, leading to sepsis. Contrast-enhanced computed tomography revealed abscess formation at the injection site. Surgical drainage and debridement were performed, and antibiotic therapy was tailored based on culture results. Postoperative management included intensive care unit care, repeated debridement, and wound closure with a split-thickness skin graft. The patient was discharged 55 days after admission. This case highlights the significant risks associated with nonabsorbable fillers, particularly delayed infections and their severe consequences. A review of the literature reveals numerous reports of similar complications worldwide, necessitating surgical intervention in most cases. To prevent such outcomes, rigorous safety evaluations and monitoring systems led by professional societies and governments are essential. Furthermore, a safety network for treating patients with late-onset complications must be established to ensure timely and effective care.
水凝胶填充剂是一种亲水性凝胶，由98%的生理盐水和2%的聚丙烯酰胺凝胶组成，于2015年在日本推出用于隆胸。尽管它最初很受欢迎，但它已与严重并发症相关联，包括延迟感染、脓肿形成、材料迁移和纤维化。2019年，由于安全问题，日本美容整形外科学会禁止将其用于隆胸。然而，迟发性并发症的病例仍不断出现。在此，我们报告一例水凝胶填充剂注射6年后注射部位脓肿导致败血症的病例。一名有甲基苯丙胺成瘾史的34岁女性接受了水凝胶填充剂隆胸。六年后，她出现红斑、肿胀和发热，导致败血症。增强计算机断层扫描显示注射部位有脓肿形成。进行了手术引流和清创，并根据培养结果调整了抗生素治疗。术后管理包括重症监护病房护理、反复清创以及用中厚皮片进行伤口闭合。患者入院55天后出院。该病例凸显了与不可吸收填充剂相关的重大风险，尤其是延迟感染及其严重后果。文献回顾显示，全球有大量关于类似并发症的报告，大多数情况下需要手术干预。为防止此类结果，由专业协会和政府牵头进行严格的安全评估和监测系统至关重要。此外，必须建立一个治疗迟发性并发症患者的安全网络，以确保及时有效的护理。
