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Imaging findings of breast augmentation with injected hydrophilic polyacrylamide gel: Patient reports and literature review
Authors:Najoua Ben Khedher  Julie David  Isabelle Trop  Suzanne Drouin  Laurence Peloquin  Lucie Lalonde
Institution:a Centre d’Investigation et de Recherche Diagnostique des maladies du sein (CRID), Centre hospitalier de l’Université de Montréal, Hôtel-Dieu, 3840 rue Saint-Urbain, Montréal (Québec), Canada H2W 1T8
b Clinique Radiologique Léger et associées, 1851 rue Sherbrooke Est, Bureau 201, Montréal (Québec), Canada H2K 4L5
Abstract:Hydrophilic polyacrylamide gel (PAAG) is a nonresorbable soft tissue filler that has been used as implant material for breast augmentation in some countries, particularly from the Asian continent. Many complications associated with hydrogel use have been reported in the clinical literature including inflammation, persistent mastodynia, formation of multiple lumps, poor cosmetic results, glandular atrophy, and significant spread of hydrogel into the surrounding tissue. Data on long-term toxicity is currently unavailable.The radiologic features of PAAG injection mammoplasty frequently constitute a diagnostic challenge for radiologists. Indeed, the imaging appearances of uncomplicated PAAG implants may mimic conventional implants on mammography, sonography and MRI, with some distinguishing features. The location and local spread of the injected PAAG, and the eventual detection of local inflammation, are best evaluated by ultrasonography and especially MRI, considered the most sensitive technique for assessment of PAAG mammoplasty. MRI clearly depicts the volume and the distribution of gel within the breast; contrast medium enhancement allows delineation of areas of inflammation and infection. It is important to be familiar with the spectrum of imaging findings in order to make an accurate diagnosis and offer proper management.This paper aims to review the normal and abnormal mammographic, sonographic, and MR imaging characteristics of PAAG augmentation mammoplasty through presented patient reviews of three women having undergone direct PAAG injection.
Keywords:Breast augmentation  Polyacrylamide hydrogel  Complication  Breast MRI  Breast sonography  Mammography
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