Complications and Management of Injectable Breast Augmentation

Injectable breast augmentation using polymeric fillers such as polyacrylamide hydrogel and copolyamide-based gels has been linked to a broad spectrum of adverse events. Early reactions often manifest as pain, swelling, infection and foreign-body granulomas, while delayed presentations may occur years or even decades after injection, featuring gel migration, chronic inflammation, seroma or galactocele formation and tissue necrosis. Histopathological studies highlight the persistence of low-molecular-weight degradation products that provoke ongoing inflammatory responses and complicate radiological assessment. Management requires a combination of detailed imaging, immunological evaluation and surgical intervention. Removal of residual filler by incision, irrigation and drainage remains the cornerstone of treatment, with immediate or delayed reconstruction tailored according to patient risk factors, extent of tissue damage and aesthetic goals. Delayed reconstruction has been shown to reduce early complication rates while preserving patient satisfaction, underscoring the need for individualised, multidisciplinary care pathways and long-term surveillance to mitigate potential neoplastic progression or functional impairments.

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Complications and Management of Injectable Breast Augmentation publication trend

The graph below shows the total number of articles in complications and management of injectable breast augmentation across all publications each year (not limited to Nature Index journals).

Technical terms

Polyacrylamide hydrogel: A synthetic polymeric filler formerly used for mammary augmentation, prone to long-term persistence and toxic degradation.

Aquafilling: A hydrophilic gel composed of copolyamide used in non-surgical breast augmentation, associated with inflammatory and migratory complications.

Chronic inflammation: Prolonged immune response characterised by sustained infiltration of macrophages and lymphocytes.

Seroma: Accumulation of serous fluid within tissue spaces following filler injection or surgical intervention.

Baker grade: A classification system for capsular contracture severity around breast implants, ranging from I (soft) to IV (hard and painful).

References

1. Long-Term Biodegradation of Polyacrylamide Gel Residues in Mammary Glands: Physico-Chemical Analysis, Chromatographic Detection, and Implications for Chronic Inflammation. Molecules (2024).
2. Injection of Aquafilling® for Breast Augmentation Causes Inflammatory Responses Independent of Visible Symptoms. Aesthetic Plastic Surgery (2020).
3. Complication after Aquafilling® gel-mediated augmentation mammoplasty—galactocele formation in a lactating woman: a case report and review of literature. European Journal of Plastic Surgery (2021).
4. Evaluating the safety, efficacy, and risk factors of different strategies for breast reconstruction following polyacrylamide hydrogel removal: A 20-year retrospective cohort study of 436 cases. Asian Journal of Surgery (2024).