Management of complication after breast augmentation with methacrylate

• Different biomaterials have been used for breast augmentation, including paraffin, dimethilpolysiloxane (liquid silicon), polyacrylammyde hydrogel and hyaluronic acid.
• In many countries, unregulated manufactured materials are available for biomedical use.
• Permanent filler to the breast can lead to severe complications.
• Complete removal of permanent fillers is challenging and require open surgical procedure.
• Female patients who underwent permanent injection to the breast should avoid breast feeding.

IntroductionSeveral alloplastic biomaterials are available for injection to the breast, nevertheless not all of them are approved for biomedical use. Although in North America and Western Europe experience with synthetic biomaterials for breast augmentation is very limited, migratory streams might expose physicians worldwide to manage the related complications of these procedures. The aim of this study was to share with other surgeons the case of a patient presenting complications after breast augmentation with an unknown synthetic substance containing methacrylate.Presentation of caseA 33-years old Asian woman presented to our Institution with breast deformities, lumps and chest pain. The patient referred previous breast injection “with hospital fat” performed in China six years before. She was not aware about the details of the procedure, and language barriers limited communication. Clinical examination and ultrasounds revealed the irregular distribution of an unknown substance in both breasts. The material was surgically removed and replaced in the same session with polyurethane implants. Chemical analysis revealed the presence of methacrylate.DiscussionWith a growing demand for non-invasive cosmetic surgery, has been reported a growing population of untrained and unlicensed personnel performing cosmetic surgery in many countries where there are no laws that restrict the use of cosmetic procedures to physicians with appropriate training and with approved materials. Surgical removal of this substances can be extremely challenging and an open procedure with surgical debridement is recommended.ConclusionBreast augmentation with non-absorbable biomaterials can lead to severe complications, in particular for patients intending to breastfeed.