Lumboabdominal migration of injected polyacrylamide hydrogel following breast augmentation: a case report and literature review

BACKGROUND: Polyacrylamide hydrogel (PAAG) injection has been used for breast augmentation, enjoying popularity for nearly 20 years in the late 20(th) century. However, numerous complications were gradually observed in the years following the injection, including breast lumps, inflammation, firmness, and migration. Distant migration of breast fillers is relatively rare. CASE DESCRIPTION: This case report describes the treatment of a patient who experienced complications due to distant migration of fillers after PAAG injection for breast augmentation. The patient had a right-sided lumboabdominal mass measured approximately 35 cm × 20 cm, with asymmetrical breasts and a significantly smaller right-side breast compared to the left-side. The patient underwent surgery to extract the breast augmentation material from the lumboabdominal wall and breasts, followed by a robot-assisted excision of the lumboabdominal wall capsule and removal of residual breast augmentation agent in breasts, and immediate prosthetic breast reconstruction. Postoperative abdominal scarring was strategically concealed in an area that can be covered by pants, and the breast incisions were hidden under the axillary regions. The patient was satisfied with the abdominal scarring and reconstructed breasts. CONCLUSIONS: Robot-assisted excision of the lumboabdominal wall capsule is a feasible technique for extensive migration of breast fillers in the future. Further follow-up is needed to determine the long-term effects.