Extensive thoracoabdominal and pelvic soft-tissue abscesses approximately 10 years after breast Aquafilling injection: a case report

Polyamide hydrogel fillers, including Aquafilling, were previously used for breast augmentation but have since been associated with severe delayed complications. We describe the case of a 51-year-old woman who developed sepsis with marked hypotension and extensive thoracoabdominal and pelvic soft-tissue abscesses approximately 10 years after bilateral breast Aquafilling injection. Imaging showed widespread migrated filler-related fluid collections involving the chest wall, axillae, abdominal wall, and pelvic regions. Emergent incision and drainage, followed by staged debridement, led to clinical improvement and near-complete radiologic resolution before discharge. No recurrent infection was observed 9 months postoperatively. This case indicates that migrated polyamide hydrogel filler may remain a long-standing nidus for culture-negative infection approximately 10 years after injection. Prompt staged surgical source control should be considered when extensive filler-related abscesses are suspected.