Application of endoscopic technique in removal of breast prosthesis from mammary augmentation by polyacrylamide hydrogel injection:report of 45 cases

Objective To explore the effect of endoscopic technique in removing breast prosthesis from mammary augmentation by polyacrylamide hydrogel (PAHG) injection.Methods Forty-five patients underwent breast augmentation with PAHG injection 2 to 10 years ago.Of them 10 cases suffered with breast pain or upper limb dysfunction,5 with mastitis,3 with breast cancer,and 40 were found with breast mass or PAHG displacement by color ultrasound.Treatment of removing the breast prosthesis with endoscopic technique was performed for the 45 cases.Under general anesthesia,three 5-mm incisions were made at the axillary transverse striation,beyond the midaxillary line at nipple level and beyond the inferior lateral margin of the breast,respectively after liposuction and most PAHG was drawn out;then working space for endoscopic operation was made with gas insufflation method,and the residual PAHG was thoroughly cleaned out with endoscopic technique.When breast shrank markedly after PAHG was removed,breast reconstruction with implants was carried out.Results PAHG removing was smoothly performed in the 45 patients (87 cases),including endoscopic PHAG removing in 25 patients and endoscopic PAHG removing plus breast reconstruction with implants in 20 patients,of them one patient had concomitant mammary gland resection.The operation duration was 45-180 min,with mean of 102 min;the intra-operative bleeding volume was 20-90 ml,with mean of 43 ml.No complications such as bleeding,infection and seroma,were found in all patients.Re-examination with ultrasound within 1 to 3 months postoperatively showed no residual PAHG in 41 patients (91.1%).In the 20 patients with endoscopic PAHG removing plus breast reconstruction,17 patients were extremely satisfied and 3 patients were passably satisfied to the postoperative cosmetic results.Conclusion AHG removing with endoscopic technique following lipolysis and liposuction has good effect and provides a new way for patients with complications after breast augmentation with injection.