Patlazhan G. Surgical treatment of complications after polyacrylamide gel injections into breast

During the period between 1999 and 2010 154 women with complications after polyacrylamide mammary syndrome (PAMS) were treated. The mean age was 35,87 ± 0,56 years. The consequences of the polyacrylamide gel (PAAG) injections were analyzed in the retrospective study while the treatment outcomes were studied in the prospective study using medical examination, mammary gland ultrasound imaging and study-specific questionnaires. All assessments were performed with the time intervals of 1, 3, 6, 12, 24 and 36 months postoperatively and statistically evaluated according to Kaplan-Mayer method. Control group included 71 patients, who underwent breast augmentation with silicon implants. Three years after the implant placement surgery outcomes turned out to be worse in the study group - the ratio of good, satisfactory and bad results were as follows - 60,4 : 32,3 : 7,3 compared to 79,7 : 16,9 : 3,4 in the control group (р=0,045). Moreover, in the study group 3 years postoperatively we evidenced significantly better outcomes in cases when breast implants were placed submuscularly as a second stage procedure (after the removal of gel and stopping inflammatory processes) and the use of implants covered with micro-polyurethane foam respectively comparing with subglandular implantation performed within one stage using textured implants. In patients diagnosed with PAMS surgical outcomes could be improved by means of pentoxifylline intravenous injections, which was shown to reduce the rate of capsular contracture. The rate in the group of PAAG patients with textured implants was reduced from 30,7% to 11.8%.