Late migration of copolyamide gel filler for breast augmention

Aqualift is a copolyamide gel filler first used in the Czech Republic for facial contouring, subsequently for breast augmentation. However there have been safety concerns over copolyamide fillers after multiple reports of mastalgia, mastitis, gel migration, inflammation, infection and nodule formation (1). We discuss a patient who presented with a late complication of Aqualift gel injection for breast augmentation. A 45 year old lady with a history of subpectoral breast filler injection with Aqualift 14 years prior presented with left sided breast tenderness, fluctuance with superior fullness and increase in size over 6 months. She suffered from hyperaesthesia over her left medial upper arm, limitation of movement of her arm and elbow flexion. MRI showed filler migration into her axilla, tracking down her arm along the neurovascular bundle. She underwent removal of the migrated filler via inframammary crease, axilla and medial arm incisions. Filler material was seen dissecting into her left pectoralis major muscle, extending to the subclavicular region, axilla and triceps muscle. Intraoperative cultures grew cutibacterium and histology was negative. Her symptoms resolved postoperatively and she regained full range of movement of her elbow and arm. Injectable fillers for breast augmentation were once a popular aesthetic procedure, offering a minimally invasive procedure with instant results. The long term sequelae that are still seen serve as a reminder of why breast filler injection has since fallen out of favour and is widely prohibited in most countries.

References
1. Nomoto S, Hirakawa K, Ogawa R. Safety of Copolyamide Filler Injection for Breast Augmentation. Plast Reconstr Surg Glob Open. 2021 Feb 17;9(2):e3296. doi: 10.1097/GOX.0000000000003296. PMID: 33680632; PMCID: PMC7929552.

Breast

PSTM 2024