A case series study on complications after breast augmentation with Macrolane™.
BACKGROUND
The use of Macrolane™ seems to have several advantages compared to the other standard methods for breast augmentation: it is faster, less invasive, and requires only local anesthesia. Nevertheless, various complications associated with the use of Macrolane™ have been described, e.g., encapsulated lumps in breast tissue, infection, and parenchymal fibrosis. We report the results of our case series study on the clinical and imaging evaluations of patients who came to our attention after breast augmentation with Macrolane™ injection and evaluate the effect of this treatment on breast cancer screening procedures.


METHODS
Between September 2009 and July 2010, seven patients, treated elsewhere with intramammary Macrolane™ injection for cosmetic purposes, presented to our institution complaining of breast pain. In all patients, Macrolane™ had been injected under local anesthesia in the retromammary space through a surgical cannula.


RESULTS
On mammography, nodules appeared as gross lobulated radiopacities with polycyclic contours. On breast ultrasound, the nodules showed hypo-anaechogenic cystlike features. In all cases, image analysis by the radiologist was hindered by the presence of the implanted substance, which did not allow the complete inspection of the whole breast tissue.


CONCLUSIONS
From our experience, although safe in other areas, injection of Macrolane™ into breast tissue cannot be recommended at this time. Our study, along with other reports, supports the need to start a clinical trial on the use of injectable fillers in the breast to validate their safety and effectiveness.


METHODS
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Radiological Sciences Unit, Department of Surgery, Microsurgery and Medical and Surgical Specialties, University of Sassari, University Hospital Trust, Viale San Pietro 43, Sassari, 07100, SS, Italy.
M P
MP
Becchere
F
F
Farace
L
L
Dessena
Francesco
F
Marongiu
A
A
Bulla
L
L
Simbula
G B
GB
Meloni
C
C
Rubino
D000328:Adult; D019928:Breast Implantation / Q000009:adverse effects* / Q000379:methods*; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000494:pharmacology; D007279:Injections, Subcutaneous / Q000009:adverse effects; D008327:Mammography / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014463:Ultrasonography
D006820:Hyaluronic Acid