MedClinic > Blog > Plastic > Removal of polyacrylamide gel (PAAG)

Removal of polyacrylamide gel (PAAG)

Unfortunately, there are plastic surgeries not only to improve your appearance and give a harmonious look to your body but also to correct the mistakes of outdated methods, which can lead to frightening results and cause irreversible harm to the body in the form of complications.

The only possible drawback with breast augmentation with implants is the small scars that remain after surgery. In the last century, the scars after some operations, of course, were not so inconspicuous, and plastic surgeons resorted to the use of injection methods for breast augmentation, namely the introduction of polyacrylamide gel (PAAG) into the mammary area.

After some time, doctors noticed that this method is not so alternative because of the chemical composition of the polyacrylamide gel. In the delayed period after surgery, migration of the gel to the axillary, cervical and epigastric regions was observed. A case of PAAG migration to the mediastinum, where large vessels and the heart are located, was described.

PAAG is a synthetic, jelly-like and non-absorbable in substance the tissues substance, which is the product of the polymerisation of acrylamide. It has highly toxic properties and does not form capsules around itself after administration, which was the reason for the migration. The migration of the gel to other zones was the easiest complication among the ones arising later.

Doctors began to note the following:

– Cyst formation

– The development of infection in the tissues

– Septic complications

– Ptosis (omission) of mammary glands of various degrees of development

– Necrosis of the skin

– Formation of fistulas

– Progression of breast augmentation, due to the properties of PAAG to accumulate water in itself.

All these symptoms and many others have been combined under the general name of post-implantation polyacrylamide mammary syndrome. Plastic surgeons around the world have since been struggling with these terrifying complications, despite the fact that the use of PAAG was prohibited several years ago.

What are the indications for the operation to remove PAAG?

– The appearance of pain in the chest area

– Discharge of purulent masses from the nipples

– Noticeable swelling of the chest

– Increase in local and general temperature

– The appearance of inflammation, which is accompanied by redness of the skin

– gel migration

What are the contraindications for surgery?

– Diseases of the cardiovascular system and respiratory system

– Violation of blood coagulation;

– Oncological formations of internal organs;

– Purulent skin diseases;

– Infectious diseases in the acute stage;

– Mental illness;

– Obesity of 3-4 stages and other metabolic disorders;

– Endocrine diseases;

– Glaucoma;

– Autoimmune diseases

– Diseases of the blood system (coagulation disorder).

What is the preoperative period like?

Before surgery, you should consult your doctor and find out if there are any contraindications. At the consultation, be sure to warn the doctor about taking any medications, even if it is just vitamins.

– For 7 days, excluding the consumption of nicotine and alcohol

– 2 weeks before surgery, stop taking oral contraceptives, anticoagulants (if they are not prescribed for vital signs), antibiotics and painkillers.

– Pass a number of laboratory and instrumental analyses (check with your doctor for a list).

How is the operation performed?

The only method for removing polyacrylamide gel to date is surgical removal. Unfortunately, it is rarely possible to perform an operation in one stage, since over time the gel penetrates the stroma of tissues into the muscles of the fascia. The number of operations directly depends on the amount of previously introduced gel and its residence time in the body. The operation takes place under general anaesthesia. After the patient is introduced into a medical sleep, markings implying future sections are applied to the PAAG accumulation zones. Cuts are made and PAAG is extruded. During the operation, ultrasound is used to monitor the degree of excretion of the gel. If necessary, the doctor can perform a subcutaneous mastectomy with the removal of fascia and muscles that are saturated with gel. In the delayed postoperative period, implants are installed. The recommended implant placement time is not earlier than 6 months after removal of the PAAG.

What is the rehabilitation period like?

After the operation, the patient remains in the hospital for observation. If PAAG has not caused inflammatory changes in the tissues of the gland, then discharge is carried out the next day. If purulent inflammation is diagnosed, then after surgery, drainages are installed in the wound to drain the purulent contents and antibiotic therapy is prescribed. Discharge is carried out after stabilisation of the patient’s condition.

Breast after surgery may hurt during the first 2-3 days. Discomfort is also noted, which is absolutely normal. If necessary, the doctor prescribes pain medication. After removal of the PAAG, the mammary glands subside, but as tissues recover, they return to their normal shape. Of course, the breasts look smaller, so after rehabilitation, you can install implants.

For a favourable recovery, the patient should wear special shaping underwear, should not wet the wound until it heals and avoid physical exertion. Return to work is allowed 7-14 days after surgery, depending on the state of health.

After discharge from the hospital, a woman should visit her doctor several more times. Observation is carried out for 6-12 months. After healing, an ultrasound is mandatory to assess the condition of the mammary glands and surrounding tissues.