Abstract: Objective Recently, increasing number of patients, who have received polyacrylamide hydrogel injection for augmentation mammoplasty, are seeking to have this gel removed regardless of whether they're suffering from symptoms or not. Blunt aspiration, which is widely performed but removes only free hydrogel, leaves residual hydrogel in the breast. Here we're going to report and discuss our methods and ideas of the treatment for polyacrylamide hydrogel-injected breasts. Methods During the period of February 2005 to December 2013, 170 women who had undergone injection of polyacrylamide hydrogel for augmentation mammoplasty presented to us for treatment. A peri-areolar incision was made on the lower border of the areola, followed by dissection to the outer surface of the infiltrated fascia of polyacrylamide hydrogel. The fascia was dissected away as completely as possible and the free polyacrylamide hydrogel was removed from the cavity. Results Almost all the patients were satisfied with the surgical results, except for 5 patients who complained about the flat appearance of the breasts. Preoperative symptoms such as breast lumps, pain, uncomfortable upper-extremity movement and breast firmness were relieved and disappeared after removal of the free polyacrylamide hydrogel and infiltrated capsule. Conclusion The removal of the infiltrated capsule and free polyacrylamide hydrogel as much as possible may be successful in removing breast lumps, pain, and uncomfortable upper -extremity movement due to breast firmness. To remove polyacrylamide hydrogel as much as possible, the removal of the infiltrated fascia and capsule together with the free polyacrylamide hydrogel is recommended.

Key words: Augmentation mammoplasty, Polyacrylamide hydrogel, Infiltrated fascia and capsule