Safety of Copolyamide Filler Injection for Breast Augmentation.

Although injections with copolyamide fillers (Aquafilling/Los Deline and Aqualift/Activegel) are currently used widely for breast augmentation, many complications have been reported. A recent position statement by a Korean aesthetic/reconstructive breast surgery society indicated these fillers are the same as polyacrylamide gel (PAAG), which is widely prohibited due to complications. To test this statement, this retrospective cohort study examined the clinical complications after breast augmentation with copolyamide fillers. Nuclear magnetic resonance (NMR) analysis of copolymer and PAAG fillers was also conducted. METHODS: All consecutive patients with concerns about or sequelae from copolyamide fillers who visited our hospital in 2018-2020 were identified. The injected formulation, complications, and intraoperative findings were recorded. Copolyamide fillers were compared with PAAG and 2 PAAG fillers (Amazingel and Aquamid) by NMR. RESULTS: Of the 29 patients (all women; average age, 42 years), 17 complained of breast deformity. Eight had puncture site infections and mammary gland inflammation. Five exhibited induration (single large/small lumps). In 4 cases, the filler had migrated outside of the breast, including to the back and vulva; these cases had severe symptoms. NMR showed that the copolyamide and PAAG fillers bore all of the characteristic peaks of PAAG. CONCLUSIONS: Our clinical/intraoperative and NMR findings showed, respectively, that copolyamide fillers cause the same complications as PAAG fillers and have the same composition. Thus, the risks of copolyamide fillers for breast augmentation are equivalent to those for PAAG fillers. It is strongly recommended not to use copolyamide fillers until their long-term safety is established.

Time-frequency analysis of serum with proton nuclear magnetic resonance for diagnosis of pancreatic cancer.

Although serum markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) have been widely used in screening for pancreatic cancer (PC), their sensitivity and specificity are unsatisfactory. Recently, a novel tool of analyzing serum using the short-time Fourier transform (STFT) of free induction decays (FIDs) obtained by 1H-NMR has been introduced. We for the first time evaluated the utility of this technology as a diagnostic tool for PC. Serum was obtained from PC patients before starting any treatments. Samples taken from individuals with benign diseases or donors for liver transplantation were obtained as controls. Serum samples from both groups underwent 1H-NMR and STFT of FIDs. STFT data were analyzed by partial least squares discriminant analysis (PLS-DA) to clarify whether differences were apparent between groups. As a result, PLS-DA score plots indicated that STFT of FIDs enabled effective classification of groups with and without PC. Additionally, in a subgroup of PC, long-term survivors (≥ 2 years) could be discriminated from short-term survivors (< 2 years), regardless of pathologic stage or CEA or CA19-9 levels. In conclusion, STFT of FIDs obtained from 1H-NMR have a potential to be a diagnostic and prognostic tool of PC.

Complications after autologous fat injection to the breast.

BACKGROUND: Although autologous fat injection (fat grafting) to the breast was performed widely throughout the twentieth century, the authors at their hospital have recently had to repair the damage suffered by a number of patients subjected to this procedure. The authors are concerned that this procedure is being performed incorrectly by untrained and untutored individuals, especially in Japan. The authors report several cases of complications after this procedure. Several related issues are discussed. METHODS: The authors retrospectively reviewed 12 patients who had received autologous fat grafts to the breast and required breast surgery and/or reconstruction to repair the damage presenting between 2001 and 2007. The symptoms are described and the fat grafting procedures that were used are analyzed. RESULTS: All 12 patients (mean age, 39.3 years) had received fat injections to the breast for augmentation mammaplasty for cosmetic purposes. They presented with palpable indurations, three with pain, one with infection, one with abnormal breast discharge, and one with lymphadenopathy. Four cases had abnormalities on breast cancer screening. All patients underwent mammography, computed tomography, and magnetic resonance imaging to evaluate the injected fats. CONCLUSIONS: Autologous fat grafting to the breast is not a simple procedure and should be performed by well-trained and skilled surgeons. Patients should be informed that it is associated with a risk of calcification, multiple cyst formation, and indurations, and that breast cancer screens will always detect abnormalities. Patients should also be followed up over the long-term and imaging analyses (e.g., mammography, echography, computed tomography, and magnetic resonance imaging) should be performed.

Clinical imaging diagnosis of implant materials for breast augmentation.

BACKGROUND: The ingredients of substances implanted for breast augmentation sometimes remain unknown due to lack of information from patients. Significant clinical problems sometimes necessitate removal and reconstruction. Thus, preoperative diagnostic imaging to identify the ingredients of implants may improve the treatment decision-making process. In this report, we created a clinical imaging index. PURPOSE: Here, we summarize computed tomography (CT) and magnetic resonance imaging (MRI) imaging of implant materials to predict the ingredients of implant substances preoperatively. METHODS: A total of 104 patients with late complications after receiving breast augmentations between 1971 and 2002 were examined using CT and MRI. In addition, further examinations were conducted, including postoperative chemical analysis using Nuclear magnetic resonance (NMR) spectroscopy and MRI imaging of various implanted substances using an experimental magnetic resonance system. RESULTS: We identified the ingredients of implant materials used for breast augmentation by imaging diagnostics as follows: silicone: radiopaque-low/high (CT-MRI T1/T2); hydrogel: radiolucent-low approximately iso/high; hydrocarbon: radiolucent-high approximately iso/low approximately iso; saline: radiolucent-low/high. CONCLUSION: We have identified by imaging diagnosis the ingredients of implant materials.