Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review

Summary:. Aquafilling is a hydrophilic gel composed of 98% physiological saline and 2% polyacrylamide gel, introduced in Japan in 2015 for breast augmentation. Despite its initial popularity, it has been associated with severe complications, including delayed infections, abscess formation, material...

Full description

Saved in:
Bibliographic Details
Main Authors: Shota Toyama, MD, Goh Akiyama, MD, PhD, Shimpei Ono, MD, PhD, Sawako Nukaga, MD, Shoji Yokobori, MD, PhD, Rei Ogawa, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2025-05-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006798
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850254920624635904
author Shota Toyama, MD
Goh Akiyama, MD, PhD
Shimpei Ono, MD, PhD
Sawako Nukaga, MD
Shoji Yokobori, MD, PhD
Rei Ogawa, MD, PhD
author_facet Shota Toyama, MD
Goh Akiyama, MD, PhD
Shimpei Ono, MD, PhD
Sawako Nukaga, MD
Shoji Yokobori, MD, PhD
Rei Ogawa, MD, PhD
author_sort Shota Toyama, MD
collection DOAJ
description Summary:. Aquafilling is a hydrophilic gel composed of 98% physiological saline and 2% polyacrylamide gel, introduced in Japan in 2015 for breast augmentation. Despite its initial popularity, it has been associated with severe complications, including delayed infections, abscess formation, material migration, and fibrosis. In 2019, the Japanese Society of Aesthetic Plastic Surgery banned its use for breast augmentation due to safety concerns. However, cases of late-onset complications continue to emerge. Here, we report a case of sepsis caused by an abscess at the injection site 6 years after Aquafilling injection. A 34-year-old woman with a history of methamphetamine addiction underwent breast augmentation with Aquafilling. Six years later, she developed erythema, swelling, and fever, leading to sepsis. Contrast-enhanced computed tomography revealed abscess formation at the injection site. Surgical drainage and debridement were performed, and antibiotic therapy was tailored based on culture results. Postoperative management included intensive care unit care, repeated debridement, and wound closure with a split-thickness skin graft. The patient was discharged 55 days after admission. This case highlights the significant risks associated with nonabsorbable fillers, particularly delayed infections and their severe consequences. A review of the literature reveals numerous reports of similar complications worldwide, necessitating surgical intervention in most cases. To prevent such outcomes, rigorous safety evaluations and monitoring systems led by professional societies and governments are essential. Furthermore, a safety network for treating patients with late-onset complications must be established to ensure timely and effective care.
format Article
id doaj-art-e8b86344180240c98a6fdb4344e24d12
institution OA Journals
issn 2169-7574
language English
publishDate 2025-05-01
publisher Wolters Kluwer
record_format Article
series Plastic and Reconstructive Surgery, Global Open
spelling doaj-art-e8b86344180240c98a6fdb4344e24d122025-08-20T01:57:00ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-05-01135e679810.1097/GOX.0000000000006798202505000-00032Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature ReviewShota Toyama, MD0Goh Akiyama, MD, PhD1Shimpei Ono, MD, PhD2Sawako Nukaga, MD3Shoji Yokobori, MD, PhD4Rei Ogawa, MD, PhD5From the * Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, JapanFrom the * Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan† Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.From the * Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, JapanSummary:. Aquafilling is a hydrophilic gel composed of 98% physiological saline and 2% polyacrylamide gel, introduced in Japan in 2015 for breast augmentation. Despite its initial popularity, it has been associated with severe complications, including delayed infections, abscess formation, material migration, and fibrosis. In 2019, the Japanese Society of Aesthetic Plastic Surgery banned its use for breast augmentation due to safety concerns. However, cases of late-onset complications continue to emerge. Here, we report a case of sepsis caused by an abscess at the injection site 6 years after Aquafilling injection. A 34-year-old woman with a history of methamphetamine addiction underwent breast augmentation with Aquafilling. Six years later, she developed erythema, swelling, and fever, leading to sepsis. Contrast-enhanced computed tomography revealed abscess formation at the injection site. Surgical drainage and debridement were performed, and antibiotic therapy was tailored based on culture results. Postoperative management included intensive care unit care, repeated debridement, and wound closure with a split-thickness skin graft. The patient was discharged 55 days after admission. This case highlights the significant risks associated with nonabsorbable fillers, particularly delayed infections and their severe consequences. A review of the literature reveals numerous reports of similar complications worldwide, necessitating surgical intervention in most cases. To prevent such outcomes, rigorous safety evaluations and monitoring systems led by professional societies and governments are essential. Furthermore, a safety network for treating patients with late-onset complications must be established to ensure timely and effective care.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006798
spellingShingle Shota Toyama, MD
Goh Akiyama, MD, PhD
Shimpei Ono, MD, PhD
Sawako Nukaga, MD
Shoji Yokobori, MD, PhD
Rei Ogawa, MD, PhD
Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review
Plastic and Reconstructive Surgery, Global Open
title Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review
title_full Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review
title_fullStr Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review
title_full_unstemmed Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review
title_short Sepsis 6 Years After Breast Augmentation With Aquafilling: A Case Report and Literature Review
title_sort sepsis 6 years after breast augmentation with aquafilling a case report and literature review
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006798
work_keys_str_mv AT shotatoyamamd sepsis6yearsafterbreastaugmentationwithaquafillingacasereportandliteraturereview
AT gohakiyamamdphd sepsis6yearsafterbreastaugmentationwithaquafillingacasereportandliteraturereview
AT shimpeionomdphd sepsis6yearsafterbreastaugmentationwithaquafillingacasereportandliteraturereview
AT sawakonukagamd sepsis6yearsafterbreastaugmentationwithaquafillingacasereportandliteraturereview
AT shojiyokoborimdphd sepsis6yearsafterbreastaugmentationwithaquafillingacasereportandliteraturereview
AT reiogawamdphd sepsis6yearsafterbreastaugmentationwithaquafillingacasereportandliteraturereview