To recognise the imaging of complications from Macrolane™ injection

Introduction

Macrolane™ volume restoration factor (VRF) (Q-Med) is in vogue for use in breast augmentation. There is sparse literature on the imaging characteristics of complications resulting from Macrolane™ injection.

Methods

This study describes the multimodality imaging of 12 patients from three centres who had breast complications as a result of Macrolane™ injection. The patients had all undergone Macrolane™ injection at varying intervals prior to presentation. Macrolane™ consists of non-animal stabilised hyaluronic acid (NASHA™) and is approved for nonsurgical breast augmentation. Treatment involves injection of up to 100 ml fluid, superficial to the pectoral muscle and deep to the glandular breast disc, and is semipermanent, usually only lasting up to 1 year before a top-up injection is required.

Results

Presenting symptoms included breast lumps, breast pain and axillary pain. The complications seen on imaging included abscess formation, indeterminate masses, subpectoral collections and complex cystic collections. The fluid and indeterminate masses were not all resorbed in the timeframe expected of Macrolane™ and remained in situ in some cases for at least 2 years.

Conclusions

Macrolane™ injection is associated with long-term complications and creates diagnostic challenges on breast imaging that are only beginning to emerge in the breast clinics and that may warrant triple assessment.