Presentation
Concerned of a painless lump in the upper inner quadrant of her right breast. On clinical examination the mass was of about 4 cm, deforming the shape of the breast, hard but movable, with clearly defined borders; axillary lymph nodes were normal.
Patient Data
4 cm cyst with inside many hyperechoic bright spots.
Polycyclic radiopaque mass with well-defined borders in the right breast
Macrolane gel aspirated using a 18G needle on a 60 mL syringe.
Case Discussion
Six months before, the patient underwent breast augmentation with Macrolane gel injections.
Macrolane is a biocompatible, soft-tissue filler of hyaluronic acid of non-animal origin (manufactured by Q-Med, Uppsala, Sweden).
The cyst was aspirated using an 18G needle on a 60 mL syringe. The procedure was repeated because the gel obstructed the lumen of the needle. In total about 25 cc Macrolane gel was aspirated. The procedure, performed without local anesthesia, was well tolerated and the cyst disappeared clinically, although ultrasound showed a persistent 1 cm cyst.
Accordingly a French prohibition of the use of Macrolane in aesthetic breast augmentation for reasons similar to criticisms of autologous fat grafting, in 2012 Q-Med, the manufacturer of Macrolane, has decided to discontinue the promotion of Macrolane for breast augmentation until further notice.
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