# Long-Term Complications of Aquafilling Injection after Male Breast Augmentation: A Case Report

## TL;DR

A man who had breast augmentation with Aquafilling gel 10 years ago needed surgery to treat severe complications, highlighting the long-term risks of this nonsurgical method.

## Contribution

This case report highlights the long-term complications and surgical management of Aquafilling gel used for male breast augmentation.

## Key findings

- A 51-year-old male patient experienced severe complications including pain, firmness, and swelling ten years after Aquafilling injections.
- Surgical intervention was necessary and successful, with no complications observed three months post-treatment.
- There is currently no antidote for Aquafilling gel; removal requires surgical debridement or irrigation and drainage.

## Abstract

(1) Background: Aquafilling, a filler initially designed for contouring the face, was developed in 2005 by the company Biomedica, Czech Republic. It is composed of 98% hydrophilic gel and 2% copolyamide. Since 2008 the use was expanded for augmentation of the breast and gluteal region. It is suitable as a nonsurgical method for patients who want discreet augmentation and would like to avoid undergoing an operation. This method promises long-term results lasting up to 10 years. However, according to the literature Aquafilling gel can cause long-term complications; (2) Methods: This case report presents a male patient who experienced severe complications following Aquafilling injections for breast augmentation after ten years of treatment; (3) Results: A 51-year-old male patient presented to our emergency room with complaints of pain, firmness, major pre-pectoral swelling and asymmetry in his breasts. Due to the severity of the clinical appearance and the patient’s discomfort, surgical intervention was deemed necessary. After undergoing three operations the patient was treated successfully and could be discharged for outpatient controls. The patient still did not show any signs of complications, three months after the event; (4) Conclusions: Although the patient has made a rapid recovery, as a result of the surgical procedure, we would recommend treating the breast region with small incisions and drainage in the future. This would have a better aesthetic result. Still there is no antidote available for the treatment of Aquafilling gel. It can only be removed by surgical debridement or irrigation and drainage.