Monday, March 28, 2011

Dermal Filler Injections for Breast Augmentation?

Dermal Filler Injection for Breast Augmentation:  Is it Safe?
Research has shown that many women have shown significant interest in having a breast augmentation.  However, only a small percentage of women who contemplated about breast enhancement opted to undergo surgical intervention.  The advent of minimally invasive procedures for breast enhancement, such as fat transfer and hyaluronic acid injections, has garnered increasing attention from the media, and significant interests from women who are seeking a minimally invasive procedure for breast augmentation.  Hyaluronic acid dermal fillers being used for facial rejuvenation is now being extensively promoted for breast augmentation in 17 countries throughout Europe and Asia. The hyaluronic acid filler, Macrolane, was developed by Swedish scientists to be used for breast augmentation, as well as for buttock augmentation.  Because of the increasing popularity of this new procedure for breast enhancement, safety issues are now being raised, especially in the United States.
Sunlight By Julius Leblanc Stewart (Photo courtesy of Wikimedia Commons)
Fast Facts About Breast Augmentation Using Macrolane (Hyaluronic Acid Dermal Filler) Injections
  • Macrolane is a hyaluronic acid gel that is both biocompatible and biodegradable in nature.
  • Macrolane used for breast enhancement are injected either subglandular (above the pectoralis muscle) or submuscular (below the pectoralis muscle.)
  • Larger volumes are required for breast enhancement as compared to facial rejuvenation.  A maximum volume of 100 ml of Macrolane per breast was used in a study conducted in Sweden.
  • Macrolane injections are temporary and lasts for 1-2 years.
  • The study conducted in Sweden showed that in women who underwent Macrolane injections, 78% of the hyaluronic acid filler remained at 3-months; 57% remained at 6-months; and 34% remained at 12-months based on the breast MRI evaluation performed after the procedure.
  • Capsular contracture (85% with Baker Scale III) was the most common complication after Macrolane injection for breast augmentation (25% of patients.)
  • No serious adverse events or inflammatory reactions were found after 1 year of injection.
  • Macrolane injections for breast augmentation is NOT FDA-approved, and is not available in the United States.

The minimally invasive nature of Macrolane injections for breast augmentation seems to be promising for those who seek an alternative solution for breast enhancement.  However, due to the limited clinical studies available regarding its safety, as well as the unknown effects for mammographic detection of breast cancer, one should proceed with caution regarding having this procedure done, especially in the United States.  I recommend asking your  plastic surgeon regarding the different alternatives for breast augmentation if one is interested to have their breast enhanced.

Emmanuel De La Cruz M.D.

References:

Hedén, et al.  Macrolane for Breast Enhancement: 12-month Follow-Up.  Plastic Reconstructive Surgery.  2011. February; 127(2): 850-60.
Hedén, et al.  Aesthetic breast surgery: Consulting for the future—Proposals for improving doctor-patient interactions. Aesthetic Plastic Surgery. 2009;33:388–394
McCleave.  Is Breast Augmentation Using Hyaluronic Acid Safe?  
Aesthetic Plast Surg. 2010 Feb;34(1):65-8; discussion 69-70. Epub 2009 Dec 5.
Nahabedian, Maurice.  Discussion: Macrolane for Breast Enhancement:12-Month Follow-Up. Plastic Reconstructive Surgery.  2011. February; 127(2): 861-862.
 

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