Abstract
A 46-year-old woman was admitted to the Plastic and Reconstructive Surgery Division of Ehime University Hospital for swelling and pain in both breasts. Approximately 10 years earlier, in June 2010, she had undergone bilateral breast augmentation surgery with hyaluronic acid. Computed tomography showed a shadow under the pectoralis major muscle and a breast abscess in the pectoralis major due to a foreign body was suspected. Puncture was performed under ultrasound guidance, but a bacteriological culture of the abscess was negative. Surgery was performed under general anesthesia and a white cystic lesion covered with a thin capsule was found in the pectoralis major. A histopathological examination revealed a foreign body reaction, and biochemical analysis showed that a small amount of hyaluronic acid remained. In breast reconstruction using a large amount of highly cross-linked hyaluronic acid, there is a high possibility that foreign substances containing hyaluronic acid will persist, so careful interviews and examinations are necessary.
(a) CT image just before surgery. (b) Preoperative design. (c) A white cystic lesion covered with a thin capsule was found in the pectoralis major. (d) Specimens of removed bilateral cysts. (f) Cyst contents: White, muddy substance.
