Objectives: This study aimed to describe clinical manifestations of complications following FoMBI, and to evaluate the impact of surgical treatment and breast reconstruction (BR) on patient-reported satisfaction and quality of life. Ultimately, the FoMBI classification and management algorithm depending on breast imaging and clinical findings are purposed.
Introduction: Foreign material breast injection (FoMBI) has been acclaimed as minimally invasive procedure for enhancing the breast volume. Nevertheless, safety issue and subsequent complications have contributed to restriction of the procedure. Development of clinical symptoms lead various treatments among individuals. To date, the patient-reported satisfaction and health-related quality of life have been uncommonly mentioned regarding the treatment outcomes. Additionally, classification and standard practice guideline on management of the complications have not been distinctly established.
Materials / method: Patients who had received FoMBI were attained through an institutional review board-approved retrospective study during the period of August 2017 and September 2020. All patients surgically treated by the single author (VL) were inquired a patient-reported satisfaction questionnaire at preoperative period and at least 6-month follow-up. The satisfaction assessment was based on volume, shape, softness, nipple sensation, symmetry of both breasts, and overall aesthetic result. The 5-level EQ-5D (EQ-5D-5L) instrument was also submitted as a standardized measure of patient health outcomes.
Results: A total of 101 FoMBI patients. The mean age at first injection was 28.6 years (range, 17 to 46 years). Polyacrylamide hydrogel was the most injected agents (31.9 percent). The average volume was 148.7 mL (range, 30 to 500 mL). The most common presenting symptoms was palpable breast lump (81.9 percent). 29 patients underwent surgical treatments without BR. BR was performed on 44 patients (21 immediate and 23 delayed reconstruction). Majority of the BR were Implant-based BR (n=41). There was significant improvement in breast volume, shape, softness, symmetry, and overall aesthetic result in BR.
Conclusion: Breast volume enhancement with FoMBI can eventually lead to hazardous complications with the unpredictable onset. The management algorithm, based on clinical symptoms and the imaging findings, could be applied as an essential guide for the appropriate treatment. FoMBI classification base on clinical and radiological finding can guide physician to solve patient problems. Apart from impairment of nipple sensitivity, improvement in all breast conditions potentially contributes to patient satisfaction and quality of life in those who received breast reconstruction.
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