Biopolymers and hydrogel in the breast: removal and breast reconstruction

The breast is the area where this problem has a consequence it has nowhere else: injected material does not only take up space, it obscures the image of the gland. And the breast is the only one of these territories that is screened periodically to rule out cancer.

That is why this page covers two things at once: removal and reconstruction, yes, but first what happens to your screening.

The general process is in the guide to biopolymer removal. If what you have is an implant and not an injected product, that is something else: it is in types of breast implant.

What was injected into breasts

Behind “they put something in my breast” there are above all two different materials, and it is worth telling them apart because their history is not the same:

• Polyacrylamide hydrogel (PAAG), marketed under names such as Amazingel and widely used for breast augmentation in China and Russia. It was banned in China in 2006 because of its high complication rate.
• Industrial liquid silicone, injected freely, which is the dominant material in the Latin American context and in clandestine injection.

What substances lie behind each name is in the table of substances and brands.

And a clarification that is needed more often than you would think: a breast implant is not a biopolymer. An implant is a device with its own shell, placed in a pocket, and it comes out whole. An injected product infiltrates. They have nothing in common, either in the problem or in the solution.

What happens over time, with the figures in front of you

The most useful published reference is a series of 135 patients operated on to remove breast hydrogel at a single hospital between 2011 and 2023. These were the complications recorded after injection:

Two things deserve comment.

Anxiety is among the top three. It is not an add-on: it is one of the consequences patients themselves report most frequently, ahead of migration and asymmetry. Living without knowing what you have inside, in an organ that also has to be screened, has a cost most websites do not mention.

The 3% breast cancer figure is not an incidence rate. It is the proportion among patients who came in with complications and had surgery, not the risk for someone with hydrogel. And the next section covers what the literature does say.

⚠️ What you need to know about your screening

This is the most important part of the page, and the one worth reading even if you decide not to have surgery.

The documented problem is not that the material causes a cancer. It is that it hides one.

A 2026 analysis of five patients diagnosed with breast cancer long after a hydrogel injection, together with a review of the literature, describes cancer appearing in a breast with hydrogel as presenting at a younger age, with the imaging markedly obscured by the material, with a high rate of axillary node metastasis and with a worse overall prognosis than conventional breast cancer.

Those authors’ conclusion is practical and can be applied tomorrow:

• Routine breast ultrasound for long-term follow-up of anyone with injected hydrogel.
• Contrast-enhanced MRI as the preferred test for assessing a suspicious lesion.
• Standardised follow-up protocols and active biopsy where there is doubt, because delay is the enemy.

And there is an additional warning that another page in this cluster already covers and which makes complete sense here: injected material can mimic disease on metabolic scans, with uptake in axillary nodes that has been described as a false positive for metastasis. It is set out in the page on which test detects it.

Translated into a single sentence: always say that you have injected material in your breast, at every scan and to every professional, even if it seems beside the point. It can prevent both a late diagnosis and an unnecessary fright.

The removal

Removing an injected product from the breast has the same underlying difficulty as anywhere else — it is infiltrated, not contained — with the added problem that here it mixes with the gland and with the pectoral muscle.

What the recent series say:

• It cannot be emptied completely. In the series of 135 patients there was residual material in 17% of those operated on. Conventional techniques, other authors note, frequently fail to achieve complete eradication.
• Techniques are evolving towards less invasive ones. A series of 42 patients used endoscopic removal via the axilla, with or without immediate placement of a prepectoral implant; there was a single local infection (2.38%), resolved with oral antibiotics, and minimal residue detectable on imaging in two patients (4.76%).
• The post-surgical complications described in the large series were, as well as residue, skin laxity (7.4%), haemorrhage (2.2%), reoperation (1.5%) and nipple or breast asymmetry (1.5%).

How we do it here

Two specific things, because they are what gets asked in the consulting room.

We do not use the endoscopic axillary route. It is the technique used in the series of 42 patients in the previous paragraph and its published results are good, but it is not part of what we do. If you have read about it and came to ask, the answer is that it is not offered here.

In reconstruction, the usual requirement is a Wise-pattern mastopexy. It is worth understanding why, because it is not an aesthetic choice: removing the material and the reactive tissue leaves less content inside a skin envelope that had stretched to accommodate it. That surplus skin does not retract on its own, and without resecting it and repositioning the nipple-areola complex the breast is left sagging and empty. The Wise pattern — a scar around the areola, another running vertically down and another horizontally in the fold — is what allows skin to be removed in both directions at once.

⚠️ It is a visible, permanent scar, and it deserves to be seen before you decide, not afterwards. It is also the underlying difference between this surgery and an augmentation: here the scar is part of the result, not a toll that gets hidden. How they develop and what can be done about them is on the cluster’s scar page.

That it is usual does not mean it is automatic. It depends on how much material there is, in which plane it sits and on the state of your skin; there are cases resolved with less and cases where the reconstruction is planned in two stages. That comes from the examination and the MRI, not from this page.

Reconstruction, and a surprising finding

Here there is a finding that deserves to be up front, because it answers the question of whether it is worth doing “something more” as well as removal.

In the series of 135 patients, 88 had removal of the hydrogel alone and 47 added breast reconstruction surgery. When they were compared using a validated breast-specific quality of life questionnaire, the reconstructed patients scored significantly better on psychosocial well-being, on satisfaction with their breasts and on sexual well-being.

And in the endoscopic technique series, the patients who had a prepectoral implant placed in the same session obtained better aesthetic results than those who had removal alone, with no increase in the risk of complications.

It does not make reconstruction compulsory — there are cases where it is not appropriate or not the moment — but it does disprove the idea that it is a dispensable extra. The general options are on the reconstruction page, and fat grafting applied to the breast is in augmentation with your own fat.

If you are thinking of having children

A specific warning, with two published cases behind it, that almost nobody gives:

• A 36-year-old woman with hydrogel injected beneath both breasts developed, on starting to breastfeed, a rapid enlargement of the left breast with severe pain; imaging showed a large fluid collection and emergency surgery was needed. It was not possible to remove all the material.
• Another patient, with hydrogel injected ten years earlier, attended repeatedly after her two pregnancies with recurrent breast infections, pain and finally massive enlargement of the breast from a ruptured galactocele that required surgery. The authors conclude that, since the safety of hydrogel for the baby is not known, breastfeeding with this material is not recommended.

They are cases, not a statistical rule. But they are enough for this to be part of the conversation before a pregnancy rather than during the postnatal period, if you are considering one. It is set out, along with the other special situations, in pregnancy and other special situations.

Frequently asked questions

Do biopolymers in the breast cause cancer?

That is not what the literature says. What is documented is that they make diagnosis harder: they obscure the imaging and are associated with later diagnoses and a worse outlook when cancer does appear. So what changes is not your risk of having it, but how you need to be monitored.

Can I have mammograms?

They can be done, but the material makes them harder to read. That is why adding ultrasound routinely in long-term follow-up is recommended, with contrast MRI for a suspicious lesion. And always: say that you have injected material.

Can I breastfeed?

There are published cases of serious complications on starting to breastfeed with injected hydrogel, and the authors of the second advise against breastfeeding because its safety for the baby is not known. It is a conversation to have before pregnancy.

Can they take it all out?

Rarely. In the series of 135 patients there was residue in 17%, and other authors note that conventional techniques frequently fail to achieve complete eradication.

Will my breast be left deformed?

It depends on how much has to be removed and on the state of the skin and the gland. In the large series there was skin laxity in 7.4% and nipple or breast asymmetry in 1.5%. It is why reconstruction is considered from the outset.

Can I have implants afterwards?

It is a possibility that gets assessed. In the endoscopic removal series a prepectoral implant was placed in the same session in 25 of 42 patients, with better aesthetic results and no increase in complications. It depends on the state of the tissue and on the history of inflammation.

Is my breast implant a biopolymer?

No. An implant is a device with a shell, placed in a pocket and removable whole; an injected product infiltrates the tissue. They are different problems. Information about implants is in types of breast implant.

They have found a lump and I have injected material — what do I do?

Get it looked at, and always say you have injected material. A nodule may be a reaction to the product, but the literature’s premise is the opposite of waiting: where there is doubt, active investigation, because delay is what worsens the outlook.

Sources

• Guan D, Yuan H, Sun K, Zheng Y, Ju S, Xia W. Clinical Experience in the Management of the Polyacrylamide Hydrogel (PAAG) Associated Complications Including Four Breast Cancer Cases: A Retrospective Study of 135 Cases. Aesthetic Plast Surg. 2025;49:779-787. A retrospective analysis of 135 patients operated on to remove breast polyacrylamide hydrogel between January 2011 and December 2023; complications after injection: induration and nodules 60.0%, pain 27.4%, anxiety 22.2%, migration 13.3%, asymmetry 8.1%, swelling 5.9%, infection 5.2%, calcification 3.7% and breast cancer 3.0%; 88 patients had removal alone and 47 added breast reconstruction; post-surgical complications: residual material 17.0%, skin laxity 7.4%, haemorrhage 2.2%, reoperation 1.5% and nipple or breast asymmetry 1.5%; BREAST-Q scores were significantly better in the reconstructed group for psychosocial well-being (p < 0.001), satisfaction with the breast (p < 0.001) and sexual well-being (p = 0.008). Level of evidence IV. https://pubmed.ncbi.nlm.nih.gov/39317860/
• Ma X, Zhu Z. Breast cancer after polyacrylamide hydrogel augmentation: A clinicopathological analysis of 5 cases and literature review. Radiol Case Rep. 2026;21:5170-5177. Polyacrylamide hydrogel was widely used for cosmetic breast augmentation in China and was later banned because of its serious long-term complications; its deposits can interfere with breast imaging and delay the diagnosis of a subsequent breast cancer; in the five cases analysed, cancer arising in breasts with hydrogel presented at a younger age, with markedly obscured imaging, a high rate of axillary node metastasis and a worse overall prognosis than conventional breast cancer; the authors recommend routine breast ultrasound for long-term surveillance, contrast-enhanced MRI as the preferred test for suspicious masses, standardised follow-up protocols and active biopsy. https://pubmed.ncbi.nlm.nih.gov/42598572/
• Li T, Zhu Z, Feng Y, Du Z. Endoscopic-assisted removal of injectable Amazingel with or without immediate prepectoral implant-based breast augmentation: safety and aesthetic outcomes from a retrospective study. Gland Surg. 2026;15:73. The polyacrylamide hydrogel marketed as Amazingel was banned in China in 2006 because of its high complication rate, and conventional removal techniques frequently fail to achieve complete eradication; a retrospective study of 42 patients operated on between April 2020 and May 2025 with transaxillary endoscopic removal, 25 of them with immediate prepectoral implant augmentation; the implant group obtained better aesthetic results on the Harris scale (p = 0.01); one patient (2.38%) had a local infection resolved with oral antibiotics and in two (4.76%) minimal residue was detected on imaging with no associated discomfort. https://pubmed.ncbi.nlm.nih.gov/41969934/
• Ebisudani S, Inagawa K, Suzuki Y, Osugi I. Unilateral Breast Inflation Caused by Breastfeeding after Polyacrylamide Hydrogel Injection. Plast Reconstr Surg Glob Open. 2021;9:e3335. A 36-year-old woman with polyacrylamide hydrogel injected beneath both mammary glands in 2016 who, on starting to breastfeed after giving birth in 2020, developed rapid enlargement of the left breast with unbearable pain; CT showed marked fluid retention with displacement of the glandular tissue, and abundant yellowish fluid was drained at surgery; complete removal of the material was not possible. https://pubmed.ncbi.nlm.nih.gov/33552807/
• Bourke AG, Jose C. Recurrent complications of PAAG implants during lactation. BMJ Case Rep. 2018. A 35-year-old woman with polyacrylamide hydrogel injected ten years earlier who attended on numerous occasions after her two pregnancies with recurrent bilateral breast infection, pain and finally massive breast enlargement from a ruptured galactocele requiring surgery; since the safety of hydrogel for the baby is not known, the authors do not recommend breastfeeding with this material. https://pubmed.ncbi.nlm.nih.gov/30396888/
• Huo B, Tso R, Shen L, Mansberg R. Confounding diagnosis of metastatic disease on FDG PET/CT due to cosmetic liquid silicone administration in breasts and gluteal regions with silicone migration to labia majora. Radiol Case Rep. 2025. Cosmetic injections of liquid silicone can produce inflammation, chronic mastitis, distant migration and lymphadenitis, and give rise to false positives for nodal involvement and distant metastasis. https://pubmed.ncbi.nlm.nih.gov/40895000/

Book your consultation

If you have material injected in your breast, there is something you can do today even if you are not considering surgery: make sure whoever handles your screening knows, and that your follow-up includes an ultrasound as well as the mammogram.

And if you want to consider removal, the conversation starts with finding out how much material there is, where it is and what state the gland is in.

Clinical confirmation by the surgeon

Dr Enrique Salmerón González

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624077

Dr Elena García Vilariño

Specialist in Plastic, Aesthetic and Reconstructive Surgery
Registration no. 46/4624503

Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.