Since the use of silicone-filled breast implants has been restricted, hydrogel has been used an alternative filler as a silicone elastomer shell filled with polysaccharide gel. However, its use has also been restricted since 2000 because of complications due to metabolic fate. The author observed the postoperative findings after implant rupture.

Among 22 cases with previous augmentation mammoplasty using hydrogel implants that received reoperation in M.D. Clinic from February 2006 to June 2008, 12 cases of implant rupture were included in this study.

The mean interval from the previous hydrogel surgery was 7 years ranging from 3 to 9 years. Symptoms were unilateral deflation in 4, unilateral breast edema in 4, unilateral changes in texture in 3 and 1 without any symptoms. There was a significant spread of hydrogel into the surrounding tissue in 2 cases of deflation, 2 cases of edema and 1 asymptomatic case. The most severe spreading occurred 6 years after implant in a patient who had been delivered of a baby 2 months before her visit. The author performed total capsulectomy in 11 cases but was unable to remove all gel in 3 cases of multiple spread. Postoperative complications were mild capsular contracture in 2 patients with incomplete removal of surrounding gel and medial herniation in 1 in multiple spreading after childbirth.

Rupture of hydrogel breast implants had a high risk of surrounding tissue damage and it is suggested that these implants should not be used for breast augmentation. Patients with hydrogel breast implants should be checked carefully for rupture.