Over the past several decades, a wide variety of commercially available synthetic
materials are used as implants, including hyaluronic acid for dermal fillers and silicone
polymers for mammary prostheses.
1
However, off-label materials consisting of unknown components have also been used,
sometimes resulting in serious problems including erythema, induration, and infection.
2
In some cases, the components of the implanted synthetic materials are not revealed
in the medical history of the patient. Several imaging techniques such as plain radiogram,
computerized tomography (CT), and magnetic resonance imaging (MRI) are described as
routine procedures to identify the implanted materials.
3
,
4
Although these approaches have proven beneficial, they potentially present some practical
limitations in identifying materials. To precisely identify the components of such
unknown materials, excised synthetic materials was chemically analyzed using nuclear
magnetic resonance (NMR) spectroscopy in our hospital since 1989.
5
In this paper, we present our experiences with liquid-state NMR analysis technique
by describing in detail 2 of our 58 cases that were studied retrospectively (Table 1).
Table 1The nature of the injected/inserted foreign materials.
| Patients’ pre-operative statements | NMR results | |||
|---|---|---|---|---|
| Silicone | PAG | CMC | Hydrocarbon | |
| Silicone (6) | 4 | 2 | ||
| PAG (1) | 1 | |||
| Collagen (1) | 1 | |||
| Hydrocarbon (2) | 1 | 1 | ||
| Unknown (49) | 35 | 9 | 4 | 2 |
| Total | 41 | 12 | 4 | 3 |
Table showing the demographics and the diagnoses of all the patients analyzed by NMR.
Fifty-eight patients were included in the study. Two of the patients have received
2 different material injections. PAG: polyacrylamide gel, and CMC: carboxylmethyl
cellulose.
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References
- Injectable soft-tissue fillers: clinical overview.Plast Reconstr Surg. 2006; 118: 98e-106e
- Complications from injectable polyacrylamide gel, a new nonbiodegradable soft tissue filler.Dermatol Surg. 2004; 30: 1507-1509
- A theoretical study of determination of the materials used in earlier mammaplasty by mammography.J Jpn Plast Reconstr Surg. 1984; 4: 886-898
- Clinical imaging diagnosis of implant materials for breast augmentation.Ann Plast Surg. 2006; 57: 6-12
- Identification of foreign material from abscesses after injection mammoplasty, by implant alleged to be collagen.Plast Reconstr Surg. 2003; 112: 931-933
Article info
Publication history
Published online: October 31, 2011
Identification
Copyright
© 2011 Published by Elsevier Inc. All rights reserved.
