Complication of AQUAfilling ® Gel Injection for Breast Augmentation: Case Report of One Case and Review of Literature

Aesthetic Plast Surg. 2018 Oct;42(5):1252-1256. doi: 10.1007/s00266-018-1107-0. Epub 2018 Feb 27.


Introduction: Augmentation mammoplasty is one of the most popular aesthetic operations in the world. In Korea, one of the fillers used for breast augmentation is AQUAfilling® gel (Biomedica. spol, s,r,o, Czech Republic). AQUAfilling® gel is a hydrophilic gel composed of 98% sodium chloride solution (0.9%) and 2% cation copolyamide.

Methods: This is a case report describing a patient that suffered complications after AQUAfilling® gel injection for breast augmentation.

Results: A 32-year-old female patient was referred to our plastic surgery department with a chief complaint of repeated wound dehiscence and fluid discharge involving both breasts. She was treated via surgical intervention for removal of necrotic infected tissue and filler, as well as massive irrigation three times. After the third surgery, there were no complications, including infection or dehiscence, during a 1-year follow-up period.

Conclusions: Although AQUAfilling® gel is easy to inject and is natural looking, once a complication occurs, treatment is difficult. Also, there are concerns regarding toxicity of the gel material and its influence on surrounding tissues. Hence, sufficient evidences of long-term safety must be accumulated and proved, until which time the aesthetic use of the unapproved filler must be restricted.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .

Keywords: AQUAfilling® gel; Breast augmentation; Complication.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Dermal Fillers / adverse effects*
  • Esthetics
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrogels / therapeutic use*
  • Injections, Intralesional
  • Mammaplasty / adverse effects*
  • Mammaplasty / methods*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Reoperation / methods
  • Republic of Korea
  • Risk Assessment
  • Tomography, X-Ray Computed / methods
  • Ultrasonography, Doppler
  • Wound Healing / physiology


  • Dermal Fillers
  • Hydrogels