There has been a lot in the press recently about Macrolane, a hyaluronic acid filler that has been used as an alternative to small volume breast augmentation. The principle behind this was that it could be done with the patient awake, under local anaesthetic, by a series of injections of this temporary filler given into the breast to increase its size by about 1 cup size.
Macrolane has now been withdrawn from the market for use in breast augmentation. I have never used Macrolane and was always uncomfortable with its concept. Without direct visualisation (as in a standard breast augmentation) and no imaging (such as ultrasound guidance), there was no way for certain of knowing where the end of the needle would be, and therefore where exactly the Macrolane was being injected. I have come across a variety of problem Macrolane cases in which, during surgery, the sticky substance was found in all sorts of places it shouldn’t have been – within the muscle, under the muscle, within the breast tissue etc. making it incredibly challenging to remove. It also occasionally became encapsulated in scar tissue that caused other problems.
As one of my mentors once said to me – if a procedure or product hasn’t been around for about 5-years, be wary of it. If its still going strong after that time, it has stood the test of time, the experience of many patients (and potential complications) as well as many surgeons. Only then can it be deemed safe to introduce to your practice. Wise words which I follow closely!
