Ultrasound diagnosis of bilateral breast abscesses following hyaluronic acid infiltration for aesthetic purposes. Case report

Abstract

A patient presented with bilateral breast masses of progressive onset and evolution, associated with mild pain. Her medical history indicated that she had undergone a hyaluronic acid injection for breast augmentation three months prior. Starting four weeks post-injection, she developed localized swelling, mild pain, and induration in both breasts. Breast ultrasound revealed collections of echogenicity ranging from hypoechoic to anechoic, poorly defined, with irregular borders, posterior acoustic enhancement, thin internal septa, and mild peripheral vascularization on color Doppler. These findings were consistent with a BIRADS 4A classification, and ultrasound-guided surgical drainage and biopsy were indicated. This case is relevant because the use of hyaluronic acid in breast augmentation is not recommended by major health authorities such as the FDA, as it has been shown to be an unsafe technique due to its potential complications, as well as the distortion of breast architecture it causes, which poses a challenge in routine breast cancer screening in patients who have undergone these procedures.