The use of acellular dermal matrix to close defect in crural fascia after removing the polyacrylamide gel (case report)

The calves play a significant role in selfesteem in women and are an important part of the body contour. Therefore, the desire to improve the shape of the legs is natural. In the late 90s and early 2000s the use of polyacrylamide gel (PAAG) for contour plastics of soft tissues was popular. Many years after the injection of PAAG, complications such as gel migration, edema, and suppuration develop. The only way to treat these complications is surgery. After the removal of PAAG and necrotic masses, deformations and a shortage of lower leg tissues appear, which cause depression in patients. Replenishing the volume of the calve only by installing a silicone implant is difficult due to a shortage of integumentary tissues, and the use of microsurgical auto flap transplantation is hardly justified.A case of correcting a significant deficit of the calf tissues in a 45-year-old patient after the removal of PAAG is presented. To achieve an optimal contour, the volume is restored by a custom-made silicone implant. The deficit of epithelial tissues is replenished by acellular dermal matrix (ADM). A stable result was obtained.The physical properties of ADM are similar to the crural fascia. Installation of ADM allows to completely isolate the implant from the subdermal space and skin wound. The use of ADM does not require microsurgical techniques, it is simpler and safer than free flaps transplantation.