After the state banned the use of polyacrylamide hydrogel (i.e., Omnidene or Ingelfahrer) injections for breast augmentation in 2005, a large number of patients with complications and overly worried patients have undergone removal surgery, but it is understood that there are still many patients who are still waiting and waiting after the injections, who are asymptomatic, who do not have any uncomfortable symptoms, whose shape and softness may still be satisfactory, and who have not experienced any complications. Do they need to be surgically removed? How should the examination be performed and the risk be determined? What is the response to treatment? This is the concern of many people. In recent years, Prof. Li Bi, a breast plastic surgeon at the Department of Plastic Surgery (Plastic Surgery) of North Medical Center, has found that what is seen during surgery in asymptomatic patients is surprising: changes in the nature of the injected material, a large number of particles of varying thickness in the injected material, large pieces of tissue loss, thickening of the envelope, degeneration of the surrounding tissue, etc. Therefore, asymptomatic does not mean no internal changes, and asymptomatic does not mean forever asymptomatic. Therefore, asymptomatic does not mean no internal changes, and asymptomatic does not mean forever asymptomatic. At the 11th national meeting of the Chinese Society of Plastic Surgery held in Xinjiang in August this year, Prof. Li Bi made a presentation on “Management strategies for asymptomatic patients after polyacrylamide hydrogel injection for breast augmentation”, summarizing the previous experiences and studies and clearly pointing out the principles of management, which caused a great response. Prof. Li Bi believes that there is a consensus on the indications for surgical removal in asymptomatic patients: Excessive psychological burden, affecting life Before pregnancy An additional item should be added at present: MRI performance Prof. Li Bi divided the surgical findings into three categories: I: injected material is viscous, colorless or yellowish, transparent, gel-like, and contains few granules. The envelope or interval is thicker II: the injected material is thinner, yellow, opaque, containing more and finer granules, more uniform, similar to cornmeal porridge. Thin envelope III: the injected material is thick, yellow, opaque, containing more granular material and coarser, yellow or white, and may have large pieces of free tissue, similar to millet porridge. Studies have shown that the injected material can significantly erode the surrounding tissue and cause it to become free, which is a high risk factor for complications such as infection. It has been found that there are three types of MRI findings, which correspond to the surgical findings: Type I: high signal in T2 with homogeneous signal Type II: high signal in T2 with heterogeneous signal. Type III: Mixed high signal in T2 term with heterogeneous signal and patchy low signal shadows of different sizes; therefore, preoperative MRI can determine the changes in the injected material and surrounding tissues, and an experienced professional surgeon can decide whether it needs to be removed by surgery as soon as possible. Prof. Li Bi suggests that asymptomatic patients should pay full attention to it, and it is better to all have an MRI examination to judge the risk a little.