In the late nineties, polyacrylamide gel (PAAG) gained popularity in China as a soft tissue filler for breast augmentation and contouring, but was banned 10 years later due to the increasing incidence of complications. We report a case of PAAG complication that occurred 20 years after the initial injection, where the patient had significant unilateral breast swelling and an intracapsular lesion. Surgical removal of the breast filler and immediate breast reconstruction was successfully …