Title: Vulvar Migration of Injected Polyacrylamide Hydrogel Following Breast Augmentation#
A Case Report and Literature Review
Version: 0 Date: 19 Dec 2023
Reviewer:  Nora Sabah Rasoul
Reviewer's report:
Dr. Nora Sabah Rasoul
I would like to thank the authors for their hard work invested in the creation of this article, it is
an interesting and important subject as it is associated with many complications.
I have remarks to mention hoping to strengthen your work.
Title
Please change vulva to vulvar and I suggest to replace (gel filler) by polyacrylamide hydrogel.
Abstract
1. Line No. 11 in background please change vulva to vulvar, line No. 12 add as after repeated.
2. Please write few words about your case (for example we will report a case of …..) in the
background.
Case presentation
3. In abstract there should be no abbreviations.
4. Rewrite it in a way so it will clear for any reader to the abstract alone.
5. Discussion and conclusion please it is just conclusion no need to add the word discussion.
6. Please write what you concluded from the case.
7. Keywords: I suggest to add vulva and to replace gel filler by polyacrylamide hydrogel.
All manuscript (the text, the paragraph……) needs to be rewritten.
Background
1- The references (1&5) please cite the original paper, reference 1 American
Society of Plastic Surgeons. 2011 Cosmetic plastic surgery statistics. Available
at: http://www.plasticsurgery.org/Documents/news-resources/statistics/2011-statistics/2011-
cosmetic-procedures-trends-statistics.pdf. Accessed February 21, 2012
Do the same for reference 5 and you can add the updated version of US Food and Drug
Administration about dermal fillers.
2- Line 46 more aggressive surgery plan change to surgical, line 50 detailed discussed change
to (discussed in details).
Case presentation
1- Regarding local clinic is it public or private? Is there such facility in local clinic? Please add
the country and the hospital name.
2- Line 57 please change vulvar to vulva &vice versa in lines 62, 67, 81.
3- Line 63 I suggest to mention first the ultrasound finding before CT scan.
4- Please put explanation below each figure with its number so we can identify each one. Do
you have figure shows the Vacuum sealing drainage (VSD) after the operation?
5- Line 70 please mention the no. and size of the incisions which had been made.
6- Line 79 add report or examination to pathology.
7- Line 81 (Postoperative thoraco-abdomin-pelvic CT showed the most) change to
(Postoperative thoraco-abdomino-pelvic CT scan showed that most), line 82 this patient to the
patient (change this to the).
Discussion and conclusion
1- Please change vulva to vulvar in lines 93, 100, 137, 157 and 163.
2- In the first paragraph please write OR& AND in lines 89, 90, 91 in lowercase.
3- Line 102 indeed the patients were females as you choose the vulva.
4- Regarding review of literature please add the duration between diagnosis and surgical
intervention to now the differences and similarity with case and even regarding severity.
5- Lines 107, 108 rewrite it again. Line 110 change onset symptoms to onset of symptom. Line
118 table to stable. Line 125 during the last ten years. Line 129 which is associated please change
which to who. Add (the) in line 134 consistent with the reported.
6- Line 137 I think it should be (A previous experimental assessment that showed there was).
At end of Line 142 delete (the) and replace it by (in).
7- Line 159 please add an explanation for why PAAG becomes a good medium for bacterial
growth, the following articles I hope will help you:
Okubo M, Hyakusoku H, Kanno K, Fumiiri M (1992) Complications after injection
mammaplasty. Aesthetic Plast Surg 16:181–187
Ohtake N, Koganei Y, Itoh M, Shioya N (1989) Postoperative sequel of augmentation
mammaplasty by injection method in Japan. Aesth Plast Surg 13:67
Breiting V, Aasted A, Jørgensen A (2004) A study on patients treated with polyacrylamide
hydrogel injection for facial corrections. Aesthetic Plast Surg 28:45–53
8- Line 171 it should be (recommended for management).
9- Line 185 please mention the type of debridement.
10- Line 193 It is necessary to closure of this sinus for promoting please change to (It is necessary
to close the sinus to promote healing).
Abbreviations
Please rearrange them in an alphabetical order.