Hi Maria_Eva! I'm really sorry you're still dealing with this—polyacrylamide gel (PAAG) complications can be persistent and frustrating. Based on your history and symptoms, here’s a breakdown of what might be going on and some options to consider: Chronic Inflammatory Response - even if there's no acute inflammation, the body can mount a low-grade immune response to residual PAAG. This can lead to fibrosis, nerve irritation, and pain. Gel Migration or Encapsulation - PAAG can migrate or get encapsulated within fibrotic tissue, potentially entrapping nerves or putting pressure on muscles—especially after activity. Neuropathic Component - constant thigh pain that worsens with use might also suggest nerve involvement—either from scarring, gel impingement, or past inflammation. *What Can Be Done - Here are several options, depending on the findings from imaging and your clinical exam: 1. High-Resolution MRI (preferably with STIR sequences) - more sensitive than ultrasound for identifying gel remnants, fibrosis, and nerve involvement. This will help plan whether further removal surgery is feasible or warranted. 2. Surgical Exploration & Targeted Excision - if remnants are accessible and well localized (especially superficial or near fascia), further conservative excision or debridement may be possible. 3. Pain Management / Neuropathy Evaluation - If imaging shows no clear surgical target, working with a pain specialist can help. Although I can't diagnose any of the above without a clinical evaluation, I'd be happy to discuss further at either a complimentary virtual appointment or in-office consultation. I am a board-certified plastic and reconstructive surgeon based out of New York with a specialized focus on silicone and biopolymer removal. Over the years, I have dedicated my practice to safely addressing complications arising from these materials. Recognizing the unique challenges they pose. Please call to schedule your complimentary consultation (516) 279-2616.