Purpose Complications from Polyacrylamide hydrogel breast augmentation (PHBA) are a rare cause for presentation in Australia. We present the case of a 44 year-old female with a three-year history of intermittent right lateral breast pain. She had a background of breast augmentation with Interfall Gel in China in 2000. She was tender over the lateral aspect of her breast which was exacerbated by physical activity. MRI revealed areas of extravasation bilaterally and explantation was offered but denied by the patient who wanted close observation. Methodology: We conducted a thorough review of the English literature on Medline using the keywords ‘Polyacrylamide Hydrogel’, ‘Interfall gel’, ‘breast’, ‘augmentation’ and ‘complications’. Results: Our search revealed 36 papers examining patients treated for complications following PHBA. The majority of the studies were from Asia, where the technique was primarily used, with no studies in an Australian population. Conclusions Although a rare presentation, Australia’s population has many immigrants from Asian nations and further presentations are to be expected. The literature clearly supports the importance of careful monitoring of these patients, due to the potential for severe complications such as infection, sepsis, breast autoinflation, significant tenderness and possibly increased risk of breast malignancy. MRI is also crucial in evaluating these cases, namely to rule out malignancy and for pre-operative planning in severe cases. However the majority of presentations are suitable for careful monitoring.