The aesthetic result of the increase in plastic breast depends on many factors.The choice of location pockets and the implant installation method.The aesthetics of the bust after mammoplastics is affected by the individual initial data of the patient, including the shape of the chest and the mammary glands, the condition of the skin, the thickness of the subcutaneous fat.These anatomical characteristics and others are taken into account when choosing a profile, basic width, size and shape of endoproshese.An important criterion for a successful operation is to achieve a stable result that will delight a woman for many years.
The publication deals with the main mammary increases - Surgical access types, types of anatomical pockets to install implants, advantages and disadvantages of various mammoplasty methods.You will learn how to recover properly after the operation, which is possible and what cannot be done during the rehabilitation period.
Indications for the widening of the breast with the implants
The operation to enlarge the breast with the implants is carried out according to the aesthetic indications.The main indication of increase mammoplasty is the desire for the patient to improve breast aesthetics by increasing his size and modeling the shape.During the operation, the deficiencies due to the deformation of the nipple complex (stretching of the areola, change in the form) and omission of the glands after the baby's diet or due to age -related changes can also be eliminated.
The reason for the call to plastic surgeon may be the following problems:
- Damage of the aesthetics of the thoracic glands after pregnancy and breastfeeding.
- Change the shape of the bust following an involutional (aging) processes.
- Congenital hypoplasia of the mammary or amastia glands.
- Asymmetry, both innate and acquired.
- Tubular breasts.
- Mastoptose with signs of mammary glands hypotrophy.
- Femmelessness of women with regard to the shape or size of a bust.
The widening of the breast with the implants is also carried out by patients who have undergone radical operations on the mammary glands as part of the treatment of clever neoplasms.The reconstructive increase mammoplasty allows you to recreate natural and aesthetically attractive breasts without increasing the risk of developing tumor processes.
What individual characteristics are taken into account before the operation?
Surgical correction tactics are determined by the patient's individual characteristics.Yes, there is always the possibility of putting a large implant, but far from always being such a step will lead to the desired result - a change in natural and harmonious appearance.
The following factors are influenced by the choice of the shape, profile and size of the endoproshese, as well as by the choice of implantation pockets and the method of installing the implant
- The age of the woman.
- The initial shape and the size of the mammary glands.
- The height and the width of the chest.
- The severity of the subcutaneous fat.
- The elasticity of the integumentary tissues of the mammary glands.
- The width of the interrogation interval.
- The presence of signs of ptose (prolapse) of the bust.
The increase in increase mammoplasty also affects if a woman plans to give birth in the future to give birth and breastfeed.When choosing access, the need in plastic of the Mamelon-Arroolar complex is also taken into account, which may be necessary to obtain the optimal aesthetic result.
Implant installation methods
Given the above-mentioned individual characteristics of anatomy and other factors, a plastic surgeon chooses one of the three ways (types of surgical access) of breast augmentation:
- Areolar (breast enlargement "through the areola").
- SUBMAMMAIRE.
- Axillary.
You will find below the characteristics, advantages and disadvantages of each method of increasing mammoplasty in detail.
Access to the Areolar
With areolar or perireolar access, the plastic surgeon puts the implants through the incision, which passes along the periphery of the pigmented area of the areola.The main advantage of such surgical access is the invisibility of scars.The scar is located on the border of the light and dark skin, so it is quite difficult to notice.
In the periarean method to increase the chest glands, there are other advantages, in addition to the minimum severity of the postoperative scar:
- During the operation, it is possible to perform plasticism from the Mamelon complex.In some cases, it is difficult to reach the optimal aesthetics of a bust without correcting the size and shape of the SAK, and this advantage of periarene access can play a decisive role.
- Périréyular access eliminates the risk of damage to the related (sensitive) nerve fibers, which go to SAK in the loading fold area.Due to this advantage, the mammoplasty area allows you to completely maintain the sensitivity of the nipple and the areola.
- Simultaneously with the increase in the bust, you can correct the initial step of mastoptose.
Despite the advantages of the periaretary access listed above, the technique cannot be recommended to all women.In particular, this method of installing implants is not recommended for girls who plan to give birth to children and breastfeed them.This is explained by the fact that during the operation, there is a risk of damage to the milk conduits, which will affect the lactation function.
Access to periarization does not allow a complete overview of all implant pockets, which requires restrictions on the size of the implant.This method is well suited to patients who wish to put a small endoprosthesis and slightly increase the chest.In a situation where a woman wants to add 2-3 sizes to the mammary glands, it is preferable to use sub-dynamic or axillary access.
Undermentative access
With sub-rowing access, the installation of endoprosthesis is carried out through horizontal incisions, which pass under the chest gland in a natural skin fold.Postoperative scars when using this implant installation method are considerably expressed, but they are hidden in the skin fold.The scars are visible in the bed and standing position, they are covered by the lower pole of the chest gland.
The main advantage of sub-dynamic access is a very good overview of the operating field.For a plastic surgeon, it is the simplest type of mammoplasty, because there is full access to all implant pockets and it is easy to obtain an absolutely symmetrical placement of the implants.Thanks to this feature, large endoprostheses can be installed.
Another advantage of the sub-dynamic methodology to increase the bust is the lack of risk of damage to milk conduits.After the operation, the lactation function is preserved, which allows you to recommend this method for patients who provide for the baby's pregnancy and breastfeeding.
The sub-dynamic method of installation of implants is not devoid of gaps.For many patients as plastic surgeons, the principal less of the methodology in a pronounced and sufficiently extensive scar, which passes in a fold under the chest.The drawback is the risk of damage to the related nerves innervating the SAK.If during the operation, the nerve is dissected, the sensitivity of the nipple and the areola will be disturbed.
The use of sub-rowing access does not allow simultaneously with an increase mammoplasty to perform plastic surgery by a single incision.In addition, women who have the initial signs of a bust (mastopose) often turn using a plastic surgeon.If access to the periarism allows you to eliminate age-related manifestations, then when using sub-demmalary access, it is impossible to correct mastopose simultaneously with the widening of the chest.
Axillar access
With axillary access, breast augmentation is made through the cuts, which are in the axillary pit.The key advantage of the methodology is that the scars die from the mammary glands and do not affect their aesthetic perception.On the other hand, the scars are noticeable, and this can become a problem if a woman wears open clothes.For example, scars can be clearly visible during sport, especially in a body position, hands raised.
Nevertheless, Axillar access is considered to be "the ordeal" in the increase mammoplasty.The operation is carried out under the control of the fiber-optical equipment (endoscope), which allows a plastic surgeon to access all the implant pockets.There is no risk of damage to the nervous trunks.There is no risk of dissection of milk conduits, which allows us to recommend this method of installing implants to girls planning pregnancy.There are no restrictions in terms of endoprosthesis - the Axillar access type allows you to put implants of any volume, shape and profile.
The disadvantages of the axillary breast augmentation method are that the plastic surgeon has no way of correcting the consequences of the mammary glands omission or making plastic of the nipple-animal complex.For this reason, axillary access is used mainly to model the bust size, when there are no concomitant aesthetic problems requiring surgical correction.
Surgical access selection criteria
In clinical practice, plastic surgeons use several criteria for choosing surgical access to increase the chest glands.One of the main criteria is the age of the woman and her other plans concerning pregnancy.If the patient plans to give birth to the children, it is advisable to refuse periarenary access.Axillar access or sub-dynamic access is preferable.
If a woman does not plan to give birth, you can use one of the types of surgical access previously considered.In situations where, in order to improve the aesthetics of the bust, simultaneously with its increase, it is necessary to carry out plastic of the areola, perianialolar access is preferable.The same method of installing implants is better suited to patients with the initial signs of mastoptose.
Patients who wish to increase the bust with several sizes, a plastic surgeon can recommend an under-dynamic or axillary method.The optimal choice in this situation is an increase in the chest glands through the axillary pit, however, the aesthetic wishes of women are also taken into account.If it expresses the desire to hide the scar in a natural fold under the chest, the sub-dynamic access is selected.
Choose a pocket to install the implant
The following aspect of the increase in mammoplasty is associated with the choice of the anatomical region in which the implants will be installed.
The implantation pocket can be located:
- under the mammary gland (subgandular placement);
- under the pectoral muscle (subdiscular location);
- Partially under the gland, partially under the muscle (combined version).
Subgandular placement.The implant is installed in anatomical space under the gland.The most superficial pocket is separated from the body surface only with blanket tissues and breast glands, and due to this characteristic, it is not recommended to be used if necessary to increase the chest with several sizes.Great endoprosthesis can be visually determined.In addition, the risk of developing steps - aesthetic complication increases, in which a kind of "not" is formed above the upper edge of the implant.
With the sub-winning placement of endoprosthisisse, the risk of developing other complications of aesthetic nature, in particular, the appearance of the deformation of the integumentary tissues above the thoracic gland in the form of "waves" or "mountain ash".With the development of a capsular contracture, the deterioration of the aesthetics of the bust is also more pronounced with the superficial placement of the implant.
Another characteristic of this type of placement is that endoprosthesis and breast glands are only supported by CUPER bonds - the structures of the connective tissue, whose elasticity decreases with age.For this reason, with a subgandular implant installation, the risk of developing mastoptosis increases, especially in women with breasts initially important.
Sub-muscular investment.The placement of the implant under a large chest muscle avoids the characteristic problems of a subgandular location.Less the risk of capsular contracture and the appearance of a skin deformation above the chest in the form of "Rowan" and "Waves".Endoprosthesis is solidly fixed with muscles and does not increase the probability of developing mastopose.
But the placement of the implant under the muscle has the opposite side.
First, in girls actively involved in sports, the risk of rotation or movement of the implant increases.If, to increase the thoracic glands, fashionable implants have been used, rotation (turn) can cause breast deformation, which can only be corrected during a repeated operation.
Second, with the subdiscipular placement, the degree of tissue injury during surgery increases.For this reason, healing goes more slowly and the rehabilitation period is extended to wear compression underwear and followed all restrictions longer.
Combined placement.The best option is the combined placement, in which the segment of upper endoprosthhesis is under the muscle, and the lower pole is under the gland.With this arrangement, the risk of deformation of the steps is excluded.Below the risk of turning and moving the implant, the development of a capsular contracture and other aesthetic complications.Healing is faster, the rehabilitation period is reduced.
Types of implants
The widening of the breast is carried out by implants from the main world manufacturers.Silicone medical endoprostheses with a high degree of cohesion and various degrees of density have been made.Silicon is covered with an elastomer shell, which eliminates the probability of gel diffusion.The external capsule is represented by a porous shell, the special texture of which contributes to the integration of the implant into the living tissues and its reliable fixing.Due to the porous membrane, the risk of a goat fibrous contracture is reduced.
The line of each manufacturer has several hundred types of implants which differ in the following characteristics:
- Form: An implant can be anatomical (drop -shaped) or round.
- Basic width: horizontal size of the lower pole of the endoprosthhesis.
- Profile: Height of the endoprosthesis.
- Size: volume.
The choice of the implant is determined by the wishes, as well as by the initial data of the individual characteristics of the patient of the structure of the chest and the mammary glands.For example, girls with a pronounced inter-thilet gap are better suited to anatomical implants with low profile with a large base.Women who want to move accents to the neckline are more suitable for round implants with full profile, which visually increase the upper pole of the mammary gland.
Preparation of breast augmentation with implants
The preparation of plastic surgery within expanded breast can be divided into two stages - diagnostic and aesthetic.The purpose of the aesthetic stadium of the preparation is to choose the perfect implant and to decide on the tactics of the surgical intervention.Based on the results of modeling and computer analysis of the patient's initial data, the surgeon selects the endoprosthesis installation method and an anatomical pocket for his placement.
The purpose of the diagnostic stage is to minimize operational and anesthesiological risks, as well as eliminate contraindications for surgery.Each woman, before increasing the breast glands, undergoes a complete diagnosis, including an extended list of instrumental and laboratory methods.Mammography with a consultation of a gynecologist and mammologist is surely prescribed.
A few weeks before increasing mammoplasty, a woman should stop taking certain drugs, in particular, contraceptive hormonal drugs and anticoagulants.It is necessary to abandon the anti-inflammatory and analgesic drugs of the group NSAIDs because they slow down blood coagulation.It is also necessary to stop taking alcohol and abandoning smoking, because ethanol and nicotine slow down regenerative processes and negatively affect the rate of recovery after mammoplasty.
Rehabilitation after mammoplasty
The early postoperative period is accompanied by typical symptoms for any operation - swelling, pain and hematomas in the field of operational wound, fever, general discomfort.These symptoms are a normal body reaction in response to a violation of tissue integrity.The preparations prescribed by a plastic surgeon-anti-inflammatory, anti-explore, pain relievers will help to deal with the difficulties of this period.For the prevention of infectious complications, the doctor prescribes a short antibiotic lesson.
The specifics of the rehabilitation period after mammoplasty is that it is necessary to constantly wear a compression bra.Elastic linen is sewn on an individual order even before surgery.You must wear it continuously, you can only remove it for a while from hygiene procedures.As for body hygiene, within the first 7 to 10 days after increasing the chest glands, it should be limited by damp wipes, you cannot take a shower.
You cannot sleep after the operation only on your back.From 10 to 14 days, it is allowed to sleep on the side, but it is always impossible to light the stomach.You cannot play dance or sports.The ban on physical activity, including cleaning, is valid for 4 weeks;Electric loads and certain types of cardio training are contraindicated for 3 months (or until the special resolution of a plastic surgeon).
Throughout the restoration period, you cannot talk about direct sunlight or solarium.You can't go to a sauna or a bath, take hot baths at home.Alcohol and smoking are contraindicated.Compression linen is authorized to be withdrawn from the second month, but during the year, you must wear a bra with large straps and a large belt that supports the chest well.