If you go out into the street and ask ten men why plastic surgery is necessary, many will answer without hesitation: "To enlarge women's breasts."This logic is not accidental: human civilization, whether women like it or not, is intrinsically patriarchal, that is to say, men dominate almost everywhere.For them, the bust is the most attractive part of a woman's body.
Therefore, since ancient times, women, in order to make a stronger impression on the stronger half of humanity, have found different ways to make their breasts more prominent.First of all, it is clothing with deep necklines, then underwear that creates beneficial optical effects.But all these measures were temporary and women wanted something permanent or at least lasting.
Only the development of plastic surgery has helped women to have an appearance that truly conforms to their own wishes and to meet the standards of external beauty set by men.In 1889, something that millions of beautiful ladies around the world dreamed of happened: a method of artificial breast augmentation was invented, which later became known as breast endoprostheses (from the Greek words "endon" - "inside" and "prosthesis" - "add, join").
The first material used to enlarge female breasts was paraffin, originally called petroleum wax because it was made from this flammable liquid.In the first decades of the last century, aesthetic medicine tried many materials suitable for endoprostheses: ivory and glass beads, polyethylene and polyurethane, polyester foam and much more.All this led to sad consequences.
It was not until 1961 that two American plastic surgeons from Houston, Thomas Cronin and Frank Gerow, manufactured and used the first silicone implants during surgical operations, thus achieving a real breakthrough in aesthetic medicine.But it took more than half a century before fifth-generation implants were invented, in the mid-1990s. They are distinguished by improved physical and chemical characteristics: they are denser and more reliable;the gel that fills them is very resistant and therefore does not leak through the hull.
Operation steps
Since breast arthroplasty is a fairly serious surgical procedure, it is performed only under general anesthesia.Throughout the operation, all vital indicators of the body are monitored using special monitors: blood pressure, heart rate, degree of blood oxygen saturation, etc.
Before the operation, the surgeon applies marking with a special marker, according to which the surgical approach is subsequently carried out.The incisions are generally made so that postoperative scars are barely visible.The choice of surgical approach depends on a number of determining factors.These include:
- position (high, middle or low) of the mammary glands on the chest wall;
- the presence or absence of breast ptosis - ptosis and its degrees (there are three in total);
- skin characteristics: thickness and elasticity, presence of stretch marks;
- anatomical features of the pectoral major muscles, sternum and ribs.
Next, a pocket (bed) is formed for the installation of implants.It can be located under the pectoralis major muscle, under the mammary gland, or a combined option is performed.The first method is used more often because it provides a more stable result.
After placement of the implants, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are applied using modern absorbable suture material or special medical glue.Next, the patient wears compression garments to prevent displacement of the implants and increased postoperative tissue swelling.For several hours after the operation, the patient remains in the rehabilitation department, where her condition is monitored by medical staff.
Typically, breast replacement surgery takes between 40 minutes and an hour and a half.Sometimes it takes longer depending on the surgical technique used and several other factors.For example, a patient's desire to enlarge her breasts several sizes at once.Additionally, if you have previously had breast reconstruction surgery following breast cancer or trauma, the procedure may be more difficult and take longer.
Operation methods
There are four main surgical approaches used worldwide.
- Inframammary (under the mammary gland).
This method involves cutting the skin only under the breast (in the inframammary fold), which, if there is a well-formed fold, makes the incisions imperceptible.In other cases, this access does not provide sufficient cosmetic results.The advantages of this approach include the fact that when used, the breast tissue is practically not affected. - Periareolar.
With this approach, the incision is located along the lower semicircle of the areola, on the border of the pigmented skin of the areola and the unpainted skin.As a result, after a few months, the postoperative scar becomes almost indistinguishable.In this case, the breast tissue deviates in the lower part.This in no way prevents the possibility of breastfeeding in the future and, contrary to common misconceptions, does not reduce the sensitivity of the nipples in the postoperative period. - Axillary (axillary).
This surgical approach involves making an incision in the axillary region.It also does not affect breast tissue.The use of the method is all the more justified as the initial size is very small and the inframammary fold is not formed.In other cases, it has limits.To achieve axillary access, endoscopic video technology is necessary.It allows the operation to be carried out in a safer and less traumatic way, taking into account the distance between the incision and the operating area. - Transumbilical.
This is a little used technique.This involves installing an implant through an incision in the umbilical area.In this way, only an implant filled with saline solution can be placed.The implant shell is first installed and then filled.Such breast implants are practically not used because, as experience has shown, silicone implants allow you to achieve a more stable result, taking into account all the nuances of a particular case.
The final choice of the implant placement method and surgical approach depends on the characteristics of each patient, and only a selective individual approach to each case allows you to achieve the most aesthetic result.
Preparing for surgery
Before starting preparations for the surgical procedure, the patient should inquire with the plastic surgeon about all aspects of the planned procedure: type of implant, manufacturer, availability and duration of warranty, shape, type of shell and filling.The most common silicone implants currently in the world are those with a textured shell and filled with shape memory silicone gel.
There are different types of implant fillers.
- silicone liquid, the consistency of which resembles vegetable oil;
- standard cohesive silicone gel (cohesion is the bond between the molecules of a substance, which determines its strength), with a jelly-like consistency;
- silicone gel with a high degree of cohesion, the consistency of which resembles marmalade;
- “soft touch” silicone gel (from the English “soft touch”) - increased softness;
- saline solution, consistency of a bag filled with water;
- soybean oil, similar in consistency to the first load.
Each filler has its own advantages and disadvantages.For example, a highly cohesive gel holds its intended shape well with a high level of projection, but feels denser to the touch.A saline solution makes the breasts as soft and natural as possible, but does not guarantee that their shape will be maintained.8 to 10 months after the start of use, the formation of salt crystals that can pierce the shell may begin.
In addition, there is a “gurgling” effect, which is also not suitable for all patients.
There is another way to enlarge breasts without using foreign bodies.This involves the introduction of fat cells – lipofilling or lipomodeling.This method was proposed relatively recently, in 2004, although similar experiments have been carried out since the second half of the 20th century.However, during these years, the implantation of fat did not have a positive effect, since it was quickly absorbed by the body.
Today, plastic surgeons have learned to treat fat cells so that the effect of their injection lasts longer.Despite this, after a year and a half, up to 60% of the volume of grafted tissue is absorbed, so the operation will have to be repeated.Therefore, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, the patient will have to undergo a complete medical examination to ensure that there are no medical contraindications and to minimize possible risks.It will include:
- blood tests: clinical and biochemical, for coagulation, for Rh group and factor, for HIV, syphilis and markers of hepatitis C and B;
- general urine analysis.
Additionally, a mammogram or ultrasound of the mammary glands, chest x-ray or fluorography, electrocardiogram and ultrasound of the veins of the lower extremities will be required.In addition, during a consultation with a plastic surgeon, the patient should be informed about all existing diseases, previous operations, allergic reactions, as well as medications taken, including dietary supplements.
In addition, before the operation, you will need to stop smoking and drinking alcohol for at least two weeks, since the first has a detrimental effect on healing, and the second is not compatible with antibiotics, which are prescribed for prophylactic purposes in the postoperative period.
In addition, any woman planning mammoplasty should know and take into account the fact that it is extremely undesirable to plan pregnancy within a year after the operation.The fact is that changes in hormonal levels in the early postoperative period and at the beginning of the lactation process (formation of breast milk) can affect breast implants in the most unpredictable way.
Contraindications to breast endoprosthesis are:
- pregnancy;
- diabetes mellitus;
- serious endocrine and autoimmune diseases;
- blood clotting disorder;
- diseases of the mammary glands (including massive formations), requiring observation by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular and respiratory systems which constitute a contraindication to general anesthesia;
- under 18 years of age;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
Full recovery after breast replacement surgery occurs within a few months.This period can be divided into several main stages.
During the first 3-4 days following surgery, patients may feel discomfort: heaviness and feelings of bursting in the pectoral major muscles.They can be relieved by taking painkillers prescribed by the attending physician.On the fourth day, these manifestations usually disappear.
Soft tissue swelling in the surgical area is possible.Sometimes it lasts several weeks and extends to the abdominal area.These are normal symptoms and should not be cause for concern.
Hand movements will be limited for 24 to 48 hours following the procedure.
During the first week you should not drive.During this time, it's best to keep your clothes as comfortable and easy to remove as possible.
You will need to limit your physical activity as much as possible.However, bed rest is not necessary at all.It is also strongly recommended to avoid nicotine and alcohol.
A week after the operation, you can already drive a car, but only if you do not take painkillers, which seriously impair motor skills.It is important to consult your surgeon before resuming driving.
If your job does not involve intense physical activity, returning to work is possible within one week.However, you should avoid lifting heavy objects (more than 4 to 5 kg) and refrain from any excessive physical activity.
A month after surgery, your doctor will likely clear you to resume light exercise.However, most surgeons still do not recommend doing much upper body work during this time, especially involving the pectoral major muscles.Light cardio exercises are possible without running or swimming.This is when you will start to see the results of breast augmentation.The breasts will begin to return to their natural position and take on a more natural shape.Be careful though, this process can take several months.Four weeks after surgery, compression garments are usually removed and you can begin wearing bras without underwires or pumps.
A few months after the operation, you will be able to see if the results are as expected.As for scars, they will continue to gradually fade over time and blend into the surrounding skin.They should become virtually invisible after a year if properly maintained.Two to three months after the operation, the breasts become softer, acquiring the consistency of natural breast tissue, then becoming increasingly soft as the months go by.After three months, you can start more intense upper body exercises.
There are a few additional post-surgery tips you can use to speed up your recovery:
- avoid taking medications that affect blood clotting;
- regularly moisturize your mammary glands to avoid stretch marks;
- suppress the desire to remove the bandages and watch the progress - this can cause infection;
- give your implants time to “adapt”: at first, they will not have a natural appearance, with an overfilled upper pole, but gradually they will take on a natural teardrop shape;
- make sure you get enough rest as this speeds up the recovery process;
- Avoid wearing tight clothing, especially those that require you to raise your arms high to put them on;
- For a month after the operation, you should only sleep on your back!You can't sleep on your side, much less on your stomach.The first few days it will be easier to sleep with pillows placed high behind your back;
- if you feel severe pain, asymmetrical swelling appears or the bandage gets wet, consult a doctor immediately;
- Don't worry if you experience increased sensitivity or decreased sensitivity in your nipples after surgery: this is normal;
- the sensations on the right and left may not be the same - this is not a sign of a problem and happens to almost everyone;
- Please note that most women can breastfeed after surgery, but milk production may be slower.