Mammoplasty

Shape correction, breast augmentation is one of the most popular plastic surgery procedures. With the help of mammoplasty, you can correct congenital or acquired breast defects, restore their volume, elasticity after childbirth and breastfeeding. Correctly performed surgery helps a woman to become more attractive, more self-confident.

Indications for surgery

• Descent and decrease in the elasticity of the mammary glands (mastoptosis).
• Breast enlargement while maintaining its tone and position (macropathy).
• Reduction of the mammary glands after breastfeeding.
• Small breasts (micromastia).
• Enlarged breast volume in men (gynecomastia).

Types of mammoplasty

1. Breast augmentation(endoprosthesis) - breast augmentation, correction of its shape by means of implants. It is used after childbirth, breastfeeding, with congenital asymmetry.
2. Breast reduction- Reduce breast size with mastoptosis or macropathy.
3. breast lift- breast lift. It is indicated for mastoptosis, if the volume of the breast meets the requirements for the operation.

Endoprosthesis of the mammary glands

The operation involves the installation of silicone implants (implants) in the mammary glands. The choice of the incision site is consistent with the woman. The implant is placed under the pectoral muscle and, if the volume of the breast permits, between the muscle and the mammary gland. The incision is sutured, no drainage is required. The nipple and areola are enlarged after surgery.

Breast implants

Endoprostheses in silicone or polyurethane correct the volume, the shape of the bust, give a feeling of natural body tissues.

The duration of the implants exceeds 15 years, after which it is recommended to replace them.

Products differ in a number of indicators:

1. Fillers: cohesive gels or saline (sodium chloride). The composition of the gels is more elastic, homogeneous, light, but dangerous for the body if it leaks. Saline is safer, softer, cheaper. Negative properties: gurgles when moving, subject to leaks.
2. Structure: rough (structured) or smooth. Textured implants are more stable, but skin folds can appear from the friction of body tissues against their surface. The disadvantage of smooth implants is the likelihood of displacement.
3. Shape: anatomical or round. The former have a more natural look, while the latter retain the symmetry and shape of the breasts even when moved.

Breast reduction

When performing this type of surgery, fatty tissue and breast tissue are partially removed, their size changes and a new shape is given.

Removing excess tissue reduces the likelihood of cancer.

Breast reduction options:

1. liposuction. The method is considered conservative and leaves no seams. Designed for minor breast reduction with mild degrees of mastoptosis.
2. Short (vertical) seam. A popular method in which the breasts retain their natural shape and the nipples are sensitive. The operation takes little time and the complication rate is low.
3. T-shaped cut (anchor). The classic method, which is used for large amounts of removed tissue. Its disadvantages are the duration of recovery, a large scar.
4. Amputation with nipple transfer. It is used for very large breasts. The method is associated with a high risk of injury to the mammary glands, loss of nipple sensation, and inability to breastfeed.

breast lift

Breast lift without implants is possible in several ways:

1. Vertical is used for 1-2 degree mastoptosis, the seams are almost invisible, the cosmetic effect is lasting. The method is ineffective for lowering the breast by 3-4 degrees.
2. Anchor mastopexy gives good results for ptosis of any complexity. Its disadvantages include a longer recovery period, noticeable stitches, an increased risk of injury to the breast tissue.
3. Periareolar mastopexy is the removal of a small piece of skin around the areola. It is indicated for pseudoptosis, for other forms of relaxation of the bust it is ineffective.

Operational phases

For an excellent result of plastic surgery, high quality medical care at all 3 stages is important. The preparatory period lasts 1-2 weeks. The actual surgery takes 1 to 4 hours.

Full recovery occurs within 1. 5 months.

Preparation for mammoplasty

The operation is carried out no earlier than a year after the end of lactation. 2 weeks before surgery it is forbidden to take hormonal contraceptives, aspirin and preparations containing salicylates.

You should stop drinking alcohol, smoking.

In preparation, research is necessarily carried out:

• general and biochemical blood tests;
• electrocardiogram;
• blood test for anticoagulants (coagulogram);
• Ultrasound of the mammary glands;
• general urinalysis
• tests for hepatitis and HIV virus.

The course of surgical intervention

Torso plastics are performed under general anesthesia. A special type is the dermal tension of the expander. It is used to increase the volume of the breast with a lack of its own tissue and large implant size. The procedure is carried out in 2 stages. First, an expander is installed to gradually stretch the breast tissue over 1. 5-2 months.

When the desired size is reached, an endoprosthesis is placed in the breast.

Operational etching methods:

1. Through the crease under the breast (inframammary access). Safe method for breast augmentation. A scar from a 4-5 cm long incision disappears over time under a slightly lowered breast. Access is difficult with micromastia in thin girls.
2. An incision around or along the lower arch of the areola (periareolar approach). Advantage: Surgical scars are almost invisible. For patients intending to breastfeed, this method is not recommended due to the high risk of breast injury.
3. Endoscopic augmentation through the axillary approach. High-tech equipment helps install the implant without damaging blood vessels and nerve fibers. A 3-4 cm long incision is made in the axillary area, then the scar is naturally masked. There is a limitation to the volume of the implant - up to 400 ml.
4. Endoscopic access through the navel. This method is little used due to the remoteness of the entry point from the site of the operation, difficulty with the formation of a "pocket" for the prosthesis.

Rehabilitation after mammoplasty

If the operation took place without complications, the patient spends up to 3 days in the hospital. After discharge, it is necessary to attend dressings. Moderate pain in the intervention area that occurs in the first few days is considered natural. Sensations of skin tension are possible due to postoperative edema, which subsides after about 5-7 days.

After 4-6 weeks, the breasts sag slightly, look more natural, and the capsules form around the implants.

Successful Recovery Rules:

• Do not load the shoulder girdle, do not lift weights.
• Do not visit fitness clubs, swimming pools, saunas, baths.
• Sleep on your back.
• Don't raise your hands.
• After breast augmentation, be sure to wear compression garments.

Possible complications

• Capsular contracture. The body forms a shell around the endoprosthesis, which can lead to its displacement, violation of the symmetry of the mammary glands and their hardening.
• Infection. Infection occurs during the operation due to the violation of the rules of asepsis or after non-compliance with antiseptic standards of care. The period of particular risk is 1 week after the operation.
• Keloids, hypertrophic scars. They appear if the body is predisposed to their formation. The formations look like dense ridges that rise above the surface of the skin and spoil the appearance of the breast.
• Accumulation of blood, serous fluid (hematoma, seroma) and, as a result, darkening of the skin color. It occurs when blood vessels, lymphatic vessels are damaged during surgery or during the recovery period. Complication appears due to low blood clotting, sharp increases in blood pressure, endoprostheses of the wrong size.
• Reduction or loss of sensitivity of the nipples, areolas. It often occurs when large breasts are reduced with breast reduction due to nerve damage.
• Rupture of the implant. It occurs due to the thin shell, which is often found in inexpensive dentures. The salt filler is easily absorbed by the body without causing harm. Damage to an endoprosthesis with a cohesive gel is not always evident, but it is dangerous if the silicone penetrates the body's tissues.

Breastfeeding after surgery

The safest operation is through an incision in the armpit (transaxillary) or under the breast (inframammary).

About a year after surgery, breastfeeding is allowed.

Breastfeeding problems can occur in the following cases:

• The endoprosthesis is positioned to compress the mammary glands, reducing the volume of milk they produce.
• A cut along the areola is more likely to damage the nerve endings around the nipple.
• Reduction plastic, associated with a reduction in breast size, disrupts the milk ducts, blocks their functions.

In which cases is breast plastic surgery contraindicated?

• Cardiovascular diseases, varicose veins (thrombophlebitis, thrombosis).
• Severe forms of mastopathy.
• Oncology.
• Blood clotting disorders, diabetes mellitus.
• Infectious diseases (ARVI, flu).
• Neurological, mental disorders.
• Pregnancy, breastfeeding.
• Age under 18.

Advantages and disadvantages of mammoplasty

Advantages of plastic breast correction:

• Application of modern interventions.
• Correction of congenital and acquired defects of the mammary glands.
• Long-lasting and pronounced aesthetic effect.
• Short terms of the operation.
• The possibility to choose the shape, the material of the endoprostheses at will.
• Preservation of the ability to milk.

Possible drawbacks include:

• Skin marks from incisions - stitches, scars (unless special absorbable materials were used).
• Threat of complications (infection, breast deformity, bleeding).
• The need to change endoprostheses every 10-15 years.
• The high cost of mammoplasty.
• The need for general anesthesia.
• Painful sensations in the first postoperative days.
• The need to constantly wear compression underwear.
• A long period of rehabilitation (from several months to a year) with the refusal of sports, physical activity, pregnancy, breastfeeding.