If you go out on 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 want it or not, is intrinsically patriarchal, that is, 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 come up with different ways to make their breasts more prominent.At first it was dresses with deep necklines, then underwear that created beneficial optical effects.But all these were temporary measures and women wanted something permanent or at least long-lasting.
Only the development of plastic surgery helped women to truly appear according to their desires and meet the standards of external beauty set by men.In 1889, what millions of beautiful women around the world dreamed of happened: a method of artificial breast enlargement was invented, which later became known as breast endoprosthesis (from the Greek words "endon" - "internal" and "implant" - "addition, union").
The first material used to enlarge female breasts was paraffin, initially called petroleum wax, since it was composed of this flammable liquid.In the first decades of the last century, aesthetic medicine experimented with many materials suitable for endoprosthesis: ivory and glass beads, polyethylene and polyurethane, polyester foam and much more.All this led to sad consequences.
Only in 1961, two American plastic surgeons from Houston, Thomas Cronin and Frank Gerow, manufactured and used the first silicone prostheses during surgical operations, 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 highly durable and therefore does not leak through the shell.
Operational phases
Since breast replacement is a fairly serious surgical procedure, it is performed only under general anesthesia.During the entire operation, all vital indicators of the body are monitored using special monitors: blood pressure, heart rate, degree of oxygen saturation in the blood, etc.
Before the operation, the surgeon applies marks with a special marker, according to which the surgical approach is then carried out.Incisions are usually made so that postoperative scars are minimally visible.The choice of surgical approach depends on a series of determining factors.In particular, these are:
- position (high, medium 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 characteristics of the pectoralis major muscles, sternum and ribs.
Then 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 the installation 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 is used.Compression garments are then placed on the patient 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.
In general, breast replacement surgery lasts from 40 minutes to an hour and a half.Sometimes it takes longer depending on the surgical technique used and a number of other factors.For example, a patient's desire to enlarge her breasts by several sizes at once.Also, if you have previously had breast reconstruction surgery following breast cancer or trauma, the procedure may be more difficult and take longer.
Operational methods
There are four main surgical approaches used worldwide.
- Submammary (under the mammary gland).
This method involves cutting the skin only under the breast (in the inframammary fold), which, if the fold is well formed, makes the incisions imperceptible.In other cases, this access does not provide sufficient aesthetic results.The advantages of this approach include the fact that when it is used, the breast tissue is practically not damaged. - Periareolar.
With this approach, the incision is placed along the lower semicircle of the areola, at the border between the pigmented skin of the areola and the unpainted skin.For this reason, after a few months the postoperative scar becomes almost indistinguishable.In this case, the breast tissue recedes at the bottom.This in no way prevents the possibility of breastfeeding in the future and, contrary to what is mistakenly thought, 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.This also does not affect breast tissue.The use of the method is more justified when the initial size is very small and the inframammary fold is not formed.In other cases it has limitations.Video endoscopic technology is required to obtain axillary access.It allows the operation to be performed in a safer and less traumatic way, given the distance of the incision from the operating area. - Transumbilical.
This is a rarely used technique.It involves installing an implant through an incision in the umbilical area.In this way it is possible to install only a system filled with saline solution.First the shell of the plant is installed, then it is filled.Such breast implants are practically not used, since, 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 installation method and surgical approach depends on the characteristics of each patient, and only a selective individual approach to each case allows obtaining the most aesthetic result.
Preparation for surgery
Before starting preparations for surgery, the patient should inform the plastic surgeon about all aspects of the planned procedure: type of implant, manufacturer, availability and duration of warranty, shape, type of cup and filling.The most common currently in the world are silicone implants with a structured shell and filler - silicone gel with shape memory.
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 consistency reminiscent of gelatin;
- silicone gel with a high degree of cohesion, the consistency of which resembles jam;
- “soft touch” silicone gel (from the English “soft touch”) - greater softness;
- saline solution, the consistency of a bag full of water;
- soybean oil, similar in consistency to the first filler.
Each filler has its advantages and disadvantages.For example, a highly cohesive gel holds its intended shape well with a high level of projection, but is denser to the touch.A saline solution makes the breast as soft and natural as possible, but does not guarantee that it will maintain its shape.After 8-10 months from the start of use, the formation of salt crystals may begin which can perforate the shell.
Furthermore, there is a “bubbling” effect, which is not suitable for all patients.
There is another way to enlarge your breasts without the use of foreign materials.This is the introduction of fat cells: lipofilling or lipomodeling.This method was proposed relatively recently, in 2004, although similar experiments have been conducted since the second half of the 20th century.However, in those years, fat implantation did not have a positive effect, as it was quickly absorbed by the body.
Today, plastic surgeons have learned to treat fat cells in such a way that the effect of their injection lasts longer.Despite this, after a year and a half, up to 60% of the volume of the transplanted tissue is absorbed, so it will be necessary to repeat the operation.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 the Rh group and factor, for HIV, syphilis and markers of hepatitis C and B;
- general urinalysis.
In addition, mammography or ultrasound of the mammary glands, chest x-ray or fluorography, electrocardiogram and ultrasound of the veins of the lower extremities will be necessary.Also, during consultation with a plastic surgeon, the patient should be informed about all existing diseases, previous operations, allergic reactions and medications taken, including dietary supplements.
In addition, before the operation, you will have to stop smoking and drinking alcohol for at least two weeks, since the former has a negative effect on healing, and the latter is not compatible with antibiotics, which are prescribed prophylactically in the postoperative period.
In addition, every woman planning a mammoplasty should know and take into account the fact that planning a pregnancy within a year after the operation is extremely undesirable.The fact is that changes in hormone 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.
The contraindications for performing breast endoprosthesis are:
- pregnancy;
- diabetes mellitus;
- serious endocrine and autoimmune diseases;
- blood clotting disorder;
- diseases of the mammary glands (including mass formations), requiring observation by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular and respiratory systems that serve as a contraindication to general anesthesia;
- age under 18;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
Full recovery after breast replacement occurs within several months.This period can be divided into several main phases.
During the first 3-4 days after surgery, patients may feel discomfort: heaviness and a sensation of bursting in the area of the pectoralis major muscles.They can be relieved by taking analgesics prescribed by your doctor.On the fourth day these manifestations usually disappear.
Soft tissue swelling in the surgical area is possible.Sometimes it lasts several weeks and spreads to the abdominal area.These are normal symptoms and should not be a cause for concern.
Hand movements will be limited for the first 24 to 48 hours after the procedure.
During the first week you should not drive.During this time, it's best to keep your clothing as comfortable and easy to remove as possible.
You will want to limit physical activity as much as possible.However, bed rest is not at all necessary.Avoidance of nicotine and alcohol is also highly recommended.
A week after the operation it is already possible to drive the car, but only if you do not take painkillers which seriously impair your motor skills.It is important to consult your surgeon before you start driving again.
If your job does not involve strenuous physical activity, returning to work is possible within a week.You will still need to avoid lifting heavy objects (more than 4-5 kg) and refrain from excessive physical activity.
A month after surgery, your doctor will likely allow you to resume light exercise.However, most surgeons still do not recommend performing much upper body work during this period, especially involving the pectoralis major muscles.Light cardio exercises are possible without running or swimming.During this time you will begin to see the results of breast augmentation.The breasts will begin to fall into their natural position and take on a more natural shape.However, please note that this process may take several months.Four weeks after surgery, compression garments are usually removed and you can begin wearing bras without underwires or push-ups.
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 within a year if properly cared for.Two to three months after surgery, the breasts become softer, acquire the consistency of natural breast tissue, and then become softer and softer every month.After three months, you can start more intense upper body exercise.
There are some other post-surgery tips you can use to speed up recovery:
- avoid taking drugs that affect blood clotting;
- regularly moisturize the mammary glands to avoid stretch marks;
- suppress the desire to remove the bandages and observe the progress - this can provoke an infection;
- give your implants time to "adapt": at first they will seem unnatural, with the upper pole excessively filled, but gradually they will acquire a natural teardrop shape;
- make sure you get plenty of rest as this speeds up the recovery process;
- Avoid wearing tight clothing, especially those that require you to raise your arms when wearing them;
- For a month after surgery, you must sleep only on your back!You can't sleep on your side, much less on your stomach.In the first few days it will be easier to sleep with the pillows positioned high behind your back;
- if you feel severe pain, asymmetric swelling appears or the bandage is wet, consult a doctor immediately;
- Don't worry if you notice an increase or decrease in nipple sensitivity after surgery: this is normal;
- sensations on the right and left may not be the same - this is not a sign of problems and happens to almost everyone;
- Please note that most women can breastfeed after surgery, however milk production may be slower.