Mammoplasty

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

Indications for surgery

• Lowering and reduced elasticity of the mammary glands (mastoptosis).
• Increased breast volume, while maintaining its tone and position (macropathy).
• Reduction of the mammary glands after breastfeeding.
• Small breast size (micromastia).
• Increased breast volume in men (gynecomastia).

Types of mammoplasty

1. Magnifying mammoplasty(endoprosthesis) - breast augmentation, correction of its shape with the help of implants. Used after childbirth, breastfeeding, with congenital asymmetry.
2. Reduction mammoplasty- Breast reduction with mastoptosis or macropathy.
3. Mastopexy- lifting the chest. It is indicated for mastoptosis if the breast volume meets the requirements for surgery.

Endoprosthesis of the mammary glands

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

Breast implants

Silicone or polyurethane endoprostheses correct the volume, the shape of the bust, give a feeling of natural body tissues.

The service life of the implants exceeds 15 years, after which it is recommended that they be replaced.

The 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. The saline solution is safer, softer, cheaper. Negative properties - the bubble when moving, prone to leakage.
2. Structure: rough (textured) or smooth. Textured implants are more stable, but skin folds can be caused by friction of body tissues on their surface. The disadvantage of smooth dentures is the likelihood of displacement.
3. Shape: anatomical or round. The former have a more natural appearance, while the latter retain the symmetry and shape of the breasts even when displaced.

Reduction mammoplasty

When this type of operation is performed, the adipose tissue and breast tissue are partially removed, their size is changed and a new shape is given.

Excision of excess tissue reduces the likelihood of cancer.

Possibilities for reduction mammoplasty:

1. Liposuction. The method is considered conservative and leaves no stitches. Designed for slight breast reduction with mild mastoptosis.
2. Short (vertical) seam. A popular method in which the breasts maintain their natural shape and the nipples are sensitive. The operation takes a little time and the complication rate is low.
3. T-shaped (anchor) cut. The classic method used to remove large amounts of tissue. Its disadvantages are the duration of recovery, a large scar.
4. Nipple amputation. Used for very large breasts. The method is associated with a high risk of injury to the mammary glands, loss of nipple sensitivity and inability to breastfeed.

Mastopexy

Breast lift without implants is possible in several ways:

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

Stages of operation

High-quality medical care at all 3 stages is important for an excellent result from plastic surgery. The preparation 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 performed no earlier than one year after the end of lactation. 2 weeks before the operation it is forbidden to take hormonal contraceptives, aspirin and preparations containing salicylates.

You need to stop drinking alcohol, smoking.

During the preparation, examinations must be performed:

• general and biochemical blood tests;
• electrocardiogram;
• blood test for anticoagulants (coagulogram);
• Ultrasound of the mammary glands;
• general urine analysis
• testing for hepatitis and HIV viruses.

The course of the surgical intervention

Breast augmentation is performed under general anesthesia. A special type is expander dermotony. It is used to increase the volume of the breast with a lack of its own tissue and large size of the implant. The procedure is performed in 2 stages. First, an expander is installed to gradually stretch the breast tissue for 1, 5–2 months.

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

Surgical methods of incision:

1. Through the fold under the breast (submammary access). A safe method to increase mammoplasty. A scar from an incision 4-5 cm long disappears with time under the slightly lowered breast. Access is difficult with micromastia in thin girls.
2. Incision around or along the inferior areola of the areola (periareolar approach). Advantage - surgical scars are almost invisible. For patients who are planning to breast-feed, this method is not recommended due to the high risk of breast injury.
3. Endoscopic magnification by axillary approach. High-tech equipment helps install the implant without damaging blood vessels and nerve fibers. An incision 3-4 cm long is made in the axillary area, after which the scar is naturally masked. There is a limit for the volume of the implant - up to 400 ml.
4. Endoscopic access through the navel. This method is little used due to the distance of the entry point from the site of surgery, difficulties with the formation of a "pocket" for the prosthesis.

Rehabilitation after mammoplasty

If the operation went without complications, the patient spends up to 3 days in the hospital. After discharge it is necessary to attend dressings. Moderate pain in the area of intervention, which occurs in the first days, is considered natural. The feeling of tightness of the skin is possible due to postoperative edema, which disappears after about 5-7 days.

After 4-6 weeks, the breast sags slightly, looks more natural and capsules form around the implants.

Rules for successful recovery:

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

Possible complications

• Capsular contracture. The body forms a sheath around the endoprosthesis, which can lead to its displacement, breaking the symmetry of the mammary glands and their hardening.
• Infection. The infection occurs during the operation due to violation of the rules of asepsis or after non-compliance with antiseptic standards of care. The period of special risk is 1 week after the operation.
• Keloid, hypertrophic scars. They appear if the body is prone to their formation. The formations look like dense ridges rising 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 skin color. This happens when the blood vessels, lymph vessels are damaged during surgery or during the recovery period. Complication occurs due to low blood coagulation, a sharp rise in blood pressure, improperly sized endoprosthesis.
• Reduction or loss of sensitivity of the nipples, areolas. It often occurs when large breasts are reduced with reduction mammoplasty due to nerve damage.
• Rupture of the implant. It occurs due to the thin shell, which is often found in cheap dentures. The salt filler is easily absorbed by the body without causing harm. Damage to the endoprosthesis with cohesive gel is not always noticeable, but it is dangerous if the silicone gets into the tissues of the body.

Breastfeeding after surgery

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

Breastfeeding is allowed about a year after the operation.

Breastfeeding problems can occur in the following cases:

• The endoprosthesis is placed to compress the mammary glands, reducing the volume of milk they produce.
• An incision in the areola is more likely to injure the nerve endings around the nipple.
• Reduction plastic, associated with reducing breast size, disrupts the milk ducts, blocking their functions.

In what 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, influenza).
• Neurological, mental disorders.
• Pregnancy, breastfeeding.
• Age under 18 years.

Advantages and disadvantages of mammoplasty

Advantages of breast augmentation:

• Implementation of modern interventions.
• Correction of congenital and acquired defects of the mammary glands.
• Long-lasting and emphasized aesthetic effect.
• Short terms of the operation.
• Possibility to choose the shape, material of endoprostheses at will.
• Preservation of the ability to lactate.

Possible disadvantages include:

• Skin marks from incisions - stitches, scars (unless special absorbent materials are used).
• Threat of complications (infection, breast deformity, bleeding).
• The need to replace 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.
• Long period of rehabilitation (from several months to a year) with refusal of sports, physical activity, pregnancy, breastfeeding.