The aesthetic result of plastic breast enlargement depends on many factors.The choice of implant pockets and the implant installation method is of great importance.The aesthetics of the bust after mammoplasty is influenced by the individual initial data of the patient, including the shape of the chest and mammary glands, the condition of the skin, the thickness of the subcutaneous fat layer.These and other anatomical characteristics are taken into account when choosing a profile, basic width, size and shape of the endoprosthesis.An important criterion for a successful surgery is to achieve a stable result that will delight a woman for many years.
The publication discusses the main ways of breast enlargement - types of surgical access, types of anatomical pockets for installing implants, advantages and disadvantages of different methods of mammoplasty.You will learn how to recover properly after surgery, what is possible and what cannot be done during the rehabilitation period.
Breast enlargement indications with implants
The surgery to enlarge the breast with implants is performed according to aesthetic indications.The main indication of an increase in mammoplasty is the patient's desire to improve the aesthetics of the breast by increasing its size and modeling the form.During the surgery, deficiencies due to deformation of the radio complex (stretching of the areola, change in form) and leakage of the glands after eating the baby or due to age-related changes can also be eliminated.
The reason for the appeal to the plastic surgeon may be the following problems:
- Worsening of the aesthetics of the breast after pregnancy and lactation.
- Changing the shape of the bust as a result of involuntary (aging) processes.
- Congenital hypoplasia of the mammary glands or Amatika.
- Asymmetry, both congenital and acquired nature.
- Tube breasts.
- Mastoptosis with signs of mammary hypotrophy.
- Woman dissatisfaction with the shape or size of the bust.
Breast enlargement with implants is also performed by patients who have undergone radical surgery on the mammary glands as part of the treatment of malignant neoplasms.Reconstructive mammoplasty to enlarge 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 surgery?
The tactics of surgical correction are determined by the individual characteristics of the patient.Yes, there is always the opportunity to put a large size implant, but far from always such a step will lead to the desired result - a natural and harmonious change in appearance.
The following factors are influenced by the choice of the shape, profile and size of the endoprosthesis, as well as the choice of implant pockets and the implant installation method
- The age of the woman.
- The original shape and size of the mammary glands.
- The height and width of the chest.
- The weight of subcutaneous fat.
- The elasticity of integrades of mammary gland tissues.
- The width of the interval of questioning.
- The presence of signs of ptosis (prolapse) of the bust.
The mammoplasty tactic for enlargement also affects whether the woman plans to give birth in the future to give birth and breastfeeding.When choosing access, the need for the plastic of the-Jolar grain complex is also taken into account, which may be required to achieve the optimal aesthetic result.
Methods for installing implants
Considering the above individual characteristics of anatomy and other factors, a plastic surgeon chooses one of the three ways (types of surgical access) of breast enlargement:
- Areolar (breast enlargement "through the areola").
- Submamarik.
- Axillary.
Below are the characteristics, pros and cons of each method of enhancing mammoplasty.
Areolar access
With areolar or periareolar access, the plastic surgeon places the implants through the incision that passes along the periphery of the pigmented area of the areola.The main advantage of such surgical access is the invisibility of the scars.The scar is located on the limit of light and dark skin and therefore it is quite difficult to notice it.
There are other advantages in the perirellar method of enlarging the breast, in addition to the minimum severity of the postoperative scar:
- During the operation, it is possible to carry out plasticism of the Areler Complex Complex.In some cases, it is difficult to achieve the optimal aesthetics of the bust without adjusting the size and shape of the SAK, and this advantage of Periarelar Access can play a decisive role.
- Periareyular Access eliminates the risk of damage to afferent (sensitive) nerve fibers that move to SAK in the area of the load fold.Because of this advantage, the area of mammoplasty allows you to fully maintain the sensitivity of the grain and areola.
- At the same time as the bust enlargement, you can adjust the initial stage of mastosis.
Despite the benefits of Periarelar 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 have children and breastfeed them.This is explained by the fact that during the operation there is a risk of damage to the milk ducts, which will affect the function of lactation.
Periareyolar Access does not allow a complete overview of all the pockets of implants, which requires restrictions on the size of the implant.This method is very suitable for those patients who want to put a small endoprosthesis and slightly enlarge the breasts.In a situation where a woman wants to add 2-3 sizes to her breasts, it is preferable to use submarine or axillary access.
Seal
With access to the submarch, the installation of endoprosthesis is performed through horizontal cuts that pass under the breast into the natural folding of the skin.Postoperative scars using this implant installation method are significantly expressed, but they are hidden in folding the skin.The scars are visible in the position of lying down, and in the upright position they are covered by the lower pole of the breast.
The main advantage of underwater access is a very good review of the service field.For a plastic surgeon, this is the easiest type of mammoplasty as it has full access to all the pockets of the implant and it is easy to achieve absolutely symmetrical implant placement.Thanks to this feature, large endoprosthesis can be installed.
Another advantage of the lubricant methodology for enlarging the bust is the lack of risk of damage to the dairy channels.After surgery, the lactation function is maintained, allowing you to recommend this method for patients planning in the future pregnancy and breastfeeding of your baby.
The implant installation method is not deprived of disadvantages.For many patients from plastic surgeons, the main disadvantage of the methodology in a pronounced and sufficiently extended scar that passes into a fold under the chest.The disadvantage is the risk of damage to the afferent nerves that innervate SAK.If the nerve is dismembered during the operation, the sensitivity of the grain and areola will be disturbed.
The use of submalasmic access does not allow at the same time as mammoplasty to increase plastic surgery by one incision.In addition, women who have the initial signs of bust (mastoposis) often turn to the help of a plastic surgeon.If Periareyular Access allows you to eliminate age -related manifestations, then when you use access to lobes, it is impossible to adjust at the same time mastptosis with breast augmentation.
Axillary access
Axillary access is an enlargement of the breast through cuts that are in the axillary well.The main advantage of the methodology is that the marks pass by 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, the scars can be clearly visible during sports, especially in the position of the body with arms raised.
Nevertheless, it is axillary access that is considered a "gold standard" in mammoplasty to enlarge.The operation is performed under the control of optical equipment (endoscope), which allows a plastic surgeon to have access to all pockets of the implant.There is no risk of nerve damage.There is no risk of dissection of the dairy channels, which allows us to recommend this method for installing implants on girls planning pregnancy.There are no restrictions on endoprosthesis - the type of axillary access allows you to put implants of any volume, shape and profile.
The disadvantages of the axillary method to enlarge the breast are that the plastic surgeon has no way of correcting the effects of mammary leakage or to perform plastic of the anomalous grain complex.For this reason, axillary access is mainly used to model the size of the bust when there are no concomitant aesthetic problems requiring surgical correction.
Criteria for selecting surgical access
In clinical practice, plastic surgeons use several criteria to choose surgical access to enlarge the breasts.One of the main criteria is the age of the woman and her older plans for pregnancy.If the patient plans to give birth to children, it is advisable to refuse periarelar access.Access to axillary access or subordinate access is preferable.
If a woman does not plan to give birth, you can use one of the earlier types of surgical access.In situations where, in order to improve the aesthetics of the bust, at the same time as its increase, it is necessary to perform the plastic of the areola, preferably periareal access is preferably.The same method of installing implants is more suitable for patients with the initial signs of mastoposis.
Patients who want to increase the bust by several sizes, a plastic surgeon may recommend a method of subordination or axillary.The optimal choice in this situation is the enlargement of the breast through the axillary well, but the aesthetic desires of the woman are also taken into account.If she expresses the desire to hide the scar in a natural fold under her breasts, access to the submaria is chosen.
Choosing a pocket to install an implant
The next aspect of enlargement of mammoplasty is related to the choice of anatomical area in which implants will be installed.
Implant pocket can be located:
- under the mammary gland (subduar placement);
- under the thoracic muscle (subordinate location);
- Partly under the gland, partly under the muscle (combined version).
Subporedation.The implant is installed in the anatomical space under the gland.The more compliant pocket is separated from the surface of the body only by roof tissues and mammary glands, and because of this characteristic it is not recommended to be used if it is necessary to increase the breasts by several sizes.A large endoprosthesis can be visually determined.In addition, the risk of developing step deformation - aesthetic complications increases, whereby a "step" type is formed above the upper edge of the implant.
With the subdularity placement of the endoprosthesis, the risk of developing other complications of the aesthetic nature, more special, the appearance of deformation of integmented tissues over the breast in the form of "waves" or "mountain ash".With the development of capsule contracture, the worsening of the aesthetics of the bust is also more pronounced with the surface placement of the implant.
Another characteristic of this type of placement is that endoprosthesis and mammary glands are supported only by Cuper connections - the structures of the connective tissue whose elasticity decreases with age.For this reason, with a subdivision implant installation, the risk of developing mastoposis increases, especially in women with initially large breasts.
Subysus arrangement.Placing the implant under a large pectoral muscle avoids the problems that are characteristic of a subduar place.A less risk of capsule contracture and the appearance of skin deformity over the breasts in the form of "Rowan" and "Waves".The endoprosthesis is securely fixed with the muscles and does not increase the likelihood of mastopia.
But placement of the implant under the muscle has the reverse side.
First, in girls who are actively involved in sports, the risk of rotation or displacement of the implant increases.If modern implants are used to enlarge the breasts, rotation (turn) can lead to deformation of the breast, which can only be corrected during recurrent surgery.
Secondly, with the submissocular placement, the degree of injury to the tissues during surgery increases.Therefore, healing goes slower and the rehabilitation period is extended to wear linen for compression and follow all restrictions for a longer time.
Combined location.The best option is the combined placement, whereby the segment of the upper endoprosthesis is under the muscle and the lower pole is under the gland.With this arrangement, the risk of step deformation is excluded.Under the risk of rotation and displacement of the implant, the development of capsule contracture and other aesthetic complications.Healing is faster, the rehabilitation period is reduced.
Types of implants
Breast enlargement is done by implants from leading world manufacturers.Medical silicone endoprosthesis with high cohesion and different degrees of density have been made.The silicon is covered with an elastomeric sheath that eliminates the likelihood of diffusion of gel.The outer capsule is represented by a porous shell, whose special texture contributes to the integration of the implant into living tissues and its reliable fixation.Due to the porous membrane, the risk of fibrous capsule is reduced.
Each manufacturer's line presents several hundred types of implants that differ in the following characteristics:
- Form: The implant can be anatomical (drop -form) or circle.
- Main width: horizontal size of the lower pole of the endoprosthesis.
- Profile: Endoprosthesis height.
- Size: volume.
The choice of implant is determined by the desires, as well as by the initial data of the patient - individual characteristics of the structure of the breast and mammary glands.For example, girls with a clearly expressed between -toll gap are more suitable for low -profile anatomical implants with a wide base.Women who want to move the accents of the neckline are more suitable for round full implants that visually increase the upper pole of the mammary gland.
Preparing to enlarge the breast with implants
Preparation for plastic surgery to enlarged breast can be divided into two stages - diagnostic and aesthetics.The purpose of the aesthetic stage of preparation is to choose the perfect implant and to decide on the tactics of surgery.Based on the results of computer modeling and analysis of the patient's initial data, the surgeon selects the method for installing the endoprosthesis and an anatomical pocket for its placement.
The purpose of the diagnostic stage is to minimize operating and anesthesia risks, as well as to eliminate contraindications for surgery.Every woman, before enlarging the mammary glands, is undergoing a comprehensive diagnosis, including an extended list of instrumental and laboratory methods.Mammography with a gynecologist and mammologist is certainly prescribed.
A few weeks before increasing mammoplasty, a woman should stop taking certain medicines, more special, contraceptive hormonal drugs and anticoagulants.It is necessary to abandon the anti -inflammatory and analgesic drugs of the NSAID group as they slow down the coagulation of the blood.You also need to stop taking alcohol and give up smoking, as 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 of any surgery - swelling, pain and hematomas in the area of operating wound, fever, general malaise.These symptoms are a normal reaction of the body in response to a violation of tissue integrity.The preparations prescribed by a plastic surgeon -inspirational, anti -oxpulture, painkillers will help to cope with the difficulties of this period.The doctor prescribes a short course of antibiotics to prevent infectious complications.
The specificity of the period of rehabilitation after mammoplasty is that it is necessary to constantly carry a bra for compression.The elastic underwear is sewn in an individual order before surgery.You need to wear it constantly, you can only remove it for some time of hygiene procedures.As for the hygiene of the body, during the first 7-10 days after enlargement of the breast, it should be limited by wet wipes, you cannot take a shower.
You can sleep after surgery only on your back.It is allowed to sleep from the 10-14 days, but it is still impossible to get involved in the stomach.You can't play dancing or sports.The prohibition of physical activity, including the household, is valid for 4 weeks;Power lines and some types of cardio training are contraindicated for 3 months (or to the special resolution of a plastic surgeon).
Throughout the recovery period you can not sunbaths in either direct sunlight or in the solarium.You can't go to a sauna or bath, get hot baths at home.Alcohol and smoking are contraindicated.The compression linen is allowed to be removed from the second month, but during the year you should wear a bra with wide straps and a wide belt that supports the well on the chest.