If you go out on the street and ask ten men why plastic surgery is necessary, many will answer without hesitation: "To increase female breasts."This logic is not accidental: human civilization, whether the ladies like it or not, is originally patriarchal, that is, men dominate almost everywhere.For them, the bust is the most attractive part of the female body.
Therefore, since ancient times, ladies, in order to make a stronger impression on the strong half of humanity, have come up with various ways to make their breasts more prominent.At first, it was clothes with deep necklines, and then underwear, which created favorable optical effects.But these were all temporary measures, and women wanted something permanent, or at least long-lasting.
Only the development of plastic surgery helped women to really look according to their own desires and meet the standards of external beauty set by men.In 1889, something happened that millions of beautiful ladies around the world dream about - a method of artificial breast enlargement was invented, which later became known as breast endoprosthesis (from the Greek words "endon" - "inside" and "prothesis" - "addition, joining").
The first material used to enlarge female breasts was paraffin, which was originally called petroleum wax because it was made from this flammable liquid.In the first decades of the last century, aesthetic medicine tested many materials suitable for endoprosthetics: ivory and glass beads, polyethylene and polyurethane, polyester foam and many others.All this led to sad consequences.
Only in 1961, two American plastic surgeons from Houston, Thomas Cronin and Frank Gerow, produced and used the first silicone implants during surgery, making 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 physico-chemical characteristics: they are denser and more reliable;the gel that fills them is very durable and therefore does not leak through the shell.
Stages of operation
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 with the help of special monitors: blood pressure, heart rate, degree of saturation of the blood with oxygen, etc.
Before the operation, the surgeon makes a mark with a special marker, according to which the surgical access is then carried out.Incisions are usually made so that postoperative scars are minimally noticeable.The choice of surgical approach depends on a number 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 ptosis of the breast - ptosis and its degrees (three in total);
- skin characteristics: thickness and elasticity, presence of stretch marks;
- anatomical features of the pectoralis major muscle, sternum and ribs.
Then a pocket (bed) is formed to place the 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, as it provides a more stable result.
After placing the implants, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are applied using a modern resorbable suture or a special medical glue is used.The patient is then dressed in a compression garment to prevent displacement of the implants and increase in postoperative tissue swelling.A few hours after the operation, the patient remains in the rehabilitation unit, where her condition is monitored by medical staff.
In general, breast replacement surgery takes 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, the patient's desire to increase his breasts by several sizes at once.Also, if you have previously had breast reconstruction surgery after breast cancer or trauma, the procedure may be more difficult and take longer.
Operative methods
There are four main surgical approaches that are used worldwide.
- Submammary (under the mammary gland).
This method involves cutting the skin just below the breast (in the submammary fold), which, in the presence of a well-formed fold, makes the incisions unnoticeable.In other cases, this approach does not provide sufficient cosmetic results.The advantages of this approach include the fact that when it is used, the breast tissue is practically not affected. - Periareolar.
In this approach, the incision is located along the lower semicircle of the areola, at the border of the pigmented skin of the areola and the unpigmented skin.Therefore, after a few months, the postoperative scar becomes almost indistinguishable.In this case, the breast tissue is separated in the lower part.This in no way interferes with 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 the 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, there are restrictions.Endoscopic video technology is required to achieve axillary access.It allows the operation to be performed safer and less traumatic, given the distance of the incision from the operation area. - Transumbilical.
This is a rarely used technique.This involves installing an implant through an incision in the belly button area.In this way, only a saline-filled implant can be installed.First, the implant shell is installed, then it is filled.Such breast implants are practically not used, because, as experience shows, silicone implants allow to achieve a more stable result, taking into account all the nuances of a particular case.
The final choice of implant installation 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.
Preparation for surgery
Before starting the preparation for surgery, the patient must understand from the plastic surgeon all aspects of the planned procedure: type of implant, manufacturer, availability and duration of the guarantee, shape, type of shell and filling.Currently, the most common in the world are silicone implants with a textured 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 silicone cohesive (cohesion is the connection between the molecules of a substance that determines its strength) gel, with a consistency reminiscent of jelly;
- silicone gel with a high degree of cohesion, the consistency of which resembles marmalade;
- silicone gel "soft touch" (from English "soft touch") - increased softness;
- saline, 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 retains its intended shape well with a high level of projection, but is denser to the touch.The saline solution makes the breasts as soft and natural as possible, but does not guarantee preservation of their shape.8-10 months after the start of use, salt crystals may begin to form, which can break through the shell.
It also has a "bubbling" effect, which also does not suit all patients.
There is another way to increase breasts without using 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 twentieth century.However, in those years, fat implantation did not have a positive effect, as it is quickly absorbed by the body.
Today, plastic surgeons have learned to process fat cells in such a way that the effect of their injection lasts longer.However, after a year and a half up to 60% of the volume of the transplanted tissue is absorbed, so the operation will have to be repeated.Thus, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, the patient must 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 group and Rh factor, for HIV, syphilis and hepatitis C and B markers;
- 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 required.In addition, during a consultation with a plastic surgeon, the patient must be informed about all existing diseases, previous operations, allergic reactions, as well as about the medications taken, including nutritional 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 bad effect on healing, and the latter is not compatible with antibiotics that are prescribed for prophylactic purposes 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 hormonal levels in the early postoperative period and the beginning of the lactation process (formation of breast milk) can affect breast implants in the most unpredictable way.
Contraindications for breast endoprosthesis are:
- pregnancy;
- diabetes mellitus;
- severe endocrine and autoimmune diseases;
- blood coagulation disorder;
- diseases of the mammary glands (including mass formations) requiring monitoring by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular and respiratory systems, which serve as a contraindication for general anesthesia;
- age under 18 years;
- less than six months after stopping breast-feeding.
Rehabilitation after surgery
Full recovery after breast replacement occurs within a few months.This period can be divided into several main stages.
During the first 3-4 days after the operation, patients may experience discomfort: a feeling of heaviness and bursting in the area of the pectoralis major muscle.They can be relieved by taking analgesics prescribed by the attending physician.On the fourth day, these manifestations usually disappear.
Swelling of the soft tissues in the area of the operation is possible.Sometimes it lasts for several weeks and spreads to the abdominal area.These are normal symptoms and should not be a cause for concern.
Arm movements will be limited for the first 24-48 hours after the procedure.
During the first week you should not drive.During this time, it is best to keep your clothes as comfortable and easy to remove as possible.
You will need to limit physical activity as much as possible.However, bed rest is not necessary at all.It is also highly recommended that you 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 returning to driving.
If your work does not involve intense physical activity, then returning to work is possible within a week.However, you will need to avoid lifting heavy (more than 4-5 kg) objects and refrain from excessive physical activity.
One month after surgery, your doctor will likely allow you to resume light exercise.However, most surgeons still do not recommend doing much upper body work during this period, especially involving the pectoralis major muscles.Light cardio without running or swimming is possible.Around this time, you will begin to see the results of breast augmentation.The breasts will begin to assume their natural position and take on a more natural shape.However, keep in mind that this process can take several months.Four weeks after surgery, the compression garment is usually removed and you can start wearing bras without wires or push-ups.
A few months after surgery, you will be able to see if the results are as expected.As for the scars, they will continue to gradually fade over time and blend in with the surrounding skin.They should become almost invisible within a year if cared for properly.Two to three months after the operation, the breasts become softer, take on the consistency of natural breast tissue, and then with each month they become softer.After three months, you can start more intense upper body exercises.
There are a few more post-surgery tips you can use to speed up your 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 look at the progress - this can provoke an infection;
- give your implants time to "adapt": at first they will look unnatural, with an excessively filled upper pole, but gradually they will take on a natural teardrop shape;
- don't forget to rest a lot, as this speeds up the recovery process;
- Avoid wearing tight clothes, especially those that require you to raise your arms high when putting them on;
- One month after the operation, you should only sleep on your back!You can't sleep on your side, much less on your stomach.In the first days, it will be easier to sleep with high pillows behind the back;
- if you feel severe pain, asymmetric swelling appears or the bandage is wet, consult a doctor immediately;
- Do not worry if you feel increased or decreased sensitivity of the nipples after the operation: 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, but milk production may be slower.