Mammoplasty

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

Operation Indications

• Decreased mammary glands and decreased elasticity (mastoptosis).
• Increase breast volume while maintaining its tone and position (macropathy).
• Shrinkage of the mammary glands after lactation.
• Small breast size (micromastia).
• Increased breast volume in men (gynecomastia).

Types of mammoplasty

1. Enhancing mammoplasty(Endoprosthesis) - Breast augmentation, correction of its shape using implants. It is used after childbirth, during breastfeeding, with congenital asymmetry.
2. Reduction mammoplasty- Reduction of bust size by mastoptosis or macropathy.
3. Mastopexy- Breast augmentation. It is indicated for mastoptosis if the breast volume meets the requirements of the operation.

Breast endoprosthesis

The operation involves inserting a silicone prosthesis (implant) into the breast. The choice of wound site is appropriate for the woman. The implant is placed under the chest muscle and, if breast volume is allowed, between the muscle and the mammary gland. The wound is sutured, drainage is not required. The breast and areola are enlarged after surgery.

Breast implants

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

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

The products differ in a number of ways:

1. Fillers: bound gel or saline (sodium chloride). The composition of the gel is more elastic, uniform, light, but dangerous for the body in case of leakage. Salt solution is safer, softer, cheaper. Negative traits - moves while moving, prone to leakage.
2. Structure: rough (textured) or smooth. Textured implants are more stable, but skin folds may appear as a result of friction of body tissues on their surface. The disadvantage of a smooth prosthesis is the probability of displacement.
3. Shape: Anatomical or round. The former have a more natural look, while the latter maintain the symmetry and shape of the breast even when moving.

Reduction mammoplasty

During this type of surgery, the fatty tissue and breast tissue are partially dissolved, changing their size and creating a new shape.

Excess tissue excision reduces the likelihood of cancer.

Mammoplasty reduction options:

1. Liposuction. The method is considered conservative and leaves no seams. Designed for small breast reduction with a degree of light mastoptosis.
2. Short (vertical) suture. A popular method in which the breast retains its natural shape and the breast head is sensitive. The operation takes little time and the proportion of complications is low.
3. T-shaped (anchor) cut. The classic method used for large amounts of removed tissue. Its disadvantages are the duration of recovery, a large scar.
4. Amputation by breast transfer. It is used for very large breasts. The method is associated with breast damage, loss of breast sensitivity, and inability to breastfeed.

Mastopexy

Breast augmentation without implants is possible in several ways:

1. Vertical is used for 1-2 degree mastoptosis, the sutures are almost invisible, and the cosmetic effect is long lasting. The method is ineffective for raising the breast by 3-4 degrees.
2. Anchor mastopexy gives good results during ptosis of any complexity. Its disadvantages include a long recovery period, noticeable sutures, increased risk of breast tissue damage.
3. Periareolar mastopexy is the removal of a small piece of skin around the areola. It is indicated for pseudoptosis, it is ineffective on other forms of bust casting.

Stages of operation

High quality medical care at all three stages is important for the excellent results of plastic surgery. The preparation period lasts 1-2 weeks. The actual surgical intervention lasts from 1 to 4 hours.

Full recovery occurs within 1. 5 months.

Preparing for mammoplasty

The operation is performed not earlier than one year after the end of lactation. It is forbidden to take drugs containing hormonal contraceptives, aspirin and salicylates for 2 weeks before the operation.

You need to stop drinking alcohol, smoking.

During the preparation, research must be conducted:

• General and biochemical blood tests;
• Electrocardiograph;
• Blood test for anticoagulants (coagulation test);
• Breast ultrasound;
• General analysis of urine
• Testing for hepatitis and HIV.

Course of surgical intervention

Bust plastic surgery is done under general anesthesia. A special type is expansive dermotension. It is used to increase breast volume due to the lack of its own tissue and the large size of the implant. The procedure is performed in 2 stages. First, the extension 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.

Wound surgery methods:

1. Through the fold under the breast (lower mass access). A safe method for augmentation mammoplasty. A 4-5 cm long incision scar disappears slightly below the breast over time. Access to girls with micromastia is difficult.
2. Wound around or along the lower arch of the areola (periareolar approach). Advantage - Surgical scars are almost invisible. For patients who are planning to breastfeed, this method is not recommended due to the high risk of breast injury.
3. Endoscopic enlargement by axillary approach. High-tech equipment facilitates implant placement without damaging blood vessels and nerve fibers. A 3-4 cm long incision is made in the axillary zone and then the scar is naturally masked. There is a limit on the volume of the implant - up to 400 ml.
4. Endoscopic access through the umbilicus. This method is less used due to the distance of the entry point from the place of surgery, due to the difficulties of forming a "pocket" for the prosthesis.

Rehabilitation after mammoplasty

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

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

Rules for successful recovery:

• Do not lift 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.
• Be sure to wear compression garments after breast augmentation.

Possible complications

• Capsule contracture. The body forms a membrane around the endoprosthesis, which can cause it to move, disrupting the symmetry of the mammary glands and tightening them.
• Infection. Infection occurs due to a violation of the rules of asepsis during surgery or after non-compliance with antiseptic standards of care. The special risk period is 1 week after surgery.
• Keloid, hypertrophic scars. They appear if the body is prone to their formation. The formations look like dense ridges that rise to the surface of the skin and spoil the appearance of the breast.
• Accumulation of blood, serous fluid (hematoma, seroma) and, as a result, discoloration of the skin. This occurs when blood vessels, lymphatic vessels are damaged during surgery or during recovery. Complications occur due to low blood coagulation, a sharp rise in blood pressure, improperly sized endoprosthesis.
• Decreased or lost sensitivity of mammals, areolas. It often occurs when the large breast is reduced by mammoplasty due to nerve damage.
• Implant rupture. This is due to the thin membrane that is often found in cheap prostheses. The salt filler is easily absorbed by the body without harm. Damage to the endoprosthesis bound to the gel is not always noticeable, but it is dangerous if the silicone gets into the tissues of the body.

Breastfeeding after surgery

The safest surgery is done in the arm (transaxillary) or under the breast (lower arm).

About a year after surgery, breastfeeding is allowed.

Lactation problems can occur in the following cases:

• The endoprosthesis is placed in such a way as to compress the mammary glands, reducing the volume of milk produced by them.
• Cutting along the areola is more likely to damage the nerve endings around the breast.
• Shrinkage plastic, which is associated with a reduction in 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 up to 18 years.

Advantages and disadvantages of mammoplasty

Advantages of breast plastic correction:

• Use of modern interventions.
• Correction of congenital and acquired defects of the mammary glands.
• Long lasting and pronounced aesthetic effect.
• Short term of operation.
• Ability to choose the shape of the endoprosthesis, the material at will.
• Maintain lactation ability.

Possible disadvantages include:

• Skin marks from wounds - stitches, scars (unless special absorbent materials were used).
• Risk of complications (infection, breast deformity, bleeding).
• The need to change the endoprosthesis every 10-15 years.
• High cost of mammoplasty.
• The need for general anesthesia.
• Painful sensations in the first postoperative days.
• It is constantly necessary to wear compression underwear.
• Long period of rehabilitation (from several months to one year) with refusal of sports, physical activity, pregnancy, breastfeeding.