The aesthetic result of a plastic breast augmentation depends on many factors.The selection of the implantation bags and the method for installing implants is of great importance.The aesthetics of the bust after mammoplasty are influenced by the patient's individual initial data, including the shape of the breast and mammary glands, the condition of the skin, the thickness of the subcutaneous layer of fat.These and other anatomical features are taken into account when choosing a profile, a basic width, the size and form of the endoprosthesis.An important criterion for successful operation is to achieve a stable result that a woman inspires for many years.
In the publication, the main methods of breast enlargement are discussed - types of surgical access, types of anatomical pockets to install implants, advantages and disadvantages of various methods of mammoplasty.You will find out how you can recover properly after the operation, what is possible and what cannot be done during the rehabilitation phase.
Indications for breast enlargement with implants
The operation to enlarge the breast with implants takes place according to aesthetic indications.The main display for augmentation mammaloplasty is the patient's wish to improve the aesthetics of the breast by increasing its size and modeling the shape.During the operation, deficiencies can also be eliminated due to the deformation of the nipple-arelar complex (stretching of the department stores, changes in the shape) and out of the glands after feeding the baby or due to age-related changes.
The reason for the calling on the plastic surgeons can be the following problems:
- Determination of the aesthetics of the mammary glands after pregnancy and breastfeeding.
- Change in the shape of the bust as a result of involved (aging) processes.
- Congenital hypoplasia of breast glands or amastia.
- Asymmetry, both innate and acquired nature.
- Roasts.
- Mastoptosis with signs of hypotrophy of the mammary glands.
- Woman dissatisfaction with the shape or size of a bust.
Breast augmentation with implants is also carried out by patients who were subjected to radical operations on the mammary glands as part of the treatment of malignant neoplasms.With a reconstructive augmentation mammoplasty, you can reproduce natural and aesthetically attractive breasts without increasing the risk of developing tumor processes.
Which individual features are taken into account before the operation?
The tactics of the surgical correction are determined by the individual characteristics of the patient.Yes, there is always the possibility to set an implant of a large size, but far away always leads such a step to the desired result - a natural and harmonious change in appearance.
The following factors are influenced by the selection of the shape, profile and size of the endoprosthesis as well as the selection of the implantation bags and the method to install the implant
- The age of the woman.
- The initial shape and size of the mammary glands.
- The height and width of the chest.
- The severity of the subcutaneous fat.
- The elasticity of the integration of the mammary glands.
- The width of the query interval.
- The presence of signs of ptosis (prolapse) of the bust.
The tactics of the augmentation mammaloplasty also have an impact whether a woman born in the future to give birth and breastfeed.When choosing the access, the need in the plastic of the nipple trouble is also taken into account, which may be necessary to achieve the optimal aesthetic result.
Methods for installing implants
Taking into account the above -mentioned individual properties of the anatomy and other factors, a plastic surgeon chooses one of three options (types of surgical access) of breast enlargement:
- Areolar (breast augmentation "by Asola").
- Submammics.
- Armpit.
In the following you will find the features, advantages and disadvantages of each magnification method in detail.
Areolar access
With an area or periareolar access, the plastic surgeon sets the implants through the incision that runs along the periphery of the pigmented zone of the wart aid.The main advantage of such a surgical access is the invisibility of scars.The scar is located on the edge of the light and dark skin, and therefore it is quite difficult to notice it.
In addition to the minimum heavy -by of the postoperative scar, the periarelus method for increasing the mammary glands is further advantages:
- During operation, it is possible to carry out the plasticism of the nipple-arelar complex.In some cases, it is difficult to achieve the optimal aesthetics of a bust without correcting the size and shape of the SAK, and this advantage of periarel arrangement can play a crucial role.
- PeriareUlar access eliminates the risk of damage to the afferent (sensitive) nerve fibers that go to the SAK in the area of the charging fold.Due to this advantage, the area of mammoplasty completely enables the sensitivity of the nipple and warting zone.
- At the same time, with the increase in the bust, you can correct the early stages of mastoptosis.
Despite the advantages of the periariar access listed above, the technology cannot be recommended to all women.In particular, this method for installing implants is not recommended for girls to give birth to children and to satisfy them.This is explained by the fact that there is a risk of damage to the milk channels during operation, which influences the lactation function.
Periareolar access does not provide a complete overview of all implant bags, which limits the size of the implant.This method is well suited for patients who want to set a small endoprosthesis and easily increase the chest.In a situation in which a woman wants to add noon to 2-3 sizes, it is preferable to use submammamal or axillary access.
Submin men
With Submammar access, the installation of endoprostheses is carried out by horizontal cuts, which run under the mammary gland in natural skin folds.Postoperative scars when using this method for installing implants are significantly expressed, but they are hidden in the skin fold.The scars are visible in the position of lying down and in a standing position they are covered by the lower pole of the mammary gland.
The main advantage of submammary access is a very good overview of the company.For a plastic surgeon, this is the simplest type of mammoplasty, as there is a complete access to all implant bags and it is easy to achieve an absolutely symmetrical placement of implants.Thanks to this function, large endoprostheses can be installed.
Another advantage of the submammary methodology to increase the bust is the lack of damage to milk channels.After the operation, the lactation function is retained so that you can recommend this method for patients who are planning in the future pregnancy and breastfeeding of the baby.
The submammamental method for installing implants is not without defects.For many patients with plastic surgeons, which mainly of the methodology in a pronounced and sufficiently extensive scar, which runs under the chest in a wrinkle.The disadvantage is the risk of damage to the afferent's nerves that the sak innervern.If the nerve is dissected during operation, the sensitivity of the nipple and wart movement is disturbed.
The use of the submammary access does not at the same time allow mammoplasty to carry out plastic surgery by a cut.In addition, women who have the first signs of a bust (mastoptosis) often shoot for the help of a plastic surgeon.If you enable periarees to eliminate age -related manifestations, it is not at the same time to correct mastoptosis with breast enlargement when using submammatics access.
Axillar access
With axillary access, breast enlargement is carried out by the cuts that are located in the Axillary Fossa.The main advantage of the methodology is that the scars die from the mammary glands and do not influence their aesthetic perception.On the other hand, scars can be felt, and this can become a problem if a woman wears open clothing.For example, scars can be clearly visible during sport, especially in a body position with elevated hands.
Nevertheless, it is Axillar Access that is seen as a "gold standard" in the augmentation mammaloplasty.The operation is carried out under the control of the fiber optic devices (endoscope), which means that a plastic surgeon can access all implant bags.There is no risk of damage to the nerve trunks.There is no risk of dissection of milk channels, so that we can recommend this method to install implants for pregnancy from girls.There are no restrictions on the endoprosthesis - the Axillar access type enables you to set implants of volume, shape and profile.
The disadvantages of the axillary method of breast enlargement are that the plastic surgeon has no way of correcting the consequences of omitting the mammary glands or performing plastic of the nipple complex.For this reason, the axillary access is mainly used to model the size of the bust if there are no simultaneous aesthetic problems that require surgical correction.
Selection criteria for surgical access
In clinical practice, plastic surgeons use several criteria for the selection of surgical access to increase the mammary glands.One of the main criteria is the age of women and her other plans for pregnancy.If the patient plans to give birth to children, it is advisable to refuse access to periarelaries.An Axillar access or submitting access is preferable.
If a woman does not intend to provide birth, you can use one of the previously considered suleragic access.In situations in which it is necessary to improve the aesthetics of the bust at the same time as its increase, it is necessary to carry out the plastic of the wart zone, the perireyolar access is preferable.The same method for installing implants is more suitable for patients with the first signs of mastoptosis.
Patients who want to increase the bust by several sizes can recommend a plastic surgeon a submammamor or axillary method.The optimal choice in this situation is an increase in the mammary glands through the armpit fossa, but the aesthetic wishes of the woman are also taken into account.If she expresses the desire to hide the scar in a natural fold under the chest, the submammary access is selected.
Selection of a bag for installing implants
The next aspect of increasing mammoplasty is connected to the choice of the anatomical region in which implants are installed.
The implantation bag can be found:
- Under the mammary gland (subgandular placement);
- Under the chest muscle (submiscular place);
- Partly under the gland, partly under the muscle (combined version).
Subgandular placement.The implant is installed under the gland in anatomical space.The superficial bag is only separated from the surface of the body with lifting fabrics and mammary glands.Based on this function, it is not recommended if it is necessary to increase the breast by several sizes.A large endoprosthesis can be determined visually.In addition, the risk of step deformation increases - aesthetic complication increases, in which a kind of "step" is formed above the upper edge of the implant.
With the subgandular placement of the endoprosthesis, the risk of developing other complications of aesthetic nature, in particular the appearance of the deformation of the integration of the integration over the breast gland in the form of "waves" or "mountain ash".With the development of the capsule contracts, the deterioration of the aesthetics of the bust is also pronounced by the superficial placement of the implant.
Another characteristic of this type of placement is that the endoprosthesis and the mammary glands are only supported by kitchen bonds - the structures of the connective tissue, the elasticity of which decreases with age.For this reason, the risk of mastoptosis increases with a subgandular installation of implant, especially for women with initially large breasts.
Underconable placement.The placement of the implant under a large chest muscle avoids the problems characteristic of a sub -engineular point.Less the risk of capsule contracts and the occurrence of skin deformation above the chest in the form of "rowan" and "waves".The endoprosthesis is certainly fixed with the muscles and does not increase the likelihood that it develops mastoptosis.
But the placement of the implant under the muscle has the opposite side.
Firstly, girls who are actively involved in sport increases the risk of rotation or postponement of implants.If, to increase the mammary glands, trendy implants have been used, rotation (rotation) can lead to breast deformation that can only be corrected during a repeated operation.
Second, with a submiscipular placement, the degree of violation of tissues increases during the operation.For this reason, the healing becomes slower and the rehabilitation period is extended to wear compression underwear and to follow all restrictions for a longer period of time.
Combined placement.The best option is the combined placement, in which 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 shooting and distributing implant, the development of capsule contracts and other aesthetic complications.Healing is faster, the rehabilitation period is reduced.
Types of implants
Breast augmentation is carried out by implants of leading world manufacturers.Medical silicone endoprostheses with a high degree of cohesion and different degrees of density.Silicon is covered with an elastomer shell that eliminates the likelihood of money consumption.The outer capsule is represented by a porous shell, the special texture of which contributes to the integration of implants into living substances and its reliable fixation.Due to the porous membrane, the risk of a fiber capsule contracture is reduced.
The line of each manufacturer contains several hundred species of implants that differ in the following properties:
- Form: An implant can be anatomical (sloping) or round.
- Basic width: horizontal size of the lower pole of the endoprosthesis.
- Profile: Endoprosthe height.
- Size: volume.
The selection of the implant is determined by the wishes and the initial data of the patient - individual properties of the structure of the breast and mammary glands.For example, girls with a pronounced Inter -Tthilet gap are better suited for anatomical implants with low profiles with a wide basis.Women who want to shift the accents to the neckline are better suited for round complete implants that visually increase the upper pole of the mammary gland.
Preparation for breast enlargement with implants
The preparation for plastic surgery on enlarged breast can be divided into two stages - diagnostic and aesthetic.The purpose of the aesthetic stage of the preparation is to choose the perfect implant and to choose the tactics of the surgical interventions.Based on the results of the computer modeling and analysis of the patient's initial data, the surgeon selects the method for installing the endoprosthesis and an anatomical bag for placement.
The purpose of the diagnostic stage is to minimize the operational and anesthesiological risks and to eliminate contraindications for the operation.Before increasing the mammary glands, every woman becomes a comprehensive diagnosis, including an extended list of instrumental and laboratory methods.Mammography with a consultation of a gynecologist and mammologist is certainly prescribed.
A few weeks before the increase in mammoplasty, a woman should stop taking certain medication, especially hormonal contraceptives and anticoagulants.It is necessary to give up anti -inflammatory and analgesic drugs from the NSAID group because they slow down the blood clotting.It is also necessary to set alcohol and give up smoking, since ethanol and nicotine slow regenerative processes and negatively influence the pace of recovery after mammoplasty.
Rehabilitation after mammoplasty
The early postoperative period is accompanied by typical symptoms for every operation - swelling, pain and hematomas in the field of operational wound, trouble, general discomfort.These symptoms are a normal reaction of the body in response to a violation of fabric.The anti -explocative, pain relievers, which can be dealt with by a plastic surgeon, anti -expression, which can deal with the difficulties of that time.To prevent infectious complications, the doctor prescribes a short course of antibiotics.
The details of the rehabilitation period after mammoplasty are that it is necessary to constantly wear a compression bra.Elastic linen are also sewn on individual order before the operation.You have to carry it continuously, you can only remove it from hygiene methods for a while.As far as body hygiene is concerned, it should not take a shower in the first 7 to 10 days after the breast glands increased by wet towels.
You can only sleep on your back after the operation.From 10 to 14 days it can sleep on the side, but it is still impossible to switch on the stomach.You can neither dance nor play sports.The ban on physical activity, including the household, is valid for 4 weeks;Power loads and some types of cardio training are contraindicated for 3 months (or until the special resolution of a plastic surgeon).
During the entire restoration period, you cannot sunbathe in direct sunlight or in the solarium.You cannot go to a sauna or bathroom and take hot baths at home.Alcohol and smoking are contraindicated.Compression lines can be removed from the second month, but in the course of the year you have to wear a bra with wide straps and a wide belt that supports the breast well.