If you go out on the street and ask ten men why they need plastic surgery, most of them will answer without hesitation: "To enlarge women's breasts."This logic is not accidental: human civilization, whether the ladies like it or not, is essentially patriarchal, that is, men rule almost everywhere.For them, the bust is the most attractive part of a woman's body.
Therefore, since ancient times, ladies have found various ways to make their breasts more prominent in order to make a stronger impression on the stronger half of humanity.First there were dresses with a deep neckline, then underwear that created useful 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 desires and meet the external beauty standards set by men.In 1889, something that millions of beautiful ladies around the world dreamed of happened - the method of artificial breast augmentation, which later became known as breast endoprosthesis, was invented (from the Greek "endon" - "inside" and "prothesis" - "to add, join").
The first material used to enlarge women's breasts was paraffin, first called petroleum wax because it was made from a 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 more.All this led to sad consequences.
It was only in 1961 that 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 physical and chemical properties: they are denser and more reliable;the gel that fills them is highly resistant and therefore does not leak from the shell.
Operational stages
Since breast replacement is a fairly serious surgical operation, it is performed only under general anesthesia.During the entire operation, all vital indicators of the body are monitored using special monitors: blood pressure, heart rate, blood oxygen saturation, etc.
Before the operation, the surgeon applies marks with a special marker, so the surgical approach is carried out later.The incisions are usually made in such a way that the postoperative scars are minimally noticeable.The choice of surgical approach depends on a number of determining factors.In particular, they are:
- the position of the mammary glands on the chest wall (high, medium or low);
- the presence or absence of breast ptosis - ptosis and its degrees (there are three in total);
- skin characteristics: thickness and elasticity, presence of stretch marks;
- anatomical features of the main muscles of the sternum, sternum and ribs.
Then a pocket (bed) is formed for the installation of 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 because it gives a more stable result.
After installing the implants, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are applied using modern absorbable suture material or special medical glue is used.Compression garments are then placed on the patient to prevent displacement of the implants and increased postoperative tissue swelling.For several hours after the operation, the patient remains in the rehabilitation department, his condition is monitored by medical staff.
In general, breast replacement surgery lasts from 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 the breasts in several sizes at the same time.In addition, if you have previously had breast reconstruction surgery after breast cancer or trauma, the procedure may be more difficult and take longer.
Methods of operation
There are four main surgical approaches used worldwide.
- Submammary (under the mammary gland).
This method involves cutting the skin just below the breast (in the inframammary fold), making the incision invisible if there is a well-formed fold.In other cases, this entry does not provide sufficient cosmetic results.The advantages of this approach are that the breast tissue is practically not affected when it is used. - Periareolar.
With 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 is almost indistinguishable.In this case, the breast tissue is separated from each other in the lower part.This in no way prevents 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 breast tissue.The use of the method is more justified when the initial size is very small and the inframammary layer is not formed.In other cases there are restrictions.Endoscopic video technology is required to achieve axillary access.It allows for a safer and less traumatic operation, taking into account the distance of the incision to the operative field. - Transumbilical.
This is a rarely used technique.This involves placing the implant through an incision in the navel area.Only saline-filled implants can be installed in this way.First, the implant shell is installed, then it is filled.Such breast implants are practically not used, because, as experience shows, silicone implants allow for 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 to achieve the most aesthetic result.
Preparation for surgery
Before starting preparations for the operation, the patient should learn 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 tissue shell and filler - shape memory silicone gel.
There are different types of implant fillers.
- silicone liquid with a consistency similar to vegetable oil;
- standard silicone cohesive (cohesion is the connection between the molecules of the substance, determines its strength) gel with a consistency reminiscent of gel;
- silicone gel with a high degree of cohesion, similar in consistency to marmalade;
- silicone gel "soft touch" (from English "soft touch") - increased softness;
- saline solution, the consistency of a bag filled with water;
- soybean oil similar in consistency to the first filler.
Each filler has its advantages and disadvantages.For example, a highly sticky gel holds its intended shape well with a high level of projection, but is denser to the touch.The saline solution makes the breasts feel as soft and natural as possible, but does not ensure that they retain their shape.After 8-10 months of use, salt crystals that can pierce the skin may begin to form.
In addition, there is a "gurgling" effect that does not suit all patients.
There is another way to enlarge breasts without using external materials.This is the application of fat cells - lipofilling or lipomodelling.This method was proposed relatively recently, in 2004, although similar experiments have been carried out since the second half of the 20th century.However, in those years, fat implantation did not have a positive effect, because it was 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.Nevertheless, after a year and a half, up to 60% of the volume of the transplanted tissue is absorbed, so the operation must 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, group and Rh factor, HIV, syphilis and hepatitis C and B markers;
- general urinalysis.
In addition, mammography or ultrasound of the mammary glands, X-ray or fluorography of the chest, electrocardiogram and ultrasound of the vessels of the lower extremities will be required.In addition, during the consultation with the plastic surgeon, the patient should be informed about all existing diseases, previous operations, allergic reactions, as well as medications taken, including dietary supplements.
Also, before surgery, you should stop smoking and drinking alcohol for at least two weeks, because the first has a bad effect on healing, and the second is incompatible with antibiotics prescribed for preventive purposes in the postoperative period.
In addition, every woman planning a mammoplasty should know and take into account that it is extremely undesirable to plan a pregnancy within a year after the operation.The fact is that in the early postoperative period, changes in hormonal levels and the beginning of the lactation process (formation of breast milk) can affect breast implants in the most unexpected way.
Contraindications to breast endoprosthesis are as follows:
- pregnancy;
- diabetes mellitus;
- severe endocrine and autoimmune diseases;
- blood coagulation disorder;
- diseases of the mammary glands (including mass formations) that require observation by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular and respiratory systems that serve as a contraindication to general anesthesia;
- age less than 18 years;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
After breast replacement, full recovery 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: feelings of heaviness and bursting in the area of the large pectoral muscles.They can be relieved by taking analgesics prescribed by the attending physician.On the fourth day, these manifestations usually disappear.
Swelling of soft tissues in the surgical area is possible.Sometimes it lasts for several weeks and spreads to the abdomen.These are normal symptoms and should not cause concern.
Hand movements will be restricted for the first 24-48 hours after the procedure.
You should not drive in the first week.During this time, it is best to keep your clothes as comfortable and easy to remove as possible.
You should limit physical activity as much as possible.But there is absolutely no need for bed rest.Avoiding nicotine and alcohol is also recommended.
A week after the operation, you can already drive a car, but if you do not take any painkillers, it seriously impairs motor skills.It is important to consult your surgeon before returning to driving.
If your job does not involve intense physical activity, it is possible to return to work within a week.However, you should still avoid lifting heavy objects (more than 4-5 kg) and avoid excessive physical activity.
A month after surgery, your doctor will likely allow you to resume light exercise.However, most surgeons still do not recommend upper body work during this time, especially involving the pectoral muscles.Light cardio exercises are possible without running or swimming.Around this time, you will begin to see the results of breast augmentation surgery.The breasts will begin to return to their natural position and take on a more natural shape.But remember that this process can take several months.Four weeks after surgery, the compression garments are usually removed and you can start wearing an underwire or push-up bra.
A few months after the operation, 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.If properly cared for, they should be almost invisible within a year.Two to three months after the operation, the breasts become softer, take on the consistency of natural breast tissue, and then become softer every month.After three months, you can start more intensive exercises for the upper body.
Here are some more tips you can use to speed up your recovery after surgery:
- avoid taking drugs that affect blood clotting;
- moisturize your breasts regularly to prevent stretch marks;
- suppress the desire to remove the bandages and look at the progress - this can lead to infection;
- give your implants time to "adapt": at first they will look unnatural with an overfilled upper post, but gradually they will take the shape of a natural teardrop;
- be sure to get plenty of rest, as this speeds up the recovery process;
- Avoid wearing tight clothing, especially clothing that requires you to lift your arms up while wearing them;
- For a month after the operation, you only need to 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 pillows placed high behind your back;
- if you feel severe pain, asymmetric swelling appears or the bandage is wet, consult a doctor immediately;
- If you feel either increased or decreased sensitivity in your nipples after surgery, don't worry: this is normal;
- the sensations on the right and left may not be the same - this is not a sign of a problem and happens to almost everyone;
- Note that most women can breastfeed after surgery, but milk production may be slower.