The aesthetic outcome of plastic breast enlargement depends on many factors.The most important is the choice of implant pocket and the method of installing implants.Breast aesthetics after mammoplastic is affected by the patient's early data, including chest and gland shape, skin condition, subcutaneous fat layer thickness.Features of these and other anatomy -are taken into account when choosing a profile, base width, size and endoprosthesis.An important criterion for successful operation is to achieve a stable result that will delight a woman for years.
This publication discusses the main way of breast augmentation - the type of surgical access, the type of anatomical pocket for installing implants, the advantages and disadvantages of various mammoplasty methods.You will learn how to recover properly after surgery, what is possible and what cannot be done during the recovery period.
Indications for breast enlargement with implants
The operation to enlarge the breast with implants is carried out according to the aesthetic signs.The main indication for mammoplasty addition is the patient's desire to increase the aesthetic of the breast by increasing its size and modeling its shape.During surgery, deficiency due to deformation of the nipple arelar (stretching, change in form) and the relics of the glands after feeding the baby or due to age -related changes can also be eliminated.
The reason for appeals to plastic surgeons may be the following problems:
- The aesthetic deterioration of the thoracic gland after pregnancy and breastfeeding.
- Change the shape of the breast as a result of the spread process (aging).
- Congenital hypoplasia of the milk gland or amastia.
- Asymmetry, both nature and are obtained.
- Breast tube.
- Mastoptosis with signs of hypotrophy glands.
- Women are dissatisfied with the shape or size of the breast.
Breast enlargement with implants is also performed by patients undergoing radical surgery in the milk gland as part of the treatment of malignant neoplasms.Mammoplasty is a reconstructive enlargement that allows you to create an attractive natural and aesthetic breast without increasing the risk of developing a tumor process.
What are the characteristics of individuals considered before surgery?
Surgical correction tactics are determined by the individual characteristics of the patient.Yes, there is always a chance to put large size implants, but far from such steps will lead to the desired result - natural and harmonious changes in appearance.
The following factors are influenced by the selection of shapes, profiles and sizes of endoprosthesis, as well as implant pocket options and implant installations
- The age of the woman.
- The initial shape and size of the milk gland.
- The height and width of the chest.
- Severity of subcutaneous fat.
- The elasticity of the integumentary tissue of the mammary gland.
- Interogation interval width.
- The presence of signs of ptosis (prolapse) of the breast.
Mammoplasty addition tactics also affect whether a woman plans to give birth to the future to give birth and breastfeed.When choosing access, the requirements in nipple-pack complex plastic are also taken into account, which may be needed to achieve optimal aesthetic results.
Methods for installing implants
Taking into account individual features on anatomy and other factors, plastic surgeons select one of three ways (type of surgical access) breast augmentation:
- Isolar (breast enlargement "through isola").
- Submammaric.
- Axillary.
Here are the features, the advantages and disadvantages of each mammoplasty addition method in detail.
Isolar access
With isolar, or periarean, access, plastic surgeon sets implants through the slice, which passes through the edge of the isola pigment zone.The main advantage of the surgical access is scarring.The scar is located on the border of light and dark skin, and therefore it is a bit difficult to see.
In the periarelar method to improve the chest glands, there are other advantages, in addition to the minimum severity of the postoperative scars:
- During surgery, it is possible to perform the nipple arelar complex plasticism.In some cases, it is difficult to achieve the optimum aesthetics of the breast without correcting the size and shape of the sak, and the advantages of this periararar access can play a decisive role.
- Periarreyular access eliminates the risk of damage to the afferent nerve (sensitive) nerve fibers, which crosses to Sak in the loading area.Due to this advantage, the mammoplasty area allows you to maintain the nipple and isola sensitivity completely.
- At the same time as an increase in the breast, you can correct the early stages of mastoptosis.
Despite the advantages of access to the periarelar listed above, this technique cannot be recommended to all women.In particular, the method of installing this implant is not recommended for girls who plan to give birth to their children and breastfeed.This is explained by the fact that during operation there is a risk of damage to the milk channel, which will affect breastfeeding function.
Periarreyolar access does not allow the complete picture of all implant pockets, which imposes restrictions on implant size.This method is ideal for patients who want to put small endoprosthesis and slightly enhance the chest.In situations where a woman wants to add 2-3 sizes to the breast gland, it is best to use submamamal or axillary access.
Submammarous access
With submamam access, endoprostheses installation is performed through horizontal incisions, which goes under the chest glands in natural skin folds.Post -operative scars when using these implant installation methods are significantly stated, but they are hidden in skin folds.The scars appear in a position to lie down, and in a standing position, they are protected by the lower pole of the chest gland.
The main advantage of submammarous access is an excellent picture of operations.For plastic surgeons, this is the easiest type of mammoplasty, as there is complete access to all implant pockets and easy to achieve true implant placement -Symmetry.Thanks to this feature, large endoprostheses can be installed.
Another advantage of submammic methodology for improving breasts is the lack of risk of damage to the milk tract.After surgery, lactation function is preserved, which allows you to recommend this method for patients planning on future pregnancies and breastfeeding.
Submammamant method installing implants has no deficiencies.For most plastic surgeon patients, subtract the main methodology in a significant and extended scars, which passes in the folds under the chest.The downside is the risk of damage to the afferent nerves that are fun.If during the surgery surgery, the nipple and nipple sensitivity will be disrupted.
The use of submamma access does not allow simultaneously with mammoplasty enlargement to perform plastic surgery through a slice.In addition, women with early signs of breast (mastoptosis) often turn the help of plastic surgeons.If periarreyular access allows you to eliminate age -related manifestations, then when using submamam access, it is impossible to correct mastoptosis simultaneously with chest enlargement.
Axillar Access
With axillary access, breast enlargement is done through the wound, which is on the axillary fossa.The main advantage of the methodology is that scars escape from the mammary gland and do not affect their aesthetic perception.Instead, scars can be seen, and this can be a problem if a woman wears open clothes.For example, scars can be clearly seen during sports, especially in the body position with their hands raised.
However, it is Axillar access that is considered "gold standard" in additional mammoplasty.The operation was carried out under the control of the fiber equipment (endoscope), which allowed plastic surgeons to access all implant pockets.There is no risk of damage to the nerves.There is no risk of milk tract surgery, which allows us to recommend this method of installing implants to girls who plan pregnancy.No restrictions in terms of endoprosthesis - the type of Axillar access allows you to put the implant of any volume, shape and profile.
The disadvantage of the Axillar method of breast enlargement is that the plastic surgeon has no way of correcting the result of the relief of the milk gland or to implement the nipple-cuting complex plastic.For this reason, axillary access is used primarily to model breast size, when there is no equivalent aesthetic problem that requires surgical correction.
Surgical access criteria
In clinical practice, plastic surgeons use several criteria for choosing surgical access to improve the chest gland.One of the main criteria is the age of the woman and her plans for pregnancy.If the patient plans to give birth, it is advisable to reject the accessibility of the periarelar.Axillar access or submamam access is better.
If a woman does not intend to give birth, you can use any type of surgical access that previously considered.In situations where, to improve the aesthetics of the breast, at the same time as it improves, it is necessary to implement plastic isola, the periarreyolar access is better.The same method of installing implants is more suitable for patients with early signs of mastoptosis.
Patients who want to increase their breasts in several sizes, plastic surgeons may recommend submammamor or axillar methods.The optimal option in this situation is an increase in the chest gland through the axillary fossa, however, the aesthetic requirements of women are also taken into account.If he expresses the desire to hide the scars in the natural folds under the chest, submamma access is selected.
Choosing a pocket to install an implant
The next aspect of mammoplasty increase is associated with the choice of anatomy region where the implant will be installed.
Implant pocket can be placed:
- under the milk gland (subgandular placement);
- under the chest muscle (submiskular location);
- Partly under the gland, partly under the muscle (combined version).
Subgandular placement.Implants are installed in the anatomical space under the gland.The most shallow pockets are separated from the surface of the body only with the cover and mammary glands, and as this feature is not recommended to use if necessary to increase the chest by several sizes.Large endoprosthesis can be visually determined.In addition, the risk of developing step deformation - an increase in aesthetic complications, where a "step" is formed above the upper edge of the implant.
With the placement of subgandular endoprosthesis, the risk of developing other complications of aesthetic properties, in particular, the appearance of integumentary tissue deformation on the thoracic glands in the form of "waves" or "mountain ash".With the development of capsule contraction, the aesthetic deterioration of the breast is also more noticeable with superficial implant placement.
Another feature of this type of settlement is that endoprosthesis and mammary glands are supported only by the cupcakes - the connective tissue structure, the elasticity that decreases with age.For this reason, with the installation of subgandular implants, the risk of developing mastoptosis increases, especially in women with large early breasts.
Submuscular placement.Implant placement under large chest muscles avoids the problem of subgandular location.Less risk of capsule contraction and the appearance of skin deformation on the chest in the form of "Rowan" and "Wave".Endoprosthesis is safe with the muscles and does not increase the likelihood of developing mastoptosis.
But the placement of the implant under the muscle has the opposite side.
First, in children who are actively involved in sports, the risk of rotation or the transfer of implants increases.If, to increase the chest gland, stylish implants are used, rotation (turn) can cause breast deformation, which can only be corrected during repeated surgery.
Second, with submiscipular placement, the level of tissue injury during surgery increases.As a result, the healing is slowing down and the recovery period is extended to wear compression pants and follow all restrictions for longer.
Combined placement.The best option is a combined placement, where the upper endoprosthesis segment is under the muscle, and the lower pole is below the gland.With this order, the risk of deformation of the step is excluded.Under the risk of switching and displacement of implants, the development of capsule contraction and other aesthetic complications.Healing faster, the recovery period is reduced.
The type of implant
Breast enlargement is done by implants from leading world manufacturers.Medical silicone endoprostheses with high levels of unity and various levels of density are made.Silicone is covered with elastomeric shells, which eliminates the possibility of gel dispersion.External capsules are represented by porous shells, a special texture that contributes to the integration of implants into their living fabrics and reliable setting.Due to the porous membrane, the risk of fibrous contractions is reduced.
The line of each manufacturer presents a few hundred different types of implants in the following features:
- Form: Implants can be anatomy (drop -shaped) or round.
- Basic width: The horizontal size of the bottom of the endoprosthesis.
- Profile: endoprosthesis height.
- Size: Volume.
The choice of implants is determined by the patient's intention, as well as the patient's initial data - the individual features of the chest structure and glands.For example, female children with better gaps are better suited for low anatomy implants with a broad base.Women who want to move the accent to the neckline are more suitable for rounded profile implants, which visually enhance the pole above the milk gland.
Preparation for breast enlargement with implants
Preparation for plastic surgery for enlarged breasts can be divided into two stages - diagnostics and aesthetics.The purpose of the level of aesthetic preparation is to choose the perfect implant and to decide on surgical intervention tactics.Based on computer modeling results and early patient data analysis, the surgeon chose the method of installing endoprosthesis and anatomical pockets for its placement.
The purpose of the diagnostic stage is to minimize the risk of operating and anesthesiology, as well as eliminate contraindications to surgery.Every woman, before increasing the milk gland, underwent a comprehensive diagnosis, including a list of expanded instrumental and laboratory methods.Mammography with a gynecologist and mammologist consultation is definitely prescribed.
A few weeks before increasing mammoplasty, a woman should stop taking certain medications, in particular, contraceptive hormone drugs and anticoagulants.It is necessary to leave anti -anti -analgesic drugs from the NSAID group, as they delay blood clotting.It should also stop taking alcohol and leaving smoking, as ethanol and nicotine slow down the regenerative process and negatively affect the recovery rate after mammoplasty.
Recovery after mammoplasty
The initial postoperative period is accompanied by typical symptoms for any operation - swelling, pain and hematoma in the area of operating, fever, general malaise.These symptoms are the normal reaction of the body in response to a violation of tissue integrity.Preparations prescribed by plastic surgeons -Anti, anti -xplocational, painkillers will help to overcome the difficulties of this period.For the prevention of infectious complications, doctors prescribe short courses of antibiotics.
Specifications of recovery period after mammoplasty are necessary to always wear compression bra.Elastic linen is sewn on individual orders even before surgery.You need to wear it continuously, you can only remove it for a while.For body hygiene, within the first 7-10 days after the increase in the chest gland, it should be limited by wet tissue, you cannot bathe.
You can sleep after surgery just behind you.From 10-14 days, it is allowed to sleep on the side, but it is still impossible to turn on the stomach.You can't play dancing or sports.Prohibition of physical activity, including household, valid for 4 weeks;Power load and several types of cardio exercises are contraindicated for 3 months (or up to a special resolution of plastic surgeons).
During the recovery period, you cannot sunbathe in direct sunlight or solarium.You can't go to the sauna or take a shower, a hot bath at home.Alcohol and smoking are contraindicated.Compression linen is allowed to be removed from the second month, but this year you need to wear a bra with a wide strap and a wide belt that supports the chest well.