If you go out on the street and ask ten men why plastic surgery is needed, many will answer without hesitation: "To enlarge women's breasts."This logic is not intentional: human civilization, whether women want it or not, is inherently patriarchal, that is, men dominate almost everywhere.For them, the breast is the most attractive part of a woman's body.
Therefore, since ancient times, women, in order to make a stronger impression on the stronger half of humanity, have come up with different ways to make their breasts more prominent.At first it was a dress with a deep neckline, then underwear that created a beneficial optical effect.But all these are temporary measures, and women want something permanent or at least durable.
Only the development of plastic surgery helped women really look according to their own wishes and meet the standards of external beauty set by men.In 1889, something dreamed of by millions of beautiful women around the world happened - a method of artificial breast enlargement was invented, which later became known as breast endoprosthetics (from the Greek words "endon" - "inside" and "prosthesis" - "add, join").
The first material used to enlarge women's breasts was paraffin, which was first called petroleum wax, because it was made of this flammable liquid.In the first decade of the last century, aesthetic medicine tried many materials suitable for endoprosthetics: ivory and glass beads, polyethylene and polyurethane, polyester foam and many others.All this leads 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 better physical and chemical characteristics: they are more compact and more reliable;the gel that fills it is very durable and therefore does not leak through the shell.
Operational level
Since breast replacement is a fairly serious surgical procedure, it is performed only under general anesthesia.During the entire operation, all important indicators of the body are monitored using special monitors: blood pressure, heart rate, blood oxygen saturation level, etc.
Before the operation, the surgeon uses a mark with a special marker, according to which the surgical approach is then performed.Incisions are usually made so that the scar after surgery is minimally visible.The choice of surgical approach depends on several determining factors.In particular, these are:
- the position (high, medium or low) of the mammary gland on the chest wall;
- the presence or absence of breast ptosis - ptosis and its degree (there are three in total);
- skin characteristics: thickness and elasticity, the presence of stretch marks;
- anatomical features of the main pectoralis muscle, sternum and ribs.
Then a pocket (bed) is formed to install the implant.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 more stable results.
After installation of the implant, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are applied using modern absorbable suture materials or special medical glue is used.Then the patient wears a compression garment to prevent displacement of the implant and increased tissue swelling after surgery.For several hours after the operation, the patient remains in the recovery ward, where his condition is monitored by medical staff.
In general, breast replacement surgery takes from 40 minutes to an hour and a half.Sometimes it takes longer depending on the surgical technique used and some other factors.For example, the patient's desire to enlarge his breasts by several sizes at once.Also, if you've had breast reconstruction surgery following breast cancer or trauma, the procedure may be more difficult and take longer.
Operating method
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 submammary fold), which, if there is a well-formed fold, makes the incision invisible.In other cases, this access does not provide sufficient cosmetic results.The advantages of this approach include the fact that when used, breast tissue is practically not affected. - 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.Because of this, after a few months the postoperative scar becomes almost indistinguishable.In this case, the breast tissue moves apart at the bottom.This does not at all prevent the possibility of breastfeeding in the future and, contrary to common misconceptions, does not reduce nipple sensitivity in the postoperative period. - Axillary (axillary).
This surgical approach involves making an incision in the axillary area.This also does not affect the breast tissue.The use of this method is more reasonable when the initial size is very small and the inframammary fold is not formed.In other cases it has limits.To achieve axillary access, endoscopic video technology is required.It allows the operation to be performed more safely and with less trauma, given the distance of the incision from the operating area. - Transumbilical.
This is a rarely used technique.It involves installing the implant through an incision in the umbilical area.In this way, only implants filled with saline solution 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 one 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 an individual approach selected for each case allows you to achieve the most aesthetic results.
Prepare for surgery
Before starting the preparation for surgery, the patient should find out from the plastic surgeon all aspects of the planned procedure: type of implant, manufacturer, availability and warranty period, shape, type of shell and filling.The most common currently in the world are silicone implants with textured shells and fillers - 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 bond between the molecules of the material, which 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 solution, the consistency of a bag filled with water;
- soybean oil, similar in consistency to the first filler.
Each filler has its own advantages and disadvantages.For example, a very dense gel retains its intended shape well with a high degree of projection, but is denser to the touch.The saline solution makes the breast feel soft and natural, but does not ensure that the shape is maintained.8-10 months after the start of use, the formation of salt crystals that can penetrate the shell may begin.
In addition, there is a "gurgling" effect, which also does not suit all patients.
There are other ways to enlarge breasts without using foreign substances.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, because it was quickly absorbed by the body.
Today, plastic surgeons have learned to process fat cells in such a way that the effects of their injections last longer.Even so, after a year and a half, up to 60% of the transplanted tissue is absorbed, so the operation needs to be repeated.Therefore, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, patients should undergo a full medical examination to ensure there are no medical contraindications and to minimize possible risks.It will include:
- blood tests: clinical and biochemical, for coagulation, for Rh group and factor, for HIV, syphilis and hepatitis C and B markers;
- general urinalysis.
In addition, mammography or mammary gland ultrasound, chest x-ray or fluorography, electrocardiogram, and lower leg vein ultrasound will be required.In addition, when consulting a plastic surgeon, the patient must be informed about all existing diseases, previous operations, allergic reactions, as well as medications taken, including food supplements.
Also, before the operation, you need to stop smoking and drinking alcohol for at least two weeks, because the first has an adverse effect on healing, and the second is incompatible with antibiotics, which 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 highly undesirable.The fact is that changes in hormone levels at the beginning of the postoperative period and the beginning of the breastfeeding process (formation of breast milk) can affect breast implants in the most unpredictable ways.
Contraindications to breast endoprosthetics are:
- pregnancy;
- diabetes mellitus;
- severe endocrine and autoimmune diseases;
- blood clotting disorders;
- mammary gland disease (including mass formation), requiring observation by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular and respiratory systems that serve as contraindications to general anesthesia;
- age less than 18 years;
- less than six months after stopping breastfeeding.
Recovery after surgery
Full recovery after breast replacement occurs in a few months.This period can be divided into several main stages.
During the first 3-4 days after surgery, the patient may experience discomfort: a feeling of heaviness and tearing 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.
Soft tissue swelling in the surgical area is possible.Sometimes it lasts for several weeks and spreads to the abdominal area.These are normal symptoms and nothing to worry about.
Hand movement will be limited for the first 24-48 hours after the procedure.
During the first week you cannot drive.At this time, it is best to keep your clothes comfortable and easy to remove.
You need to limit physical activity as much as possible.However, bed rest is not required at all.It is also highly recommended to avoid nicotine and alcohol.
A week after the operation, you can already drive a car, but only if you do not take any painkillers, which seriously affect motor skills.It is important to consult with your surgeon before returning to driving.
If your job does not involve intense physical activity, then you can return to work within a week.However, you still need to avoid lifting heavy objects (more than 4-5 kg) and refrain from excessive physical activity.
A month after surgery, your doctor may allow you to resume light exercise.However, most surgeons still do not recommend doing a lot of upper body work during this period, especially involving the pectoralis major muscle.Light cardio can be done without running or swimming.At this time, you will begin to see results from the breast augmentation.The breasts will begin to fall to their natural position and take on a more natural shape.However, please note that this process may take several months.Four weeks after surgery, the compression garment is usually removed and you can start wearing a wireless or push-up bra.
A few months after the surgery, you will be able to see if the results are as expected.As for the scar, it will continue to fade gradually 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 breast becomes softer, acquires the consistency of natural breast tissue, and then becomes more and more tender with each month.After three months, you can start more intense exercises for the upper body.
There are a few more post-surgery tips you can use to speed up your recovery:
- avoid taking drugs that affect blood clotting;
- moisturize your mammary glands regularly to prevent stretch marks;
- suppress the desire to remove the bandage and see the progress - this can provoke an infection;
- give your implants time to "adapt": at first they will look unnatural, with an overfilled upper pillar, but gradually they will acquire a natural teardrop shape;
- make sure you get plenty of rest as this speeds up the recovery process;
- Avoid wearing tight clothes, especially those that require you to raise your arms high when wearing them;
- For a month after surgery, you need to sleep on your back only!You should not sleep on your side, especially on your stomach.In the first days it will be easier to sleep with a pillow placed high on your back;
- if you experience severe pain, asymmetric swelling appears, or the bandage is wet, seek medical advice immediately;
- Don't worry if you experience either increased or decreased sensitivity in your nipples after surgery: this is normal;
- sensations on the right and left side may not be the same - this is not a sign of a problem and happens to almost everyone;
- Please note that most women can breastfeed after surgery, however milk production may be slower.