The aesthetic result of plastic breasts depends on many factors.Of great importance is the choice of implantation pockets and the implant installation method.The aesthetics of the bust after the mamopoplastic is affected by the individual initial data of the patient, including the form of the thorax and the mammary glands, the condition of the skin, the thickness of the subcutaneous fat layer.These and other anatomical characteristics are taken into account when choosing a profile, wide base, size and shape of endoprothesis.An important criterion for a successful operation is to achieve a stable result that delights a woman for many years.
The publication discusses the main forms of breast increase: types of surgical access, types of anatomical pockets to install implants, advantages and disadvantages of several methods of Mamimastia.You will learn about how to recover properly after the operation, what is possible and what cannot be done during the rehabilitation period.
Indications for breast enlargement with implants
The operation to enlarge the breast with implants is carried out according to the aesthetic indications.The main indication of the increase mammoplasty is the patient's desire to improve breast aesthetics by increasing its size and modeling the shape.During the operation, deficiencies due to the deformation of the nipple areland complex (stretching of the areola, change in the shape) and the omission of the glands after feeding the baby or changes related to age can also be eliminated.
The reason for the appeal to plastic surgeon can be the following problems:
- Deterioration of the aesthetics of the thoracic glands after pregnancy and breastfeeding.
- Change the form of the bust as a result of involuntary (aged) processes.
- Congenital hypoplasia of the mammary or amastia glands.
- Asymmetry, both innate and acquired nature.
- Tubular breasts.
- Mastoptosis with hypotrophy signs of the mammary glands.
- Dissatisfaction of women with the shape or size of a bust.
Breast enlargement with implants is also performed by patients who underwent radical operations in the mammary glands as part of the treatment of malignant neoplasms.The mammoplasty of reconstructive increase allows it to recreate natural and aesthetically attractive breasts without increasing the risk of developing tumor processes.
What individual characteristics are taken into account before the operation?
The tactics of surgical correction are determined by the individual characteristics of the patient.Yes, there is always the opportunity to put a large implant, but far away that step will lead to the desired result: a natural and harmonious change in appearance.
The following factors are influenced by the choice of the form, profile and size of the endoprosthesis, as well as the choice of implantation pockets and the method of instant
- The age of women.
- The initial shape and size of the mammary glands.
- The height and width of the chest.
- The severity of subcutaneous fat.
- The elasticity of the integumentary tissues of the mammary glands.
- The width of the interval interrogated.
- The presence of signs of ptosis (prolapse) of the bust.
The tactics of the increase mammoplasty also affect whether a woman plans to give birth in the future to give birth and breastfeed.When choosing access, the need in the plastic of the nipple-carolar complex is also taken into account, which may be necessary to achieve the optimal aesthetic result.
Methods to install implants
Taking into account the previous individual characteristics of anatomy and other factors, a plastic surgeon chooses one of the three forms (types of surgical access) of breast increase:
- Areolar (breast enlargement "through Areola").
- Submamacle.
- Axillary.
Below are the characteristics, pros and cons of each method of increasing mamublasty in detail.
Areolar access
With areolar or perialar access, the plastic surgeon establishes the implants through the incision, which passes along the periphery of the pigmented area of the areola.The main advantage of such surgical access is the invisibility of the scars.The scar is located on the edge of the skin clear and dark, and therefore it is quite difficult to notice it.
In the periarelar method to increase the thoracic glands, there are other advantages, in addition to the minimum gravity of the postoperative scar:
- During the operation, it is possible to carry out the plastism of the nipple areland 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 perialar access can play a decisive role.
- Periereyular access eliminates the risk of damage to the afferent (sensitive) nerve fibers, which pass to the Sak in the load fold area.Due to this advantage, the mamublasty area allows you to completely maintain the sensitivity of the nipple and the areola.
- Simultaneously with the increase in the bust, you can correct the initial stage of mastoptosis.
Despite the advantages of perialar access listed above, the technique cannot be recommended to all women.In particular, this method of installing implants is not recommended for girls who plan to give birth to boys and breastfeed them.This is explained by the fact that during the operation there is a risk of damage to milk ducts, which will affect the breastfeeding function.
Periaryolar access does not allow a complete description of all implant pockets, which imposes restrictions on the size of the implant.This method is suitable for those patients who want to put a small endoprosthesis and slightly increase the chest.In a situation in which a woman wants to add 2-3 sizes to the mammary glands, it is preferable to use submammamal or axillary access.
Submamajaro access
With submamatic access, the installation of endoprosthesis is carried out through horizontal incisions, which pass under the thoracic gland in a natural skin fold.Postoperative scars When using this implant installation method they express significantly, but are hidden in the skin fold.The scars are visible in the position of bedtime, and in standing position, they are covered by the lower post of the thoracic gland.
The main advantage of submammant access is a very good description of the operating field.For a plastic surgeon, this is the easiest type of mammoplasty, since there is full access to all implant pockets and it is easy to achieve absolutely symmetrical placement of the implants.Thanks to this characteristic, large endoprosis can be installed.
Another advantage of the submammary methodology to increase the bust is the lack of risk of damage to milk ducts.After the operation, the breastfeeding function is preserved, which allows you to recommend this method for patients who plan in the future pregnancy and breastfeeding of the baby.
The submammamant implant installation method does not lack deficiencies.For many patients with plastic surgeons, the least less than the methodology in a pronounced and sufficiently extended scar, which passes in a fold under the chest.The disadvantage is the risk of damage to the afferent nerves that innervate the SAK.If the nerve dissects during the operation, the sensitivity of the nipple and the areola will be altered.
The use of submample access does not simultaneously allow the increased mamublasty to perform plastic surgery through an incision.In addition, women who have the initial signs of a bust (mastoptosis) often resort to the help of a plastic surgeon.If periereyular access allows you to eliminate age -related manifestations, then, when submamatic access is used, it is impossible to correct mastopthosis simultaneously with chest enlarged.
Axillary access
With axillary access, breast increase is carried out through the cuts, which are in the axillary pit.The key advantage of the methodology is that the scars fail from the mammary glands and do not affect their aesthetic perception.On the other hand, the scars are notable, and this can become a problem if a woman wears open clothes.For example, scars can be clearly visible during sports, especially in a body position with raised hands.
However, it is access to axillar that is considered the "gold standard" in the increased mamublasty.The operation is carried out under the control of the optical fiber (endoscope) equipment, allowing a plastic surgeon to access all implant pockets.There is no risk of damage to nerve trunks.There is no risk of dissection of milk ducts, which allows us to recommend this method of installing implants to girls who plan pregnancy.There are no restrictions in terms of endoprosthesis: the type of axillary access allows you to place implants of any volume, shape and profile.
The disadvantages of the axillary breast increase method are that the plastic surgeon has no way to correct the consequences of the omission of the mammary glands or perform plastic of the nipple animular complex.For this reason, axillary access is mainly used to model the size of the bust, when there are no concomitant aesthetic problems that require surgical correction.
Surgical access selection criteria
In clinical practice, plastic surgeons use several criteria to choose surgical access to increase chest glands.One of the main criteria is the age of women and their additional plans regarding pregnancy.If the patient plans to give birth to children, it is advisable to reject periarelar access.Axillary access or submamatic access is preferable.
If a woman does not plan to give birth, she can use any of the previously considered surgical access types.In situations in which, to improve the aesthetics of the bust, simultaneously with its increase, it is necessary to perform the plastic of the areola, the periaryolar access is preferable.The same implant installation method is more suitable for patients with initial mastoptosis signs.
Patients who wish to increase the bust in various sizes, a plastic surgeon may recommend a submammamor or axillary method.The optimal choice in this situation is an increase in the thoracic glands through the axillary pit, however, the aesthetic desires of the woman are also taken into account.If she expresses the desire to hide the scar in a natural fold under the chest, submammary access is selected.
Choose a pocket to instant
The following aspect of the increase in mammoplasty is associated with the choice of the anatomical region in which the implants will be installed.
The implantation pocket can be located:
- under the mammary gland (subgandular placement);
- under the pectoral muscle (submiscular location);
- Partially under the gland, partially under the muscle (combined version).
Subgandular placement.The implant is installed in the anatomical space under the gland.The most superficial pocket is separated from the body surface only with deck tissues and peeling glands, and due to this feature it is not recommended to use if it is necessary to increase the chest in various sizes.A great endoprosthesis can be determined visually.In addition, the risk of developing the deformation of the step: increases aesthetic complication, in which a type of "step" is formed on the upper edge of the implant.
With the subgondular placement of endoprosthesis, the risk of developing other complications of aesthetic nature, in particular, the appearance of deformation of the integumentary tissues on the thoracic gland in the form of "waves" or "mountain ashes".With the development of the capsular contracture, the deterioration of the aesthetics of the bust is also more pronounced with the superficial placement of the implant.
Another characteristic of this type of placement is that endoprosthesis and mammary glands are supported only by holding links: connective tissue structures, whose elasticity decreases with age.For this reason, with a subgandular implant installation, the risk of developing mastoptosis increases, especially in women with initially large breasts.
Submuscular placement.The placement of the implant under a large chest muscle prevents the characteristic problems of a subgain location.Less the risk of capsular contracture and the appearance of skin deformation above the chest in the form of "Rowan" and "Waves".Endoprosthesis is safely fixed with the muscles and does not increase the probability of developing mastoptosis.
But the placement of the implant under the muscle has the opposite side.
First, in girls who actively participate in sports, increase the risk of rotation or implant displacement.If, to increase the thoracic glands, fashion implants were used, rotation (turn) can lead to breast deformation, which can only be corrected during a repeated operation.
Secondly, with submiscipular placement, the degree of tissue injury during surgery increases.Because of this, healing becomes slower and the rehabilitation period lengthens to wear compression underwear and follows all restrictions for a longer time.
Combined placement.The best option is the combined placement, in which the upper endoprosthesis segment is below the muscle, and the lower post is under the gland.With this agreement, the risk of deformation of steps is excluded.Below the risk of turning and moving from the implant, the development of the capsular contracture and other aesthetic complications.Healing is faster, the rehabilitation period is reduced.
Types of implants
The expansion of the breasts is carried out by implants of the main world manufacturers.Medical silicone endoprosis were made with a high degree of cohesion and various degrees of density.The silicon is covered with an elastomeric shell, which eliminates the probability of gel diffusion.The external capsule is represented by a porous shell, whose special texture contributes to the integration of the implant into living tissues and their reliable fixation.Due to the porous membrane, the fibrous capsule contracture risk is reduced.
The line of each manufacturer has several hundred types of implants that differ in the following characteristics:
- Form: an implant can be anatomical (in the form of a fall) or round.
- Base width: Horizontal size of the lower pole of endoprosthesis.
- Profile: endoprosthesis height.
- Size: volume.
The choice of implant is determined by desires, as well as the initial data of the patient and individual characteristics of the thorax structure and mammary glands.For example, girls with a pronounced gap between Thilet are more suitable for low -profile anatomical implants with a wide base.Women who wish to change accents to the neckline are more suitable for round full profile implants, which visually increase the upper pole of the mammary gland.
Preparation for breast increase with implants
Preparation for plastic surgery to the enlarged breast can be divided into two stages: diagnosis and aesthetics.The purpose of the aesthetic stage of the preparation is to choose the perfect implant and decide on the tactics of surgical intervention.According to the results of the computer modeling and analysis of the patient's initial data, the surgeon selects the method of installing endoprosthesis and an anatomical pocket for its location.
The purpose of the diagnostic stage is to minimize operational and anesthesiological risks, as well as eliminate contraindications for surgery.Each woman, before increasing the mammary glands, suffers a comprehensive diagnosis, including an expanded list of instrumental and laboratory methods.Mammography with a consultation of a gynecologist and mammologist is surely prescribed.
A few weeks before increasing mammoplasty, a woman should stop taking certain drugs, in particular, contraceptive and anticoagulant hormonal drugs.It is necessary to abandon the anti -inflammatory and analgesic medications of the NSAID group, since they slow down the blood coagulation.It is also necessary to stop drinking alcohol and abandon smoking, since ethanol and nicotine slow down regenerative processes and negatively affect the recovery rate after Mamimastia.
Rehabilitation after mamublasty
The early postoperative period is accompanied by typical symptoms for any operation: swelling, pain and bruises in the area of the operational wound, fever, discomfort.These symptoms are a normal reaction of the body in response to a violation of tissue integrity.Preparations prescribed by a plastic surgeon: anti -inflammatory, antiexpocational analgesics, will help deal with the difficulties of this period.For the prevention of infectious complications, the doctor prescribes a short antibiotic course.
The details of the rehabilitation period after mammoplasty is that it is necessary to constantly use a compression bra.Elastic linen is sewn in an individual order even before surgery.You should use it continuously, you can only eliminate it for a time of hygiene procedures.As for body hygiene, in the first 7-10 days after the increase in the thoracic glands, it must be limited by wet wipes, it cannot take a shower.
You can sleep after the operation only on your back.From 10 to 14 days, you are allowed to sleep aside, but it is still impossible to turn on your stomach.You can't play dancing or sports.The prohibition of physical activity, including home, is valid for 4 weeks;Energy charges and some types of cardiovascular training are contraindicated for 3 months (or to the special resolution of a plastic surgeon).
Throughout the restoration period, it cannot sunbathe or in direct sunlight or solarium.You cannot go to a sauna or bathtub, take hot baths at home.Alcohol and smoking are contraindicated.Compression linen is allowed to be eliminated from the second month, but during the year you must wear a bra with wide straps and a wide belt that supports the chest well.