If you go out on the street and ask ten men why plastic surgery is necessary, many will answer you without hesitation: “To enlarge women's breasts.”This logic is not accidental: human civilization, whether the ladies want it or not, is inherently patriarchal, that is, men dominate almost everywhere.For them, the bust 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 garments with deep necklines, then underwear that created beneficial optical effects.But these were all temporary measures and women wanted something permanent or at least lasting.
Only the development of plastic surgery helped women to truly look in accordance with their own desires and meet the standards of external beauty set by men.In 1889, what millions of beautiful ladies around the world dreamed of happened: a method of artificial breast enlargement was invented, which later became known as breast endoprostheses (from the Greek words "endon" - "inside" and "prosthesis" - "add, join").
The first material used to enlarge female breasts was paraffin, which was initially called petroleum wax, since it was made from this flammable liquid.In the first decades of the last century, aesthetic medicine tested many materials suitable for endoprostheses: ivory and glass beads, polyethylene and polyurethane, polyester foam and many more.All this had sad consequences.
Only in 1961, two American plastic surgeons from Houston, Thomas Cronin and Frank Gerow, manufactured and used the first silicone implants during surgery, which marked a real breakthrough in aesthetic medicine.But more than half a century passed before fifth-generation implants were invented, in the mid-1990s. They are distinguished by improved physical and chemical characteristics: they are denser and more reliable;The gel that fills them is very durable and therefore does not leak through the shell.
Operation stages
Since breast replacement is a fairly serious surgical procedure, it is performed only under general anesthesia.Throughout the entire operation, all vital indicators of the body are monitored using special monitors: blood pressure, heart rate, degree of oxygen saturation in the blood, etc.
Before the operation, the surgeon applies marks with a special marker, according to which the surgical approach is then carried out.Incisions are usually made so that postoperative scars are minimally noticeable.The choice of surgical approach depends on a series of determining factors.In particular, these are:
- position (high, medium or low) of the mammary glands on the chest wall;
- 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 characteristics of the pectoralis major muscles, sternum and ribs.
A pocket (bed) is then formed to install the 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 provides a more stable result.
After the implants are installed, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are applied using a modern absorbable suture material or a special medical glue is used.The patient is then placed in compression garments to prevent displacement of the implants and increased postoperative tissue inflammation.For several hours after the operation, the patient remains in the rehabilitation room, where medical staff monitor her condition.
Generally, breast replacement surgery lasts between 40 minutes and an hour and a half.Sometimes it takes longer depending on the surgical technique used and other factors.For example, a patient's desire to enlarge her breasts several sizes at once.Additionally, if you previously had breast reconstruction surgery after breast cancer or trauma, the procedure may be more difficult and time-consuming.
Operation methods
There are four main surgical approaches used worldwide.
- Submammary (below the mammary gland).
This method consists of cutting the skin just below the breast (in the submammary fold), which, if there is a well-formed fold, makes the incisions imperceptible.In other cases, this access does not provide sufficient aesthetic results.The advantages of this approach include the fact that when it is used, the 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 unpainted skin.Because of this, after a few months the postoperative scar becomes almost indistinguishable.In this case, the breast tissue is separated in the lower section.This does not in any way prevent the possibility of breastfeeding in the future and, contrary to what is mistakenly believed, 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.This also does not affect the breast tissue.The use of the method is more justified when the initial size is very small and the inframammary fold is not formed.In other cases it has limitations.To achieve axillary access, video endoscopic technology is required.It allows the operation to be performed in a safer and less traumatic way, given the distance of the incision from the operating area. - Transumbilical.
This is a rarely used technique.It consists of installing an implant through an incision in the umbilical area.In this way only one implant filled with saline solution can be installed.The implant capsule is first installed and then filled.These breast implants are practically not used because, as experience shows, silicone implants allow you to achieve a more stable result, taking into account all the nuances of a particular case.
The final choice of the method of implant installation and the surgical approach depends on the characteristics of each patient, and only a selective individual approach to each case allows achieving the most aesthetic result.
Preparing for surgery
Before beginning preparations for surgery, the patient should inform the plastic surgeon about all aspects of the planned procedure: type of implant, manufacturer, availability and duration of warranty, shape, type of cover and filler.The most common currently in the world are silicone implants with a textured shell and a filler - silicone gel with shape memory.
There are different types of fillings for implants.
- silicone liquid, the consistency of which resembles vegetable oil;
- standard cohesive silicone gel (cohesion is the union between the molecules of a substance, which determines its resistance), with a consistency reminiscent of gelatin;
- silicone gel with a high degree of cohesion, the consistency of which resembles jam;
- silicone gel "soft touch" (from the English "soft touch") - greater softness;
- saline solution, the consistency of a bag full of water;
- Soybean oil, similar in consistency to the first filling.
Each filler has its own advantages and disadvantages.For example, a highly cohesive gel retains its intended shape well with a high level of projection, but is denser to the touch.A saline solution makes the breasts feel as soft and natural as possible, but it does not guarantee that their shape will be maintained.8-10 months after the start of use, the formation of salt crystals may begin, which can pierce the shell.
In addition, a "gurgling" effect occurs, which is also not suitable for all patients.
There is another way to enlarge the breasts without the use of foreign materials.This is the introduction of fat cells: lipofilling or lipomodeling.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 the implantation of fat did not have a positive effect, since 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.Despite this, after a year and a half, up to 60% of the volume of transplanted tissue is absorbed, so the operation will need to be repeated.Thus, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, the patient must undergo a complete medical examination to verify that there are no medical contraindications and minimize possible risks.It will include:
- blood tests: clinical and biochemical, coagulation, group and Rh factor, HIV, syphilis and hepatitis C and B markers;
- general urinalysis.
Additionally, mammography or ultrasound of the mammary glands, chest X-ray or fluorography, electrocardiogram and ultrasound of the veins of the lower extremities will be required.In addition, during a consultation with a plastic surgeon, the patient should be informed about all existing diseases, previous operations, allergic reactions, as well as any medications taken, including dietary supplements.
In addition, before the operation, it will be necessary to stop smoking and drinking alcohol for at least two weeks, since the first has a negative effect on healing and the second is not compatible with antibiotics that 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 extremely undesirable.The fact is that changes in hormonal levels in the early postoperative period and the beginning of the lactation process (breast milk formation) can affect breast implants in the most unpredictable way.
Contraindications for performing breast endoprostheses are:
- pregnancy;
- diabetes mellitus;
- serious endocrine and autoimmune diseases;
- blood clotting disorder;
- diseases of the mammary glands (including mass formations) requiring 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 under 18 years;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery.
Complete recovery after breast replacement occurs within a few months.This period can be divided into several main stages.
During the first 3-4 days after surgery, patients may experience discomfort: heaviness and a bursting sensation in the area of the pectoralis major muscles.They can be relieved by taking painkillers prescribed by the treating doctor.On the fourth day these manifestations usually disappear.
Soft tissue swelling in the surgical area is possible.Sometimes it lasts several weeks and spreads to the abdominal area.These are normal symptoms and should not be a cause for concern.
Hand movements will be limited for the first 24 to 48 hours after the procedure.
During the first week you should not drive.During this time, it is best to keep your clothing as comfortable and easy to remove as possible.
You should limit physical activity as much as possible.However, bed rest is not necessary at all.It is also strongly recommended to avoid nicotine and alcohol.
A week after the operation, he can drive a car, but only if he does not take painkillers, which seriously impair motor skills.It is important to consult with your surgeon before driving again.
If your job does not involve strenuous physical activity, it is possible to return to work within a week.However, you should avoid lifting heavy objects (more than 4-5 kg) and refrain from excessive physical activity.
One month after surgery, your doctor will likely allow you to resume light exercise.However, most surgeons still do not recommend doing much upper body work during this period, especially the pectoralis major muscles.It is possible to do light cardiovascular exercises without running or swimming.Around this time, you will begin to see the results of your 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, compression garments are usually removed and you can start wearing bras without underwires or push-ups.
A few months after surgery you will be able to check if the results are as expected.As for the scars, they will continue to gradually fade over time and blend into the surrounding skin.If cared for properly, they should become virtually invisible within a year.Two to three months after the operation, the breasts become softer, acquire the consistency of natural breast tissue, and then become softer and softer with each month.After three months, you can start doing more intense upper body exercises.
There are a few more post-operative tips you can use to speed up your recovery:
- avoid taking medications that affect blood clotting;
- moisturize your mammary glands regularly to avoid stretch marks;
- suppress the desire to remove the bandages and observe the progress;This can lead to infection;
- Give your implants time to “adjust”: at first they will look unnatural, with the upper pole excessively filled, but little by little they will acquire a natural teardrop shape;
- Make sure you get enough rest as this speeds up the recovery process;
- Avoid wearing tight clothing, especially those that require you to raise your arms high when putting them on;
- For a month after surgery, you should only sleep on your back!You can't sleep on your side, much less on your stomach.The first few days it will be easier to sleep with the pillows placed high on your back;
- if you feel severe pain, asymmetric swelling appears or the bandage is wet, consult a doctor immediately;
- Don't worry if you experience increased or decreased sensitivity in your nipples after surgery: this is normal;
- the sensations on the right and left may not be the same;This is not a sign of problems and happens to almost everyone;
- Keep in mind that most women can breastfeed after surgery;however, milk production may be slower.