If you go out on the street and ask ten men why they need plastic surgery, many will answer without hesitation: "To enlarge female breasts."This logic is not accidental: human civilization, whether the ladies like it or not, is inherently patriarchal, i.e. almost everywhere dominated by men.For them, the bust is the most attractive part of a woman's body.
Therefore, ladies since ancient times, in order to make a stronger impression on the stronger half of humanity, came up with different ways to make their breasts as prominent as possible.At first there were clothes with a deep neckline, then underwear that created beneficial optical effects.But these were all temporary measures, and women wanted something permanent or at least long-lasting.
Only the development of plastic surgery has helped women to really look in accordance with their own desires and meet the standards of external beauty set by men.In 1889, something happened that millions of beautiful ladies around the world dreamed of - a method of artificial breast augmentation was invented, which later became known as breast endoprosthetics (from the Greek words "endon" - "inside" and "prosthesis" - "addition, joining").
The first material used to enlarge women's breasts was paraffin, which was first called petroleum wax because it was made from this flammable liquid.In the first decades of the last century, aesthetic medicine tried many materials that were suitable for endoprosthetics: ivory and glass beads, polyethylene and polyurethane, polyester foam and many more.All this led 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 characterized 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.
Phases of work
Since breast replacement is a fairly serious surgical procedure, 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, level of blood oxygen saturation, etc.
Before the operation, the surgeon makes marks with a special marker, according to which the surgical approach is then performed.Incisions are usually made so that postoperative scars are minimally noticeable.The choice of surgical approach depends on a number of decisive factors.Specifically, they are:
- the position (high, medium or low) of the mammary glands on the chest wall;
- presence or absence of breast ptosis - ptosis and its degrees (there are three of them in total);
- skin characteristics: thickness and elasticity, presence of stretch marks;
- anatomical features of the pectoral muscles, sternum and ribs.
Then a pocket (bed) is formed for implant placement.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 implant, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are placed with modern absorbable suture material or special medical glue is used.A compression garment is then put on the patient to prevent displacement of the implant and increase post-operative tissue swelling.A few hours after the operation, the patient remains in the rehabilitation department, where her condition is monitored by the 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 breast by several sizes at once.In addition, if you have previously had breast reconstruction surgery after breast cancer or trauma, the procedure may be more difficult and take longer.
Work methods
There are four main surgical approaches used worldwide.
- Submammary (below 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 incisions invisible.In other cases, this approach does not provide sufficient cosmetic results.The advantages of this approach include the fact that when 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 unpigmented skin.This is why after a few months the postoperative scar is almost indistinguishable.In this case, the breast tissue moves in the lower part.It in no way hinders 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.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 has not been formed.In other cases there are restrictions.Achieving axillary access requires endoscopic video technology.It allows the operation to be performed more safely and less traumatic, given the distance of the incision from the area of operation. - Transumbilically.
This is a rarely used technique.It involves the insertion of an implant through an incision in the umbilical region.Only an implant filled with saline can be implanted in this way.First, the implant shell is installed and then filled.Such breast implants are practically not used, because, as experience has shown, silicone implants make it possible 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 a selective individual approach to each individual case enables the achievement of the most aesthetic results.
Preparation for surgery
Before starting preparations for the operation, the patient should find out 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 textured shell and filler - 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 molecules of a substance, 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 advantages and disadvantages.For example, a highly cohesive gel holds its intended shape well with a high level of projection, but is denser to the touch.The saline solution makes the breasts as soft and natural as possible, but does not ensure that their shape is maintained.8-10 months after the start of use, salt crystals may begin to form that can break through the shell.
In addition, there is a "gurgling" effect, which also does not suit all patients.
There is another way to increase breasts without the use of foreign materials.It is the introduction of fat cells - lipofilling or lipomodelling.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, as 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 transplanted tissue volume is absorbed, so the operation will have to be repeated.So, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, the patient will have to undergo a full medical examination to ensure that there are no medical contraindications and to minimize possible risks.This will include:
- blood tests: clinical and biochemical, for coagulation, for group and Rh factor, for 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 veins of the lower extremities will be required.In addition, during the consultation with the plastic surgeon, the patient must be told about all existing diseases, previous operations, allergic reactions, as well as about the medications taken, including food supplements.
Also, before the operation, you will have to stop smoking and drinking alcohol for at least two weeks, because the first has a bad effect on healing, and the second is not compatible with antibiotics 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 the hormonal level in the early postoperative period and the beginning of the lactation process (formation of breast milk) can affect breast implants in the most unpredictable way.
Contraindications for performing breast endoprosthetics are:
- pregnancy;
- diabetes mellitus;
- severe endocrine and autoimmune diseases;
- blood clotting disorder;
- diseases of the mammary glands (including fatty formations), which require the supervision of an oncologist;
- worsening of existing chronic diseases;
- diseases of the cardiovascular and respiratory system that serve as a contraindication for general anesthesia;
- age less than 18 years;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
Full recovery after breast replacement comes within a few months.This period can be divided into several main phases.
During the first 3-4 days after surgery, patients may feel discomfort: a feeling of heaviness and cracking in the area of the large pectoral muscles.They can be alleviated by taking analgesics prescribed by the doctor.On the fourth day, these manifestations usually disappear.
Swelling of soft tissues in the area of surgery is possible.Sometimes it lasts for several weeks and spreads to the abdominal area.These are normal symptoms and should not be a cause for concern.
Arm movements will be limited for the first 24-48 hours after the procedure.
You should not drive during the first week.During this time, it is best that your clothes are as comfortable and easy to take off as possible.
You will need to limit physical activity as much as possible.However, bed rest is not necessary at all.Avoiding nicotine and alcohol is also recommended.
A week after the operation, you can already drive a car, but only if you do not take painkillers, which seriously impair motor skills.It is important to consult with your surgeon before returning to driving.
If your job does not involve intense physical activity, then returning to work is possible within a week.However, you will still need to avoid lifting heavy (more than 4-5 kg) objects and refrain from excessive physical activity.
A month after surgery, your doctor will likely allow you to resume light exercise.However, most surgeons still do not recommend a lot of upper body work during this period, especially when it comes to the pectoralis major muscles.Light cardio exercises are possible without running or swimming.Around this time, you will begin to see results from your breast augmentation.The breasts will begin to fall into 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 garments are usually removed and you can start wearing bras without wires or push-ups.
A few months after surgery, 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 into the surrounding skin.They should become almost invisible within a year if cared for properly.Two to three months after surgery, 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 upper body exercises.
There are a few more post-surgery tips to speed up your recovery:
- avoid taking medicines that affect blood clotting;
- moisturize your mammary glands regularly to avoid stretch marks;
- suppress the desire to remove the bandage and look at the progress - this can cause infection;
- give the implants time to "adjust": at first they will look unnatural, with an excessively filled upper column, but gradually they will take on a natural teardrop shape;
- be sure to get enough rest as it speeds up the recovery process;
- Avoid wearing tight clothes, especially those that require you to raise your arms high when putting them on;
- One month after surgery you must sleep only 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 the back;
- if you feel severe pain, asymmetric swelling appears or the bandage is wet, consult a doctor immediately;
- Do not worry if you feel increased or decreased sensitivity in the nipples after surgery: this is normal;
- feelings on the right and left side may not be the same - this is not a sign of trouble and happens to almost everyone;
- Keep in mind that most women can breastfeed after surgery, however milk production may be slower.