Mammoplasty

Shape correction, breast augmentation is one of the most popular plastic surgery procedures. With the help of mammoplasty, you can correct congenital or acquired breast defects, restore its volume, elasticity after childbirth and breastfeeding. Correctly performed surgery helps a woman to become more attractive, more self-confident.

Indications for surgery

• Descent and decreased elasticity of the mammary glands (mastoptosis).
• Increased breast volume while maintaining its tone and position (macropathy).
• Reduction of mammary glands after lactation.
• Small breast size (micromastia).
• Enlarged breast volume in men (gynecomastia).

Types of mammoplasty

1. Augmentation mammoplasty(endoprosthetics) - breast augmentation, correction of its shape using implants. It is used after childbirth, breastfeeding, with congenital asymmetry.
2. Reduction mammoplasty- Reducing the size of the bust with mastoptosis or macropathy.
3. Mastopexy- breast lift. It is indicated for mastoptosis, if the volume of the breast meets the requirements for the operation.

Endoprosthetics of the mammary glands

The operation involves the installation of silicone prostheses (implants) into the mammary glands. The choice of the incision site is consistent with the woman. The implant is placed under the pectoral muscle, and if the volume of the breast permits, between the muscle and the mammary gland. The incision is sutured, no drainage is required. The nipple and areola are enlarged after surgery.

Breast implants

Silicone or polyurethane endoprostheses adjust the volume, shape of the bust, give a feeling of natural body tissues.

The service life of the implants exceeds 15 years, after which they are recommended to be replaced.

Products differ in a number of indicators:

1. Fillers: cohesive gels or saline (sodium chloride). The composition of the gels is more elastic, homogeneous, lightweight, but dangerous for the body if leaked. Salt solution is safer, softer, cheaper. Negative properties - gurgles when moving, prone to leakage.
2. Structure: rough (textured) or smooth. Textured implants are more stable, but skin folds can appear from the friction of body tissues against their surface. The disadvantage of smooth dentures is the likelihood of displacement.
3. Shape: anatomical or round. The former have a more natural look, while the latter retain the symmetry and shape of the breast even when displaced.

Reduction mammoplasty

When carrying out this type of surgery, adipose tissue and breast tissue are partially removed, their size changes, and a new shape is given.

Excision of excess tissue reduces the likelihood of cancer.

Reduction mammoplasty options:

1. Liposuction. The method is considered conservative and does not leave seams. Designed for minor breast reduction with mild degrees of mastoptosis.
2. Short (vertical) seam. A popular method in which the breasts maintain their natural shape and the nipples are sensitive. The operation takes little time, the proportion of complications is low.
3. T-shaped (anchor) cut. The classic method, which is used for large amounts of tissue removed. Its disadvantages are the duration of recovery, a large scar.
4. Amputation with nipple transfer. It is used for very large breasts. The method is associated with a high risk of injury to the mammary glands, loss of nipple sensitivity, and inability to breastfeed.

Mastopexy

Breast lift without implants is possible in several ways:

1. Vertical is used for mastoptosis of 1-2 degrees, the seams are almost invisible, the cosmetic effect is long-lasting. The method is ineffective for lowering the breast of 3-4 degrees.
2. Anchor mastopexy gives good results for ptosis of any complexity. Its disadvantages include a longer recovery period, noticeable sutures, an increased risk of injury to breast tissue.
3. Periareolar mastopexy is the removal of a small piece of skin around the areola. It is indicated for pseudoptosis, for other forms of sagging of the bust it is ineffective.

Operation stages

For an excellent result of plastic surgery, high-quality medical care at all 3 stages is important. The preparatory period lasts 1-2 weeks. The actual surgical intervention takes from 1 to 4 hours.

Full recovery occurs within 1. 5 months.

Preparing for mammoplasty

The operation is performed no earlier than a year after the end of lactation. 2 weeks before surgery, it is forbidden to take hormonal contraceptives, Aspirin and preparations containing salicylates.

You should stop drinking alcohol, smoking.

In preparation, research is necessarily carried out:

• general and biochemical blood tests;
• electrocardiogram;
• blood test for anticoagulants (coagulogram);
• Ultrasound of the mammary glands;
• general urine analysis
• testing for hepatitis and HIV viruses.

The course of the surgical intervention

Bust plasty is done under general anesthesia. A special type is expander dermotension. It is used to increase the volume of the breast with a lack of its own tissue and large implant sizes. The procedure is carried out in 2 stages. First, an expander is installed to gradually stretch the breast tissue for 1. 5–2 months.

When the desired size is reached, an endoprosthesis is placed in the breast.

Operating incision methods:

1. Through the fold under the breast (submammary access). Safe method for augmentation mammoplasty. A scar from an incision 4–5 cm long disappears over time under a slightly lowered breast. Access is difficult with micromastia in thin girls.
2. An incision around or along the inferior arch of the areola (periareolar approach). Advantage - surgical scars are almost invisible. For patients planning to breastfeed, this method is not recommended due to the high risk of breast injury.
3. Endoscopic augmentation through the axillary approach. High-tech equipment helps to install the implant without damaging blood vessels and nerve fibers. An incision 3-4 cm long is made in the axillary area, and then the scar is naturally masked. There is a limitation on the volume of the implant - up to 400 ml.
4. Endoscopic access through the navel. This method is little used due to the remoteness of the entry point from the operation site, difficulties with the formation of a "pocket" for the prosthesis.

Rehabilitation after mammoplasty

If the operation took place without complications, the patient spends up to 3 days in the hospital. After discharge, it is necessary to attend dressings. Moderate pain in the intervention area that occurs in the first days is considered natural. Feelings of tightness of the skin are possible due to postoperative edema, which subside after about 5-7 days.

After 4–6 weeks, the breast sags slightly, looks more natural, and capsules form around the implants.

Successful recovery rules:

• Do not load the shoulder girdle, do not lift weights.
• Do not visit fitness clubs, swimming pools, saunas, baths.
• Sleep on your back.
• Don't put your hands up.
• After breast augmentation, be sure to wear compression garments.

Possible complications

• Capsular contracture. The body forms a shell around the endoprosthesis, which can lead to its displacement, violation of the symmetry of the mammary glands, and their hardening.
• Infection. Infection occurs during the operation due to violation of the rules of asepsis or after non-compliance with antiseptic standards of care. The period of particular risk is 1 week after the operation.
• Keloid, hypertrophic scars. They appear if the body is predisposed to their formation. The formations look like dense ridges rising above the surface of the skin and spoil the appearance of the breast.
• Accumulation of blood, serous fluid (hematoma, seroma) and, as a result, darkening of the skin color. It occurs when blood vessels, lymph vessels are damaged during surgery or during the recovery period. Complication appears due to low blood coagulation, sharp rises in blood pressure, incorrectly sized endoprosthesis.
• Reduction or loss of sensitivity of the nipples, areolas. Often occurs when large breasts are reduced with reduction mammoplasty due to nerve damage.
• Implant rupture. It occurs due to the thin shell, which is often found in inexpensive prostheses. Salt filler is easily absorbed by the body without causing harm. Damage to an endoprosthesis with a cohesive gel is not always noticeable, but it is dangerous if silicone gets into body tissues.

Breastfeeding after surgery

The safest operation is through an incision in the armpit (transaxillary) or under the breast (submammary).

About a year after surgery, breastfeeding is allowed.

Lactation problems can occur in the following cases:

• The endoprosthesis is placed so that it compresses the mammary glands, reducing the volume of milk they produce.
• A cut along the areola is more likely to injure the nerve endings around the nipple.
• Reduction plastic, associated with a decrease in breast size, disrupts the milk ducts, blocks their functions.

In what cases is breast plastic surgery contraindicated?

• Cardiovascular diseases, varicose veins (thrombophlebitis, thrombosis).
• Severe forms of mastopathy.
• Oncology.
• Blood clotting disorders, diabetes mellitus.
• Infectious diseases (ARVI, influenza).
• Neurological, mental disorders.
• Pregnancy, breastfeeding.
• Age under 18.

Advantages and disadvantages of mammoplasty

Advantages of plastic breast correction:

• Application of modern interventions.
• Correction of congenital and acquired defects of the mammary glands.
• Long lasting and pronounced aesthetic effect.
• Short terms of the operation.
• The ability to choose the shape, material of endoprostheses at will.
• Preservation of the ability to lactate.

Possible disadvantages include:

• Skin marks from incisions - stitches, scars (unless special absorbable materials were used).
• Threat of complications (infection, breast deformity, bleeding).
• The need to change endoprostheses every 10-15 years.
• The high cost of mammoplasty.
• The need for general anesthesia.
• Painful sensations in the first postoperative days.
• The need to constantly wear compression underwear.
• A long period of rehabilitation (from several months to a year) with the rejection of sports, physical activity, pregnancy, breastfeeding.