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 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, ladies, 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 clothes with deep necklines, then underwear that created beneficial optical effects.But all these were temporary measures, and women wanted something permanent or at least long-lasting.
Only the development of plastic surgery helped women truly look in accordance with their own wishes and meet the standards of external beauty set by men.In 1889, something that millions of beautiful ladies around the world dreamed of happened - a method of artificial breast enlargement was invented, which later became known as breast endoprosthetics (from the Greek words “endon” - “inside” and “prosthesis” - “adding, joining”).
The first material used to enlarge female breasts was paraffin, which was first called petroleum wax, since 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 much more.All this led to 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, 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 improved physical and chemical characteristics: they are denser and more reliable; the gel filling them is highly 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 blood oxygen saturation, etc.
Before the operation, the surgeon applies markings 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 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 features: thickness and elasticity, presence of stretch marks;
- anatomical characteristics of the pectoralis major muscles, sternum and ribs.
Then a pocket (bed) is formed for installing 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 installation of the implants, the wound is sutured.To achieve the best cosmetic effect, intradermal cosmetic sutures are applied using modern absorbable suture material or special medical glue is used.Then the patient is put on compression garments to prevent displacement of the implants and the increase in postoperative tissue swelling.For several hours after the operation, the patient remains in the rehabilitation ward, where her condition is monitored by medical staff.
In general, breast replacement surgery takes from 40 minutes to one and a half hours.Sometimes it takes longer depending on the surgical technique used and a number of other factors.For example, a patient’s desire to enlarge her breasts by several sizes at once.Additionally, if you have previously had breast reconstruction surgery following breast cancer or trauma, the procedure may be more difficult and take longer.
Operation methods
There are four main surgical approaches that are used throughout the world.
- Submammary (under the mammary gland).
This method involves cutting the skin only under the breast (in the submammary fold), which, if there is a well-formed fold, makes the incisions unnoticeable.In other cases, this access 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 unpainted skin.Due to this, after a few months the postoperative scar becomes almost indistinguishable.In this case, the breast tissue moves apart in the lower section.This does not in any way impede 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 is not formed.In other cases it has limitations.To achieve axillary access, endoscopic video technology is required.It allows the operation to be performed more safely and less traumatically, given the distance of the incision from the operation area. - Transumbilical.
This is an infrequently used technique.It involves installing an implant through an incision in the umbilical area.In this way, only an implant filled with saline solution can be installed.First, the implant shell is installed, then it is filled.Such breast implants are practically not used, since, as experience has shown, 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 a selective individual approach to each case allows you to achieve the most aesthetic result.
Preparing for surgery
Before starting preparations for surgery, the patient should find out from the plastic surgeon all aspects of the planned procedure: type of implant, manufacturer, availability and duration of warranty, shape, type of shell and filling.The most common currently 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 the 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 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 does not ensure that their shape is maintained.8-10 months after the start of use, the formation of salt crystals that can pierce the shell may begin.
In addition, there is a “gurgling” effect, which also does not suit 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 twentieth century.However, in those years, fat implantation 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 will need to undergo a full medical examination to ensure that there are no medical contraindications and to minimize possible risks.It will include:
- blood tests: clinical and biochemical, for coagulation, for group and Rh factor, for HIV, syphilis and markers of hepatitis C and B;
- 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 must be told about all existing diseases, previous operations, allergic reactions, as well as medications taken, including dietary supplements.
Also, before the operation, you will need to stop smoking and drinking alcohol at least two weeks, since the former has a bad effect on healing, and the latter is not compatible with antibiotics, which are prescribed for prophylactic purposes in the postoperative period.
In addition, every woman planning 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 endoprosthetics are:
- pregnancy;
- diabetes mellitus;
- severe 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 less than 18 years;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
Full recovery after breast replacement occurs within several months.This period can be divided into several main stages.
During the first 3-4 days after surgery, patients may experience discomfort: heaviness and bursting sensations in the area of the pectoralis major muscles.They can be relieved by taking analgesics prescribed by the attending physician.On the fourth day, these manifestations usually go away.
Swelling of soft tissues in the surgical area 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.
Hand movements will be limited for the first 24-48 hours after the procedure.
During the first week you should not drive.During this time, it is best to keep your clothes as comfortable and easy to remove as possible.
You will need to 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, you can already drive a car, but only if you do not take any 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.
One month after surgery, your doctor will likely allow you to resume light exercise.However, most surgeons do not yet recommend doing much upper body work during this period, especially involving the pectoralis major muscles.Light cardio exercises are possible without running or swimming.Around this time, you will begin to see results from 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, compression garments are usually removed and you can begin 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 scars, they will continue to gradually fade over time and blend into the surrounding skin.They should become virtually invisible within a year if properly cared for.Two to three months after the operation, the breasts become softer, acquire the consistency of natural breast tissue, and then become more and more soft with each month.After three months, you can begin more intense exercise for the upper body.
There are a few more post-surgery 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 look at the progress - this can provoke an infection;
- give your implants time to “adapt”: at first they will look unnatural, with an excessively filled upper pole, but gradually they will acquire a natural teardrop shape;
- be sure to get plenty of rest as this speeds up the recovery process;
- Avoid wearing tight-fitting clothing, especially those that require you to raise your arms high when putting them on;
- For a month after surgery, you need to 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 your back;
- if you experience severe pain, asymmetric swelling appears, or the bandage is wet, consult a doctor immediately;
- Don't worry if you experience either increased sensitivity or decreased sensitivity in your nipples after surgery: this is normal;
- sensations on the right and left may not be the same - this is not a sign of trouble and happens to almost everyone;
- Please note that most women can breastfeed after surgery, however milk production may be slower.