If you go out on the street and ask ten men why they need plastic surgery, many of them 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, meaning that men dominate almost everywhere.For them, the bust is the most attractive part of the female body.
Therefore, since ancient times, in order to make a stronger impression on the stronger half of humanity, ladies have invented various ways to highlight their breasts.At first, low-cut dresses and then underwear created beneficial optical effects.But these were all temporary measures and women wanted something permanent or at least permanent.
Only the development of plastic surgery helped women to really look according to their own wishes and to meet the external beauty requirements set by men.In 1889, something happened that millions of beautiful ladies around the world dreamed of - they invented the method of artificial breast enlargement, which later became known as breast endoprosthesis (from the Greek words "endon" - "inside" and "prothesis" - "addition, connection").
The first substance 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 endoprosthesis: ivory and glass beads, polyethylene and polyurethane, polyester foam and many others.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 brought 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 have improved physical and chemical characteristics: denser and more reliable;the gel filling them is extremely durable, so it does not leak through the shell.
Operating Sections
Since breast augmentation is a rather serious surgical procedure, it is only performed 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 places markings with a special marker, based on which the surgical approach is carried out.The incisions are usually made in such a way that the postoperative scars are minimally noticeable.The choice of surgical approach depends on several determining factors.These are in particular:
- the position of the mammary glands (high, medium or low) 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 features of the pectoral muscle, sternum and ribs.
A pocket (bed) is then created to place 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 inserting the implants, the wound is sutured.In order to achieve the best cosmetic effect, intradermal cosmetic sutures must be applied with a modern absorbable suture material or a special medical adhesive.The patient then wears a compression garment to prevent displacement of the implants and increase post-operative tissue swelling.After the operation, the patient remains in the rehabilitation department for several hours, where his condition is monitored by medical staff.
Breast prosthesis surgery usually lasts from 40 minutes to an hour and a half.Sometimes it takes longer depending on the surgical technique used and various other factors.For example, the patient's desire to enlarge his breasts by several sizes at once.Also, if you have previously had breast reconstruction surgery following breast cancer or trauma, the procedure may be more difficult and take longer.
Operating methods
Four main surgical approaches are used around the world.
- Submammary (under the mammary gland).
With this method, only the skin under the breast is cut (in the inframammary fold), which, if there is a well-formed fold, makes the incisions imperceptible.In other cases, this approach does not provide sufficient cosmetic results.The advantages of this approach include the fact that the breast tissue is practically not affected during use. - Periareolar.
With this approach, the incision is located along the lower semicircle of the areola, at the border between the pigmented skin of the areola and the unpigmented skin.Thanks to this, after a few months the postoperative scar becomes almost indistinguishable.In this case, the breast tissue moves in the lower section.This does not in any way hinder the possibility of future breastfeeding and, contrary to popular misconceptions, it does not reduce the sensitivity of the nipples in the post-operative period. - Axillary (axillary).
This surgical approach involves making an incision in the armpit.It also does not affect the breast tissue.The use of the method is more justified if the initial size is very small and the inframammary fold does not develop.In other cases, it has limitations.An endoscopic video technique is required to access the armpit.It allows for a safer and less traumatic operation, taking into account the distance of the incision from the surgical area. - Transumbilical.
This is a rarely used technique.This involves inserting the implant through an incision in the navel area.In this way, only a saline-filled implant can be inserted.First, the implant shell is installed and then filled.Such breast implants are practically not used, as experience shows that silicone implants allow to achieve a more stable result, taking into account all the nuances of the given case.
The final choice of the method of implantation of the implant and the surgical approach depends on the characteristics of each patient, and only a selective individual approach to each case enables the most aesthetic result to be achieved.
Preparation for surgery
Before starting the surgical preparations, the patient should ask the plastic surgeon about all aspects of the planned intervention: implant type, manufacturer, availability and warranty period, shape, shell and type of filling.Currently, the most widespread in the world are silicone implants with a textured shell and filling material - 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 the material that determines its strength) gel, with a jelly-like texture;
- high-cohesion silicone gel with a jam-like texture;
- "soft touch" silicone gel (from the English word "soft touch") - increased softness;
- Saline, the texture of a bag filled with water;
- soybean oil, similar in texture to the first filler.
Each filler has its own 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 the preservation of their shape.8-10 months after the start of use, the formation of salt crystals penetrating the shell may begin.
In addition, there is a "gurgling" effect, which also does not suit all patients.
There is another method of breast enlargement without the use of foreign substances.This 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 grafting did not have a positive effect, as it is quickly absorbed by the body.
Today, plastic surgeons have learned to process fat cells in such a way that the effects of their injections last longer.Nevertheless, after a year and a half, up to 60% of the volume of the transplanted tissue is absorbed, so the operation must be repeated.Thus, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, the patient must undergo a full medical examination to ensure that there are no medical contraindications and to minimize potential risks.It will include:
- blood tests: clinical and biochemical, blood coagulation, group and Rh factor, HIV, syphilis and hepatitis C and B markers;
- general urinalysis.
In addition, 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 the consultation with the plastic surgeon, the patient must be informed about all existing diseases, previous surgeries, allergic reactions, as well as the medications taken, including dietary supplements.
In addition, you must stop smoking and drinking alcohol at least two weeks before the operation, as the former has a bad effect on healing, and the latter is incompatible with antibiotics prescribed for prophylactic purposes in the postoperative period.
In addition, all women planning mammoplasty should know and take into account that planning a pregnancy within a year of the operation is highly undesirable.The fact is that in the early postoperative period and at the beginning of the lactation process (the production of breast milk), changes in hormone levels can affect breast implants in the most unpredictable way.
Contraindications for breast endoprosthesis are as follows:
- pregnancy;
- diabetes mellitus;
- severe endocrine and autoimmune diseases;
- blood clotting disorder;
- diseases of the mammary glands (including mass formations) that require monitoring by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular system and respiratory system, which serve as contraindications for general anesthesia;
- under 18 years of age;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
Full recovery after breast replacement takes place within a few months.This period can be divided into several main stages.
In the first 3-4 days after surgery, patients may experience discomfort: heaviness and cracking in a large area of the pectoral muscle.They can be alleviated by taking painkillers prescribed by the attending physician.On the fourth day, these manifestations usually disappear.
Swelling of the 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 nothing to worry about.
Hand movement will be limited for the first 24-48 hours after the procedure.
Do not drive during the first week.During this time, it is best to make your clothes 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.
You can drive a car one week after the operation, but only if you do not take any painkillers, which seriously impair motor skills.It is important to consult your surgeon before returning to driving.
If your work does not involve intense 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 too much upper body work during this period, especially the pectoralis major.Light cardio exercises can be done without running or swimming.Around this time, you will begin to see the results of breast augmentation.The breasts 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 underwires.
A few months after surgery, you will see if the results are as expected.As for the scars, they gradually fade over time and blend in with the surrounding skin.With proper care, they become practically invisible within a year.Two to three months after the operation, the breasts become softer, take on the texture of natural breast tissue, and then become softer month by month.After three months, you can start more intensive upper body training.
Here are some more post-surgery tips 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 cause infection;
- give the implants time to "adapt": at first they look unnatural, with an overly filled upper pole, but gradually they take on a natural teardrop shape;
- be sure to rest a lot, as this will speed up the recovery process;
- Avoid wearing tight clothing, especially those that require you to lift your arms high when you put them on;
- After the operation, you only have to sleep on your back for a month!He cannot sleep lying on his side, even less on his stomach.In the first few days, it will be easier to sleep high up with pillows behind your back;
- if you feel severe pain, asymmetric swelling occurs, 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;
- feelings on the right and left are not necessarily 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.