If you go out on the street and ask ten men why they need plastic surgery, many will answer without hesitation: "To make women's breasts bigger."This logic is not accidental: human culture, whether the ladies like 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 found different ways to make their breasts more visible.At first it was clothes with deep necklines, then underwear that created beneficial visual effects.But these were all temporary measures and the women wanted something permanent or at least long-lasting.
Only the development of plastic surgery helped women to really look according to 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 enlargement was invented, which later became known as endoprosthetic breast (from the Greek words "endon" - "inside" and "prosthesis" - "addition, union").
The first material used to enlarge women's breasts was paraffin, which was originally called petroleum wax, as it was made from this flammable liquid.In the first decades of the last century, aesthetic medicine tested many materials that were suitable for endoprosthetics: ivory and glass beads, polyethylene and polyurethane, polyester foam and many others.All this led to sad consequences.
As recently as 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 until 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 from the shell.
Operating stages
Since breast replacement is a fairly serious surgical procedure, it is performed only under general anesthesia.Throughout the operation, all vital indicators of the body are monitored using special monitors: blood pressure, heart rate, blood oxygen saturation level, etc.
Before the operation, the surgeon applies markings with a special marker, according to which the surgical approach is then made.The incisions are usually made so that the postoperative scars are barely noticeable.The choice of surgical approach depends on a number of determining factors.In particular, it is about:
- position (high, middle or low) of the mammary glands on the chest wall.
- the presence or absence of breast prolapse - prolapse and its degrees (there are three in total).
- skin characteristics: thickness and elasticity, presence of stretch marks.
- anatomical features of the pectoralis major muscles, sternum and ribs.
A pocket (bed) is then formed to place the implants.It can be 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 placing the implants, the wound is sutured.To achieve the best cosmetic result, intradermal cosmetic sutures are applied using modern absorbable suture material or special medical glue.The patient is then dressed in compression garments to prevent displacement of the implants and increase post-operative tissue swelling.For several hours after the operation, the patient remains in the recovery room, where her condition is monitored by medical staff.
In general, breast replacement surgery takes between 40 minutes and an hour and a half.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 after breast cancer or trauma, the procedure may be more difficult and take longer.
Operating methods
There are four main surgical approaches used around the world.
- Submammary (below the mammary gland).
This method involves cutting the skin just below the breast (in the inframammary fold), which, if there is a well-formed fold, makes the incisions unnoticeable.In other cases, this approach 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. - Periareolic.
With this approach, the incision is located along the lower semicircle of the nipple, at the border of pigmented nipple skin and unpigmented skin.Because of this, after a few months the postoperative scar becomes almost imperceptible.In this case, the breast tissue is removed in the lower part.This in no way prevents 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 armpit area.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 done more safely and less traumatically, given the distance of the incision from the operation area. - Subcephalous.
This is a rarely used technique.It involves the installation of an implant through an incision in the navel area.In this way, only a saline-filled implant can be placed.First, the implant shell is placed and then 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 in each case allows you to achieve the most aesthetic result.
Preparation for surgery
Before the preparation for surgery begins, the patient should learn 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 widespread currently in the world are silicone implants with a relief shell and filler - silicone gel with shape memory.
There are several types of filler implants.
- silicone liquid, the consistency of which resembles vegetable oil.
- Standard silicone adhesive (cohesion is the bond between the molecules of a substance, which determines its strength) gel, with a jelly-like consistency.
- silicone gel with a high degree of consistency, the consistency of which resembles jam.
- silicone gel "soft touch" (from the 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 high-viscosity gel holds its desired 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 they retain their shape.8-10 months after the start of use, salt crystals may begin to form which can puncture the shell.
In addition, there is a "gurgling" phenomenon, which also does not suit all patients.
There is another way to enlarge the breast 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 the fat cells in such a way that the effect of their injection lasts longer.Nevertheless, 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.So, unlike silicone implants, liposuction is a temporary measure.
Before breast augmentation surgery, the patient should undergo a complete medical examination to ensure that there are no medical contraindications and to minimize potential risks.It will include:
- blood tests: clinical and biochemical, for coagulation, for Rh group and factor, for HIV, syphilis and hepatitis C and B indicators.
- general urinalysis.
In addition, a mammogram or ultrasound of the mammary glands, a chest x-ray or fluorography, an electrocardiogram and an ultrasound of the veins of the lower extremities will be required.In addition, during a consultation with a plastic surgeon, the patient must be informed about all existing diseases, previous operations, allergic reactions, as well as medications taken, including nutritional supplements.
Also, before the operation, you will need to stop smoking and drinking alcohol for 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, any woman planning a breast augmentation should know and take into account the fact that planning a pregnancy within a year after the operation is highly undesirable.The fact is that changes in hormonal levels in the early postoperative period and at the beginning of the lactation process (formation of breast milk) can affect breast implants in the most unpredictable way.
Contraindications for breast implants are:
- pregnancy?
- diabetes mellitus;
- severe endocrine and autoimmune diseases.
- blood clotting disorder;
- diseases of the mammary glands (including mass formations), which require monitoring 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;
- less than six months after stopping breastfeeding.
Rehabilitation after surgery
Full recovery after breast replacement takes place within several months.This period can be divided into several main stages.
During the first 3-4 days after surgery, patients may experience discomfort: a feeling of heaviness and swelling in the area of the pectoralis major muscles.They can be relieved by taking painkillers prescribed by the attending physician.By the fourth day, these manifestations usually subside.
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 should not cause concern.
Arm movements will be limited for the first 24-48 hours after the procedure.
The first week you should not drive.During this time, it is best to keep your clothes as comfortable as possible and easy to remove.
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 strongly 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 your surgeon before returning to driving.
If your work does not involve vigorous physical activity, then returning to work is possible within a week.However, you should avoid lifting heavy (over 4-5 kg) objects and avoid 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 a lot of upper body work during this time, especially 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 breast will begin to fall into its natural position and take on a more natural shape.However, note that this process can take several months.Four weeks after surgery, the compression garments are usually removed and you can start wearing underwire bras or push-ups.
A few months after the operation, 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, regain the consistency of natural breast tissue, and then become softer each month.After three months, you can start more intense upper body exercise.
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 urge to remove the bandages and see the progress - this can cause infection.
- Give your implants time to "adjust": at first they will look unnatural, with an overly full upper pole, but gradually they will take on a natural teardrop shape.
- make sure you get plenty of rest as this speeds up the recovery process.
- Avoid wearing tight clothing, especially those that require you to lift your arms up when wearing them.
- For a month after the operation, you must sleep only on your back!You can't sleep on your side, much less on your stomach.For the first few days it will be easier to sleep with pillows placed high behind your back.
- If you experience severe pain, asymmetric swelling occurs, or the bandage is wet, consult a doctor immediately.
- Don't worry if you experience either increased 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 a problem and happens to almost everyone.
- Note that most women can breastfeed after surgery, however milk production may be slower.