Mammoplasty: description of the procedure, types of implants, contraindications for



Operations to change the shape and size of the breast (their scientific name - mammaplasty) are among the most common plastic surgeries in the world. Some women decide to go under the doctor’s knife solely for aesthetic reasons, others are pushed to this step by the effects of the disease, birth defects or trauma. But is everything as smooth as the advertising booklets of clinics specializing in plastic surgery are painted?



This surgical intervention cannot be considered vital, therefore the responsibility for making such a decision rests solely with the patient. The doctor only has to explain the possible risks associated with the operation, the features of the rehabilitation period and during the preliminary examination to exclude the presence of contraindications.

Mammoplasty has a number of positive aspects. Currently, the operation is performed with a minimally invasive endoscopic method, and the size of the incision does not exceed 2–3 cm. Moreover, the doctor makes it in an inconspicuous place, therefore the scar from the suture is not visible even close. In the course of surgery, you can not only change the size of the breast, but also correct the shape of the nipple.

In addition, doctors warn that waiting for an instant effect is not worth it. First of all, even the most experienced surgeon will not be able to make the fifth of the first size, as a rule, with the help of implants you can enlarge the breast by a maximum of 2 to 3 sizes. Also for four weeks after the operation, hematoma, soft tissue swelling and partial numbness of sensitive areas remain, which requires wearing a special compression bra and prevents to fully appreciate the result of the plastic surgeon's work. In some patients, serous fluid accumulates in the incision area (this complication is called seroma), which is a reason for a second consultation with a surgeon.

The disadvantages possessed by mammoplasty include a long rehabilitation period, possible allergic reactions to the drugs used for anesthesia and anesthesia. In addition, some types of such surgical interventions are contraindications for breastfeeding. So, lactation is impossible after reduction mammoplasty, which is carried out to reduce the size of the mammary gland .

Women giving birth or planning a pregnancy are advised to abstain from augmentation mammoplasty. During such a surgical procedure, access for endoprosthetics is provided through an incision in the areola of the nipple. And when feeding the risk of integrity of seams is high. In addition, pregnancy and its attendant weight gain, hormonal changes, milk tides can adversely affect the state of the implant, so you still have to contact a plastic surgeon to tighten the breast contours and correct the shape of the mammary glands. To avoid such effects, mammoplasty is recommended after childbirth and the end of the breastfeeding period.

Currently, several types of prostheses are used:



• silicone, are used in most cases;
• saline, filled with a neutral solution of sodium chloride or dense hydrogel, they are distinguished by lower cost of silicone, however, such implants are more prone to ruptures and damage;
• Hybrid, now practically not used, consist of a capsule filled with saline, covered with a layer of silicone filler.

Most plastic surgeons prefer to use silicone prostheses. They are more durable, easy to implant, firmly fixed in the tissues of the breast.

Depending on the density of the filler, they can be:

• soft, in appearance and tactile sensations are almost indistinguishable from the natural breast, but they are intended for minor correction, as they do not keep their shape well;
• tight, can significantly increase the size of the breast, but look unnatural, especially in the supine position, and quite firm to the touch;
• soft touch, this is a new generation of breast implants, it is a kind of "middle ground" between soft and dense silicone breast prostheses.

Mammoplasty is performed using a variety of implants. Manufacturers offer a huge range of prostheses, differing in shape and size, so each woman can choose a suitable “breast”.

Indications for the operation are:

• radical mastectomy (removal of the breast), which often occurs after the treatment of malignant tumors;
• small breast size, which is the cause of the development of various complexes and psychological problems;
• breast asymmetry;
• change in shape, omission of the breast, which usually occurs after prolonged lactation and age-related changes;
• too large mammary glands, which often causes certain inconveniences;
• woman's independent desire to improve their appearance.

In some cases, mammoplasty is shown to the representatives of the stronger sex. As a result of endocrine disorders, gynecomastia occurs - an increase in the size of the mammary glands in a man , which is the reason for such an operation.

Mammoplasty is contraindicated in the following conditions:

• pathologies of the respiratory and cardiovascular systems and other internal organs;
• bleeding disorders;
• primary and secondary (metastasis) oncological process;
• infectious processes in the acute stage;
• allergic reaction and individual intolerance to any of the drugs and materials used during the surgical intervention;
• breastfeeding process;
• pregnancy.

The operation requires the informed consent of the woman. Therefore, mammoplasty is not performed until the age of 18 years. Until this time, the shape of the breast can be adjusted with the help of special linen. With caution, the procedure is carried out in the pathologies of the endocrine system, including diabetes mellitus and thyroid gland dysfunction.

Breast mammoplasty: types, possible complications, the result of surgery

The operation to change the shape of the mammary glands is of several types:

• Breast augmentation. It is the most common form of mammoplasty. This surgical intervention is relatively simple in execution. Roughly speaking, the doctor installs a pre-selected implant through a small incision.
• Correction of the size and contours of the breast. In this case, the surgeon using the implant not only changes the size, but during the operation gives the desired shape of the breast.
• Reducing the size of the breast. In this surgical intervention, the doctor simultaneously tightens the skin and removes a certain part of the breast tissue. This operation is one of the most traumatic, since in order to achieve the desired result it is necessary to make several cuts.

Before performing a surgical procedure, it is necessary to pass all standard tests to identify possible hidden pathologies. If you suspect the presence of tumors should be done ultrasound and mammography. Mammoplasty of the breast is performed under general anesthesia, therefore, before the operation, the anesthesiologist consults a woman and discusses with it all aspects of the upcoming intervention.

1 - 2 weeks before the procedure, you must:

• stop taking hormonal contraceptives;
• Do not drink non-steroidal anti-inflammatory drugs containing salicylic acid;
• stop smoking and drinking alcohol.

If these recommendations are followed, the risk of bleeding during surgery and complications in the postoperative period is reduced. To make it easier to transfer the anesthesia, the patient is recommended to switch to a sparing diet with a minimum content of flour products and the prevalence of fiber. In the evening before the operation, you need to give up dinner, and in the morning, and drink.

Breast mammoplasty is performed in a specialized clinic, equipped with equipment for anesthesia and necessary remedial measures in case of emergency situations. The woman remains in the hospital for 3–5 days after the operation, and then she is regularly examined by the surgeon for six months.

Like any other surgery, breast mammaplasty is associated with a certain risk.

During the procedure and during the rehabilitation period there is a risk of development of various complications:

• the formation of thrombotic formations in the circulatory system;
• allergic reaction to medications for general anesthesia;
• the formation of folds and irregularities of the epidermal cover in the area of ​​implant placement;
• reversible numbness of the nerve endings of the mammary glands, but their sensitivity may not recover in the area of ​​the sutures located near the nipples;
• the formation of solid formations in the process of healing around the implant, such capsules can move the prosthesis, which leads to disruption of the shape and asymmetry of the mammary glands, the risk of such complications can be reduced by regular breast massage;
• suppuration of postoperative sutures, usually occurs with improper care of the wound;
• rupture of the implant, if a saline prosthesis is used, is safe, since the solution contained in it is completely absorbed by the cells of the mammary gland, but the ingress of silicone can cause irreversible changes in the tissues.

If side effects occur, it is usually necessary to have breast mammaplasty and implant replacement. However, in most cases, the operation goes well and does not cause any unwanted reactions.

Mammoplasty surgery: the course of the procedure, the possibility of lactation, the rehabilitation period

Surgical intervention takes place under general anesthesia. After appropriate preparation and consultation of specialists, the patient is transferred to the operating room and placed on the operating table, injected medication for anesthesia and transferred to the implant.

There are two ways to fix the prosthesis:

• retromammary (under the gland);
• submuscular (under the muscle).

Mammoplasty surgery using a submuscular technique is done with a large implant or after radical mastectomy. If you fix such a prosthesis directly under the tissues of the gland, it is fraught with the formation of skin defects. Therefore, in some cases, the surgeon uses a hybrid method of installing an implant, some of it is placed under the gland, and some - under the muscle.

To place the prosthesis in the breast tissue, the surgeon can make an incision:

• around the nipple's alveoli, if it is large enough;
• directly under the breast, the suture after such an operation heals quickly, but the scars are noticeable;
• in the armpit, the wound is invisible even on closer inspection, but the rehabilitation period lasts longer.

An experienced surgeon tries to minimally injure tissue. Abroad operation mammoplasty is performed using an endoscope. The total duration of the intervention is from 1.5 to 4 hours, it depends on the complexity of the procedure.

Implant placement is not a contraindication to breastfeeding, as the gland tissue is preserved. However, if the size of the mammary gland was reduced during the operation, lactation is no longer possible.

During the first week after mammoplasty, hematoma and edema usually occur, which disappear after 4 to 5 days. Antibiotics are prescribed to prevent infection. Compression underwear made from natural materials should be worn throughout the month. Special bras help to enhance blood circulation in the chest, reduces the risk of the formation of dense capsules and scars.

In addition, during the year after surgery, it is necessary to protect the chest from direct sunlight, to take measures to prevent pregnancy. During the first 14 days, you should refrain from sex, sleep only on your back and use an anatomical pillow. After 2 weeks, you can turn on your side, and after a month to sleep in any comfortable position. Within six months after the operation should refrain from lifting weights and intense physical exertion.

As shown by clinical experience, the operation mammaplasty well tolerated and does not cause complications. The cost of such surgery using silicone implants is $ 1,000 or more. However, such a price is fully justified by the emergence of self-confidence, the disappearance of complexes, ease of communication with representatives of the opposite sex. Sometimes breast correction surgery is combined with abdominoplasty . However, it is necessary to perform such surgical procedures in a strict sequence - first correcting the shape of the abdomen, and then improving the size of the mammary glands.