If you go out on the street and ask ten men why plastic surgery is necessary, many will answer without hesitation: “To enlarge women's breasts”.This logic is not accidental: human civilization, whether women like it or not, is inherently patriarchal, meaning 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 invented 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 measures were temporary and women wanted something permanent or at least lasting.
Only the development of plastic surgery helped women really look in accordance with their own desires and meet the standards of external beauty set by men.In 1889, something happened that millions of beautiful women around the world dreamed of - a method of artificial breast enlargement was invented, which later became known as breast endoprostheses (from the Greek words “endon” - “inside” and “prosthesis” - “add, join”).
The first material used to enlarge female breasts was paraffin, initially called petroleum wax, as it was made from this flammable liquid.In the first decades of the last century, aesthetic medicine experimented with various materials suitable for endoprostheses: ivory and glass beads, polyethylene and polyurethane, polyester foam and much more.All this led to sad consequences.
It was only in 1961 that 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 highly durable and therefore does not leak through the shell.
Operation stages
Because 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 oxygen saturation in the blood, etc.
Before the operation, the surgeon applies markings with a special marker, according to which the surgical approach is carried out.The incisions are usually made so that postoperative scars are minimally noticeable.The choice of surgical approach depends on a series of determining factors.In particular, they are:
- position (high, medium or low) of the mammary glands on the chest wall;
- 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 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 can be performed.The first method is used more often because it provides a more stable result.
After installing 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.The patient is then placed in compression garments to prevent displacement of the implants and increased swelling of the postoperative tissues.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 40 minutes to 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 increase her breasts by several sizes at once.Additionally, if you have had breast reconstruction surgery after breast cancer or trauma, the procedure may be more difficult and take longer.
Operation methods
There are four main surgical approaches used around the world.
- Submammary (under the mammary gland).
This method consists of cutting the skin just under the breast (in the submammary fold), which, if there is a well-formed fold, makes the incisions imperceptible.In other cases, this access does not provide sufficient cosmetic results.The advantages of this approach include the fact that, when used, breast tissue is virtually unaffected. - Periareolar.
With this approach, the incision is located along the lower semicircle of the areola, at the edge of the pigmented skin of the areola and the unpainted skin.Due to this, after a few months the postoperative scar becomes almost indistinguishable.In this case, the breast tissue moves away at the bottom.This does not in any way prevent the possibility of breastfeeding in the future and, contrary to common misconceptions, does not reduce the sensitivity of the nipples postoperatively. - Axillary (axillary).
This surgical approach involves making an incision in the axillary region.This also does not affect 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 gain axillary access, video endoscopic technology is required.It allows the operation to be carried out more safely and with less trauma, given the distance of the incision from the operated area. - Transumbilical.
This is a rarely used technique.It involves installing an implant through an incision in the umbilical region.This way, only one implant filled with saline solution can be installed.First, the implant shell is installed and then filled.Such breast implants are practically not used, since, as experience shows, silicone implants allow you to obtain 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 achieving the most aesthetic result.
Preparing for surgery
Before starting preparations for surgery, the patient must inform the plastic surgeon about all aspects of the planned procedure: type of implant, manufacturer, availability and warranty period, shape, type of shell and filling.The most common in the world today are silicone implants with a textured shell and filling - shape memory silicone gel.
There are different types of implant fillings.
- silicone liquid, the consistency of which resembles vegetable oil;
- standard cohesive silicone gel (cohesion is the bond between the molecules of a substance, which determines its resistance), with a consistency reminiscent of gelatin;
- silicone gel with a high degree of cohesion, whose consistency resembles marmalade;
- “soft touch” silicone gel (from the English “soft touch”) - greater softness;
- saline solution, consistency of a bag full of water;
- soybean oil, similar in consistency to the first filling.
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 feel as soft and natural as possible, but does not guarantee that their shape will be maintained.8 to 10 months after starting use, salt crystals may begin to form that can pierce the shell.
Furthermore, there is a “bubbling” effect, which also does not please all patients.
There is another way to enlarge your breasts without using 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 20th century.However, at that time, fat implantation did not have a positive effect, as it was quickly absorbed by the body.
Today, plastic surgeons have learned how to process fat cells so 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, making it necessary to repeat the operation.Therefore, unlike silicone implants, lipofilling is a temporary measure.
Before breast augmentation surgery, the patient must undergo a complete medical examination to ensure 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 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.Furthermore, during the consultation with the plastic surgeon, the patient must be informed about all existing diseases, previous operations, allergic reactions, as well as the medications being used, including dietary supplements.
Furthermore, before the operation, it will be necessary to stop smoking and drinking alcohol for at least two weeks, as the first impairs healing and the second is not compatible with antibiotics, which are prescribed for prophylactic purposes in the postoperative period.
In addition, every woman planning a 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 immediate 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 performing breast endoprostheses are:
- pregnancy;
- diabetes mellitus;
- serious endocrine and autoimmune diseases;
- blood clotting disorder;
- diseases of the mammary glands (including mass formations), which require observation by an oncologist;
- exacerbation of existing chronic diseases;
- diseases of the cardiovascular and respiratory systems that contraindicate general anesthesia;
- age under 18;
- 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 feel discomfort: a feeling of heaviness and rupture in the region of the pectoralis major muscles.They can be relieved with painkillers prescribed by the attending physician.On the fourth day, these manifestations usually disappear.
Soft tissue swelling in the surgical area is possible.Sometimes it lasts for several weeks and spreads to the abdominal region.These are normal symptoms and should not be a cause for concern.
Hand movements will be limited for the first 24 to 48 hours after the procedure.
During the first week you should not drive.During this time, it's best to keep your clothes as comfortable and easy to take off as possible.
You will need to limit physical activity as much as possible.However, bed rest is not necessary.It is also highly recommended to avoid nicotine and alcohol.
One week after the operation, you can drive, but only if you do not take painkillers, which seriously impair motor coordination.It is important to consult your surgeon before driving again.
If your job does not involve intense physical activity, returning to work will be possible within a week.However, you will still need to 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 performing too much upper body work during this time, especially involving the pectoralis major muscles.Light cardiovascular exercise is possible without running or swimming.At this time, you will start to see the results of breast enlargement.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 underwire bras 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, take on the consistency of natural breast tissue, and become softer and softer every month.After three months, you can begin more intense upper-body exercises.
There are a few more post-operative 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 observe progress - this can provoke an infection;
- give your implants time to “adapt”: at first they will look unnatural, with the upper pole excessively filled, but little by little they will acquire a natural teardrop shape;
- make sure you get plenty of rest, as this speeds up the recovery process;
- Avoid wearing tight clothes, especially those that require you to raise your arms when putting them on;
- For a month after surgery, you only need to sleep on your back!You cannot sleep on your side, much less on your stomach.In the first few days it will be easier to sleep with pillows placed well behind your back;
- if you experience severe pain, asymmetrical swelling appears 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;
- the 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, but milk production may be slower.