Breast plastic surgery (Mammoplasty)

Indications for surgery

We recommend having breast surgery in Krasnodar with Dr. Pavel Vyacheslavovich Astashkin in the following cases:

• unsatisfactory breast size – too large or small;
• congenital asymmetry - one mammary gland is very different in size from the other;
• irregular shape of the mammary glands - most often congenital, which causes difficulties in choosing underwear and can only be corrected surgically;
• changes in the shape and size of the breasts after childbirth - the breasts sag, lose their elasticity and attractive appearance.

Contacting a plastic surgeon will help get rid of problems and complexes, the patient will acquire beautiful breasts that she can rightfully be proud of.

Breast lift

Depending on the degree of ptosis of the mammary glands, the volume of glandular tissue, as well as the presence of asymmetry or changes in the nipple-areolar complex, several types of breast lift surgery are possible.

In case of minimal ptosis of the mammary glands and the need for simultaneous correction of the size of the nipple-areolar complex, a periareolar breast lift is performed. In such cases, a skin incision is made around the areola with preliminary correction of its size and shape, then the areola tissue is excised in accordance with the diameter previously discussed in consultation with a plastic surgeon, then the glandular tissue is mobilized from the fiber, while the breast tissue is moved to a new position and fixation in a new position to the pectoralis major muscle. The final stage of the operation is the application of special internal sutures that strengthen the ligamentous apparatus of the mammary gland, tightening the skin to the newly created areola and applying a circular periareolar intradermal suture. In addition, it is possible to simultaneously enlarge the breast using breast implants.

In case of initial ptosis (nipples are located either at the level or 1-2 cm below the inframammary fold), a vertical breast lift is performed. The operation is a logical continuation of the periareolar breast lift - it is complemented by oval vertical removal of excess skin. If necessary, it is possible to remove a small amount of glandular tissue or increase it using breast endoprostheses. The gland tissue is fixed in a new position. The periareolar circular and vertical sutures formed as a result of the operation, with strict adherence to all the recommendations of the plastic surgeon, heal with minimal scarring and can then be laser resurfaced.

In case of severe mastoptosis, anchor breast lift . The operation is a logical continuation of the vertical breast lift described above, when the vertical incision is supplemented by a horizontal incision along the inframammary fold. Performing such an approach allows for maximum resection of the skin, gland tissue, and fatty component. Due to the fact that during a T-breast lift, sufficient skin is removed intraoperatively, there is no excess skin, and as a result, the process of “maturation” of such breasts occurs much faster, since there is no need for natural skin contraction. The length of the inframammary incisions (and then the sutures) directly depends on the initial degree of sagging of the mammary glands. An anchor breast lift can be performed with simultaneous breast augmentation using breast endoprostheses.

Contraindications

The operation is not performed if:

• the patient's age is less than 18 years;
• there are any kind of autoimmune disorders, hormonal disorders, infections;
• confirmed presence of diabetes mellitus;
• confirmed presence of problems with blood clotting;
• cystic or oncological formations in the breast tissue have been diagnosed.

If the preliminary consultation reveals one or more contraindications, the plastic surgeon will not perform the operation, since it may be dangerous to the health and life of the patient.

Types of mammoplasty

Plastic surgeon Pavel Vyacheslavovich Astashkin performs the following types of breast surgery:

• Augmentation - breast size is increased using endoprostheses of a selected volume of a round or anatomical shape.
• Reduction - breast volume is reduced by excision of excess muscle and fatty tissue and skin.
• Mastopexy is a breast lift procedure aimed at restoring the shape of the breasts after childbirth.
• Augmentation mastopexy is a one-stage lift and increase in breast volume using implants.

Before any operation, the patient will be given a full examination, including a series of blood tests and an ECG. Compliance with the specialist’s recommendations in the preoperative period can significantly reduce the risk of complications during and after the intervention.

Breast lipofilling. Augmentation with own fat

Breast lipofilling is an increase in breast size using your own fat tissue.

Breast lipofilling is based on transplantation (autotransplantation) of adipose tissue from a place where it is in excess to the chest area. In one session it is possible to enlarge the breasts by 0.5-1.0 sizes.

Breast lipofilling is breast augmentation using your own fat tissue. After breast lipofilling, there will be no foreign bodies left in the body. A person's own tissue eliminates allergic reactions and rejection. This technique is performed without cuts or stitches, therefore it is low-traumatic and leaves no marks.

Breast lipofilling allows you to increase breast size, correct asymmetries, contour defects, and restore breasts after removal due to a tumor. With the help of lipofilling, you can hide the boundaries of the implant when the amount of your own breast tissue leaves much to be desired.

Breast lipofilling gives the effect of filling and enlargement due to the transplantation of one’s own fat tissue.

It should be especially noted that after breast augmentation using lipofilling, there is no risk of contracture formation, no foreign body and no risk of the need to replace implants, only your own fat, the size of postoperative scars is negligible - about 2 mm, the breasts are soft, natural in shape, bonus - improved shape the area from which the fat was taken.

Recovery after breast lipofilling is faster and easier than after installation of implants. During breast lipofilling, adipose tissue is planted bypassing the glandular tissue itself, which ensures that there is no increase in the risk of cancer.

One of the disadvantages of the method is breast lipofilling, albeit a small operation. After each stage, the breast will enlarge, then part of the transplanted fatty tissue will be absorbed, slightly reducing the effect of the operation.

During one procedure, the breast increases by 0.5 - 1 size. For stable breast enlargement by 2-3 sizes, 2-3 breast lipofilling procedures are required with an interval of 1-2 years. The minimum interval is 6 months.

The cost of breast augmentation using lipofilling at the Health Factory MC in Rostov-on-Don is 50,000 rubles per procedure.

The cost of breast lipofilling surgery includes:

• the cost of the breast lipofilling operation itself,
• anesthesia,
• stay in the ward for 1 day,
• compression garments Naitive
• medications that will be prescribed to you in the postoperative period
• examinations by a plastic surgeon in the postoperative period.

Additional costs not included in the price of breast augmentation using lipofilling:

Preoperative examination – 6,000 rubles

If desired, you can purchase an additional set of linen (available in white, beige, black colors) - 5,000 rubles each

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Sincerely, your plastic surgeon, head. Department of Plastic Surgery MC "Health Factory" Clinic Rostov-on-Don, Zelenkova Natalya Vyacheslavovna

Rehabilitation period

When planning to undergo breast surgery, you need to know that a successful operation is far from a 100% guarantee of success. A lot also depends on how strictly the doctor’s recommendations are followed during the rehabilitation period. For a while you will have to give up not only any physical activity, but also such familiar things as:

• visiting the sauna and solarium;
• taking hot baths;
• contrast shower in the morning;
• sleep in a prone position on your stomach.

For some time after the operation, the patient will wear special compression garments to facilitate the healing process. You should treat your body as carefully as possible, eat right, visit a doctor regularly and avoid any physical activity.

Prices for breast surgery

The cost of mammoplasty depends on the type and volume of intervention. The more complex the operation is planned, the more significant its price will be. We suggest that you contact plastic surgeon Pavel Astashkin personally, who will be able to answer all questions and tell you about all the details of the operation during a preliminary consultation.

Breast augmentation

So, you have decided to have surgery. Of course, in order to get the desired result, it is important to correctly answer the question of where to have breast enlargement. If we talk about breast augmentation in Krasnodar, then Dr. Karpyuk V.B. has extensive experience in performing mammoplasty. It will help you get the breasts of your dreams quickly, without any unpleasant consequences.

Preparing for surgery. The most important part of preparing for surgery is being fully informed and having realistic expectations regarding the outcome, possible risks and features of the postoperative period. Mammoplasty is a serious surgical operation, which is important to treat responsibly. In our clinic in Krasnodar you can get qualified advice on issues related to breast augmentation. The doctor will help you choose an implant of the right size and shape and recommend the optimal method of surgery, taking into account the patient’s wishes. Before the operation, an X-ray or ultrasound of the mammary glands is required, followed by a mammologist’s report. You should purchase a special bra in advance, which must be worn after the operation for 1.5-2 months. Stop taking aspirin or medications containing it several days before surgery.

Operation. The operation is performed under general anesthesia and lasts about 2 hours. The technique of breast replacement is determined by three interrelated factors: the type of prosthesis (round, teardrop or anatomical), the surgical approach (inframammary, transaxillary or periareolar) and the placement of the prosthesis in relation to the pectoralis major muscle (submuscular or subglandular). Most often, implantation of endoprostheses is performed through a 5-6 cm long incision in the fold under the breast. The main advantages of this submammary approach are the possibility of perfectly precise and symmetrical formation of a pocket for the endoprosthesis, as well as the ability to carefully stop bleeding. The advantage of access through the axillary fossa (transaxillary) is that the postoperative scar is located in a hidden area. However, it is more difficult for the surgeon to form a cavity of appropriate size, achieve a symmetrical arrangement of the prostheses and thoroughly stop the bleeding. This operation requires the use of endoscopic technology and special instruments. The periareolar incision is located at the border between pigmented and light skin around the areola, making it less noticeable. Its disadvantages include quite frequent damage to the terminal fibers of the sensory branch of the IV intercostal nerve, direct damage to the gland tissue, as well as limited use of certain types of prostheses (prostheses filled with non-flowing gel). Sometimes, in order to correct the shape of the breast, in addition to enlargement, it is necessary to perform a breast lift.

After operation. During the operation, soft tubes are inserted into the wound - drainages to drain the remaining blood after the intervention. They are usually removed on the second day. Wipes are applied to the wounds, the chest is bandaged, moderately squeezing the mammary glands. Soon this bandage is replaced with a special bra. There is no need to remove the sutures; they will dissolve on their own when the suture gets stronger. The breasts will be swollen and tender after the operation, but after 3-4 weeks the swelling and discomfort disappear. Rehabilitation after breast augmentation surgery proceeds quite quickly: the patient spends 1-3 days in a hospital in Krasnodar after mammoplasty, after which she is discharged home, and can return to work within a week. Immediately after mammoplasty surgery, women may feel slight pain; subsequently, the breasts may make themselves felt when making sudden movements. For several months, it is necessary to avoid rough impacts on the breasts that can cause displacement of the prostheses. After breast augmentation, you need to be examined by a plastic surgeon every six months and follow his recommendations.

Risk and possible complications. Continued bleeding after surgery can cause blood to pool around the prosthesis. Usually this blood is drained out through drains. If bleeding persists, new surgery may be required. In rare cases of inflammation, it becomes necessary to remove the implant for several months. After healing, the implant can be installed again. A specific complication of this operation is the so-called. capsular contracture, when due to excessive growth of connective tissue around the prosthesis, a thick scar capsule is formed. It can contract, causing the breast to harden, change shape, and cause pain. This condition may require further surgery to open and remove the capsule, and even replacement or removal of the prosthesis. Sometimes there is an incorrect position of the implants; they can be located asymmetrically and at different heights. This can be corrected after the tissue has healed with repeated surgery. Decreased sensitivity in the nipple area is usually temporary, but sometimes remains permanent. Prosthesis rupture is theoretically possible. If the shell contained a saline solution, then the breast will become flat; if it is a new generation silicone non-flowing gel, then it remains inside the implant even after it breaks. In this case, it is better to replace the implant. Studies conducted around the world have found no effect of silicone prostheses on the development of breast tumors and autoimmune diseases. However, prostheses make X-ray diagnosis of breast diseases more difficult and may thus increase the risk of tumor formation. After surgery, patients should take self-examination seriously, periodically undergo ultrasound diagnostics and visit a mammologist. There is no information about the negative impact of the operation on pregnancy and breastfeeding.