Breast augmentation: indications and contraindications, types of operations

Breast lifting and augmentation is one of the most popular movements in plastic surgery. Using this operation, you can adjust the shape and size of the bust. Beautiful breasts are the key to a woman’s confidence in her own sexual attractiveness. Therefore, surgeons have no shortage of clients willing to perform breast surgery.

Indications for surgery

Beauty is, of course, an eternal concept. But at the same time it is very windy. At different times, the standard for a beautiful bust was either the Venus de Milo or Marie Antoinette, the shape of whose breasts can be judged by the champagne glass - it was cast from a cast of the royal person’s mammary gland. And for every lady, the concept of “beautiful” in relation to her own breasts is special.

There are also objective indications for mammoplasty, which experts include:

• micromastia – very small breasts, which leads to the development of an inferiority complex in a woman; lipofilling can help here;
• gigantomastia – very large breasts, when the spine and organs begin to suffer from its heaviness;
• mastectomy – surgery to remove the mammary gland;
• different size of the mammary glands as a result of underdevelopment of one of them;
• changes in the shape and size of the breast after breastfeeding a child.

Since breast reduction operations (reduction mammoplasty) are less common, we will focus on breast enlargement. These operations can be carried out either separately or together.

Breast correction

The next type of surgical intervention is correction, represented by mastopexy (lift), elimination of asymmetry of the mammary glands and modification of the nipples and areolas, if necessary.

Mastopexy

A breast lift can eliminate the consequences of childbirth or injury, in which the breasts sag, lose shape and elasticity. Despite its apparent simplicity, this is one of the most complex operations, requiring the presence of stitches around the areola or in the lower part of the breast.

During the procedure, excess skin and fatty tissue are excised and the nipples are moved. For a vertical breast lift, the autoaugmentation technique is used, i.e., the upper part of the glands is filled with its own tissues to give a beautiful shape.

Often, mastopexy is combined with the installation of implants if the deformation or original shape of the breast does not allow obtaining the desired result.

Breast asymmetry

One of the most common reasons for visiting a surgeon is different size or shape of the mammary glands. To eliminate this condition, surgery is performed on one or both glands, depending on the patient's wishes.

Areola and nipple correction

Most often, such an intervention is carried out in combination with other procedures, however, asymmetry, uneven contour, size and retraction of the nipples, size and damage to the areolas can become a reason for independent surgery.

Usually people seek correction of inverted nipples, because... This pathology significantly complicates breastfeeding.

One of the reasons for the operation is the so-called. “tubular breast”, in which not only the nipple, but also the areola are completely below the surface of the breast. When the nipple-areolar complex is removed or dies due to other interventions, including the removal of a breast affected by cancer, a new areola is formed.

Any operation on the nipples can damage the milk ducts, and maintaining their patency complicates the procedure and requires special equipment.

How is a breast lift done?

The medical name for this procedure is mastopexy. The main goal of the operation is to tighten sagging breast tissue. Sagging chests, or “spaniel ears” as they are called, occur for several reasons.

1. Age - over time, the elasticity of the skin decreases due to a decrease in the production of certain substances, the tone of the muscles and connective tissues, which make up the bulk of the breast, decreases.
2. Breastfeeding - the baby constantly pulls on the nipple. The skin on the chest is constantly stretching. In addition, before childbirth, under the influence of the hormone progesterone, the woman’s body prepares for future lactation - the size of the mammary gland increases significantly. After the baby stops feeding, the milk decreases and the empty breasts sag.
3. Dramatic weight loss. The mammary gland is covered with very thin muscle and a significant layer of fatty tissue - this is how nature took care of protecting a tiny, but so important organ for procreation. If body weight decreases significantly and at the same time rapidly, then the breasts may sag due to the loss of their fat “shield”.

A lift without augmentation is a simple operation and involves removing excess skin. After this, special cosmetic stitches are applied. These don't leave scars.

But it happens that just a lift may not be enough to achieve a positive cosmetic effect. Then a lift with augmentation is performed. It would also be a good idea to pay attention to your neck.

Disadvantages of breast augmentation through the areola

• With a small diameter of the areolas, the patient is limited in choosing the size of implants.
• There is an increased risk of damage to nerve endings and milk ducts, which can negatively affect a woman's ability to lactate. This does not mean that after breast augmentation through the areola, the patient will lose the ability to breastfeed. According to statistics, 7% of women experience difficulties with milk production during pregnancy, which is only in isolated cases associated with mammoplasty. Doctors at the Pirogov Clinic have successfully performed more than 10,000 thousand plastic surgeries since 1999. By contacting us, you can be sure that at all stages of the operation, from examination to completion of rehabilitation, you will receive medical care based on high professionalism and sensitive attention to your health.

Dual purpose breast lift and augmentation

Mastopexy is quite often combined with breast augmentation surgery. This dual-use manipulation is especially popular among young mothers who want to restore not only the prenatal shape of the bust, but also its size. After all, with the cessation of feeding, alas, size is often lost.

When performing combined plastic surgery, not only skin excision is performed, but also endoprosthetics. Simply put, implants are inserted. The size and shape of the implant is selected individually depending on the patient and the recommendations of the plastic surgeon. In addition to the well-known silicone, it can be filled with cohesive gel and saline solution.

Clinics that value their reputation use prosthetics only from well-known manufacturers. Confidence in their quality and safety for the patient’s health allows us to give a lifetime guarantee on them.

Breast without seam! 3 years of practice, more than 100 operations

Seamless mammoplasty - fairy tales? “This doesn’t happen,” you say. “But it happens,” plastic surgeon Sergey Vladimirovich Sviridov will answer you. Having performed the first operation using a patented technique 3 years ago, Sergei Vladimirovich has since performed hundreds of successful operations. However, this technique raises many controversial issues... To verify its effectiveness, we went straight to a plastic surgeon in order to hear answers to all our questions in the first person.

— Sergey Vladimirovich, as you know, you received a patent for a new technology invented by you...

- Yes. But I will officially receive it in September 2013. Medicine is a serious matter. Therefore, it takes time to introduce some kind of innovation into it. I knew it wouldn't be as fast as I would like. We submitted an application and have already received confirmation from the Federal Service for the Protection of Intellectual Property.

— What is special about the technique?

— Its main difference from classical breast augmentation operations is the use of special glue, which is injected into the cavity before installing the implant. This allows all tissues to be reliably glued to the implant and completely eliminates displacement of the implant, especially its anatomical shape. The skin incision is also not stitched, but glued together at the bottom of the areola. The key word is no seam.

Most often, implants are installed under the pectoral muscle, while the muscle fibers are delicately separated and cut off in just a small area. In addition, the glue glues small vessels together, which prevents the risk of bleeding, so no drainage is required. And this is also a significant advantage. After all, drainage is terribly inconvenient for the patient. Without them, postoperative comfort and patient satisfaction after surgery are increased.

Another feature is additional conduction anesthesia, which eliminates pain after surgery during the first days. True, slight aching sensations may remain. And after 4-6 days there are practically no complaints of pain.

— That is, there are no stitches at all? What is the risk that the glue “will not withstand” the tension of the tissues or will dissolve earlier?

- No, you don’t understand quite right. In any case, deep sutures are applied, there are just much fewer of them, because the swelling of the breast after the operation is very moderate. Therefore, there is no such strong bloating in the chest as usually happened before. However, this has nothing to do with the resorption of the glue. Its consistency is very sticky. Once is enough for complete adhesion of the tissues. In general, the whole point is that the concept of “suture” is different for an ordinary person and a surgeon. In medicine, a suture is usually understood as all types of joints: this includes stitching with a thread, joining with a staple, gluing with glue, and joining with a plaster or strip. Therefore, for the surgeon, the definition of a suture is much broader. In this regard, I gave this name to my technique: “Breast without a seam,” although this is only one of all the features of this operation.

— Tell us more about the miracle glue!

— The glue is based on fibrin, which is a high molecular weight protein. And it is part of our blood. It can even be obtained from the patient's own blood. During the operation, 40 ml is withdrawn. venous blood and using a special apparatus, fibrin autoglue is prepared, which is used during the operation. The glue does not cause any reactions or allergies. The glue dissolves within 5 days. During this time, the tissue surrounding the implant is quite firmly fixed to it. It also does not affect the formation of the capsule around the implant, which is also very important. It is worth noting that fibrin glue has been used in medicine for quite a long time. It is actively used in endoscopic surgery, for example, for forehead lifting.

— Your technique involves an incision along the areola of the nipple, but what should those who want an incision under the breast or armpit do?

— The location of the incision can be anywhere. If the patient wants to do it under the armpit or under the breast, we will do it. The installation steps do not change. The gluing principle remains the same. But the most aesthetically pleasing is the incision along the areola, since there the scar will be less noticeable and all stages of the operation will be more convenient to carry out. True, in some cases it is necessary to use a submammary or axillary incision, for example, if the areolas are small or the implant is large.

— Can this technique be used for any desired volume of endoprosthesis?

- Certainly. Naturally, as with a classical operation, it is necessary to take into account the peculiarities of the structure of the patient’s body, chest, and tissue. There is also an advantage in fixation of the implant. It is known that an anatomical implant tends to rotate, and the use of glue prevents this.

— Does the rehabilitation of sutureless mammoplasty differ from classical one?

- Undoubtedly. We in the department stopped using any painkillers at all. There is, of course, a certain group of people who have increased sensitivity. However, patients still do not experience severe pain, only aching sensations. In addition, after the operation the woman does not need to come for a dressing change. Already on the 4th day, my patients calmly drive a car, give lectures at the university or take care of their children. Another benefit is less bruising and swelling. Thus, the rehabilitation period is short, easy and painless. But at the same time, it is imperative to follow the general recommendations regarding this type of operation.

— How many such operations have you already carried out?

— Enough to verify the effectiveness of this technique. This week, for example, I performed about 6 successful operations. By the way, another advantage of seamless mammoplasty is the possibility of combining it with other operations. You can do liposuction, rhinoplasty, and breast surgery at the same time. At the same time, the patients’ breasts do not bother them. This complex of features transforms a rather complex breast augmentation operation into an easily tolerated and effective one.

— Do you apply this technique, the gluing technique, to other types of operations?

- Yes, now I exclusively use this technique in breast augmentation surgeries, and also do seamless lower blepharoplasty - eyelid surgery.

- And really no one had such an idea before?

— All new products in plastic surgery and medicine in general are perceived with extreme caution. Medicine is very conservative. In addition, you first have to try something new on yourself and, as you know, in most cases, doctors do just that. Anticipating your next question, I answer: no, I did not insert implants (smiles)

. The first patient was a girl from the medical staff of our clinic. She just had confidence in me and understood that using glue was not the main thing and in no way would it worsen the result of the operation. And the result exceeded all expectations. In fact, there is still a lot that has not been revealed in medicine. But it does not stand still, but is rapidly developing, offering us something new on the path to perfection.

Sergey Vladimirovich, thank you for such an interesting conversation and detailed explanations!

Preparation for surgery

If doubts are discarded, consultations with a plastic surgeon are carried out. What else needs to be done to take preparatory steps for the operation?

A medical examination is required - an ultrasound or mammography of the glands is performed, blood tests are taken (clinical and for coagulation). It is worthwhile to first talk with the anesthesiologist who will work on the operation. This is necessary for the doctor to find out some details about the patient’s health condition and be able to more accurately calculate the dose of anesthesia.

If a woman is taking anticoagulants, such as aspirin, she should stop taking them two weeks before surgery.

Immediately before Day X, it is better to unload the body a little and not eat much. Moreover, do not drink alcohol. On the day of surgery, it is forbidden to eat food.

Conducting a preliminary inspection

Initially, the doctor determines the general shape before surgery - the width of the shoulders, chest and height. Attention should also be paid to the presence of even slight asymmetry of the nipples. A qualified doctor takes into account the size of the mammary glands before surgery, since this is often remembered after surgery. And such incompetence can result in worsening nipple sensitivity. A visit to a mammologist will be mandatory.

Preparation period

All patients first undergo a consultation, during which the doctor analyzes the condition of the breast and the individual characteristics of the patient. Based on the data obtained, a specific breast augmentation option is selected, the nature of the implants, and the course of the operation is calculated.

It is necessary to collect a number of tests and conduct an ultrasound examination of the breast. All this allows you to plan the procedure in an optimal way to achieve the desired result with a minimum of injuries.

Surveys

First of all, as with any surgical intervention, the presence of colds and exacerbations of chronic ailments is taken into account. You will also need the following results:

• Ultrasound of the mammary glands;
• general and biochemical blood tests;
• ultrasound examination of the lower extremities;
• Analysis of urine;
• ECG study.

During the preoperative period, a consultation with an anesthesiologist is required. Immediately before surgery, a light dinner is allowed. On the day of surgery, eating is strictly prohibited.

Choosing the right breast implants

Evaluating a specific implant and its type is a compromise between the patient’s wishes, the presence of objective indications, taking into account the recommendations of a professional, who includes possible contraindications. It is the doctor who will be able to weigh the advantages and disadvantages of implantation products. It is worth understanding what criteria the doctor pays attention to when choosing the required product. When selecting a product, it is recommended to take into account the balance between quality and safety of use:

• filler density, an indicator of retention of the established shape over a long period, as well as in a specific position;
• the reliability of the shell is characterized by the fact that at the slightest damage this filler will not leak out;
• the final result depends on the product - a rounded shape, a teardrop-shaped version, with distinctive protrusions;
• surface elaboration - the presence of texture for excellent fixation in materials, which as a result affects the ability of the product to remain intact even under load.

The surgeon considers other peculiar qualities - convenience at the time of surgery, the possibility of using various ways to penetrate into matter, as well as correct installation. The price category is of great importance, which contains two sides - too inflated the cost does not indicate excellent quality, too low and is completely alarming.

Typically, when choosing implants, experienced surgeons are guided by mass distribution of the brand, service life, use by medical professionals, as well as published information. Thus, existing information and research speaks volumes. However, the patient himself in this case will not be able to independently determine which option is the best. Therefore, a mandatory consultation with a specialist will be required, and in most cases several.

Progress of the operation

The operation is performed under general anesthesia. It lasts about 2-4 hours. The surgeon removes excess skin and creates a “pocket” for the implant. When the bed is prepared, the endoprosthesis is inserted into the chest. After all this, a bandage and stitches are applied. After waking up from anesthesia, the patient must spend a couple of days in the hospital.

Breast lift at home

Surgery is an effective way to eliminate visual defects of the bust, next to which there are home remedies. Their effect is clearly visible on the breasts without obvious asymmetry and severe ptosis.

Collagen mask

Constant use of masks with collagen helps maintain skin elasticity. The impact provides support to the frame that holds its shape. Timely start of using masks allows you to maintain youthful and healthy breasts for a long time.

Masks are made in various forms - from creams to patches. A standard course of use can last 14-16 days.

Wraps

With the help of wraps, the skin is saturated with beneficial microelements. Due to the created tone, its firmness and elasticity are maintained. The combination of positive influences has a beneficial effect on the frame. Before wrapping, it is recommended to cleanse the skin with a scrub - this enhances the effect of nutrients.

Exercises for the pectoral muscles

Sports can also have a positive impact on the visual aspect of the bust. By giving the chest muscles tone, the desired effect can be achieved. The standard set of exercises recommended for women to work out the décolleté area includes:

• Push ups.
• Arm exercises with dumbbells.
• Exercises like “rowing” with moving your arms back.

After physical exercise, it is recommended to take a contrast shower - it enhances tone, having a beneficial effect on the condition of the skin. As a result, the breasts retain their firmness and attractive appearance.

After operation

The aesthetic effect of a facelift depends not only on the skill of the surgeon, but also largely on how the patient spends the first days and weeks after the operation.

The first two after surgery must remain under the supervision of medical staff. At this time, the regime is as close as possible to bed rest. Usually on the third day a follow-up examination is carried out and if all is well, the woman can go home. At home, the mode is also sedentary, without sudden movements and stress. On days 7-10, the stitches are removed. If the patient does not experience physical exertion at work, she can return to work.

For the first month you need to wear compression garments. And around the clock. Approximately the same amount of swelling around the sutures and a feeling of heaviness in the glands can be observed. This is normal and will pass.

After about 2.5 months, you can resume sports and other physical activities. But when practicing, say, tennis or martial arts, it is worth remembering the need to avoid hitting the chest. The new bust will finally take shape and the seams will become invisible approximately six months after the correction.

Breast care

In the first 3-5 days, the doctor must prescribe antibiotics in order to reduce the threat of infections. You must take medications strictly as recommended. The doctor should also change the dosage and amount of intake if necessary.

During the surgical operation, the specialist determines whether drainage into the suture is needed. This manipulation is performed specifically so that in the first days after the operation, excess fluid does not accumulate from the inside and there are no complications. The therapeutic method for removing fluid is needed for up to 3 days, and according to the doctor’s prescription, up to a week. The patient should be explained how to use the drainage correctly: she must be extremely careful not to pry off the tubes while changing clothes or during sleep. It is not recommended to pull them, and in addition, drain them yourself.

You should also know how to protect the stitches after surgery from moisture: it is prohibited to take water treatments or get them wet for a week. In some cases, the period lasts longer, so the doctor will definitely tell you when it is permissible to take a shower.

On the day after surgery, it is recommended to go to bed exclusively in the supine position. For several days you need to lie with your head elevated. You should also beware of severe overexertion or heavy lifting. It is also important to take frequent walks once the discomfort subsides. This way, you can avoid the appearance of blood clots. Thrombosis is dangerous because such clots can freely enter the area of ​​the lungs and heart. After 1.5 weeks, the woman can return to her usual working routine.

Specialized bras are designed to care for new breasts. Let's look at the key reasons why you need to wear such a bra after surgery:

1. Shaping the bust. A poorly chosen product can cause abnormal breast formation. That's why it's so important to buy a special bra.
2. Preventive measures to avoid bust sagging. An incorrectly selected product results in a significant portion of the breast tissue being located below the level of the nipple. Over time, the results of the operation may disappear.
3. Prevention of breast divergence. The filler may cause both piles to move apart.
4. A product for breast lifting is the best option for maintaining the “new weight”, since it is artificial fillers that have a specific mass. If a woman previously had small breasts, then she will have to get used to a certain load. The average volume of implants installed is about 300-400 ml (200 ml is approximately the same size).