According to statistics, breast augmentation in the world today is one of the first places. Hundreds of clinics offer their services for this plastic surgery. In this regard, both the implant market and the list of mammoplasty techniques have expanded significantly. However, there are some general rules, the observance of which will help the plastic surgeon to avoid mistakes in the operation and prevent complications after it.
Rule One: Breasts are constantly changing
This is very important to understand, since the success and longevity of the result achieved with breast augmentation directly depends on the surgeon's ability to recognize upcoming changes in the future, inform the patient about this and make appropriate decisions.
Rule two: the surgeon must have sufficient experience
And not only experience, he must constantly improve and replenish his knowledge in this area. Today, the imperfection of the legislative framework in the field of healthcare sometimes allows people who were very far from it yesterday to take up any direction in plastic surgery.
Rule three: the patient must know everything
The thing is that many doctors think it is optional to devote the patient to the intricacies of a medical nature, and sometimes only the question of how much larger and more beautiful the breasts will be discussed with her. The more the patient knows, the easier it is to work with him. Moreover, there are medical legal documents that are mandatory offered for review and signature to the patient, which briefly but concisely list the features of the operation, anesthesia, further rehabilitation, as well as possible complications.
Rule four: the larger the implant, the worse the prognosis
The breast is too complex an organ, especially a paired one. The skin of the mammary glands (even if the glands themselves are tiny) can stretch like a balloon. But if there is a lot of skin and it sags, then one cannot count on a simple increase, a breast lift is necessary.
Mammary tissue is thinned and then the additional load on it is dangerous. Moreover, the lower half becomes thinner, on which the implant mainly rests, accelerating its further resorption and sagging along with the implant.
When calculating the volume of an implant, the width, height, and thickness of the glandular tissue must always be taken into account. If you overestimate the size and properties of the glandular tissue, this can be followed by a chain of errors that will lead to disastrous results: probing the edges of the implants, their contouring, pain, etc. In this regard, it is often necessary to place implants completely under the muscles.
Rule five: the choice of layer for implant placement is up to the surgeon
What are the options? There are only two of them: under the breast tissue, if it is sufficient in all respects, or under the pectoralis major muscle, on which the gland lies, in the case when the glandular tissue is thinned. The main thing is that the implant is well isolated from the skin. The existing proposals for the installation of implants under the fascia of the pectoralis major muscle or in "two planes" have a lot of drawbacks.
Rule six: choosing an implant is a collaborative decision
Today, the main importers from the USA, Germany and France are represented on the market. All modern implants are accompanied by a lifetime warranty certificate due to the modern quality of the filler (cohesive gel is a jelly-like non-fluid substance with a shape memory effect that does not contain harmful impurities). All modern implants have a textured (rough) surface. In terms of shape, today there are many modifications (round, anatomical, for the right and left mammary glands). One of the main indicators of quality is considered to be a low level of occurrence of constrictive fibrosis of the capsule.
Rule seven: the shape of the breast does not always follow the shape of the implant
Thinking that if the implant is round, then the breast will be spherical, it is wrong. Round implant - only when viewed from above, but in general it has the shape of a lens, while - different levels of height: low-, medium-, high-profile. In contrast, the anatomical shape (or drop-shaped) has a flatter upper edge and a convex lower one, with different lengths, widths and heights of the implants. Naturally, the surgeon in each case individually selects one form or another of the implant. It is very important to show the patient in advance photographs of other patients with the initial appearance and the results of operations where these and other implants were used.
Rule Eight: Choosing the site of the incision is the patient's business
There are three major and one recent proposal from surgeons. The most optimal incision is in the crease under the breast. Its length is from 4 to 5 centimeters. It is considered the most successful, because after healing it is almost invisible, because it is in the fold. Through it, the surgeon is most comfortable, and therefore better able to form a bed for the implant, and, most importantly, the gland tissue is not damaged, as is the case with the now very fashionable incision around the areola (the second type of access). The third of the access points is in the armpits. It is not a fact that the scar after the operation will be less noticeable here, it all depends on the shape of the chest. In some cases, the scar is really hardly noticeable, while the tissue of the glands is not damaged. But here, too, there are problems. Qualitatively place implants under the tissue of the glands, and also under the muscles, difficult. Muscles have to be cut off from the lower fixation points, even if the surgeon uses the most advanced technique - endoscopic, which subsequently leads to probing the edges of the implants.
American surgeons offer breast augmentation through an incision around the navel. We can do it too, only few patients currently want to have saline-filled implants, since they are the only ones that can be installed through this access.
Rule nine: the result of the first days after the operation is not final
Due to postoperative edema, individual characteristics of the body in the first 5-7 days after surgery, the breast may seem twice as large as desired. This is the normal course of the process. The edema goes away gradually, this is facilitated by special underwear and medicines. Soreness during the installation of the implant under the glands is insignificant. The pain syndrome is more pronounced with the axillary location of the bed, which is quite understandable. Also, with axillary placement, there is a period when the implant occupies a higher position on the chest wall for some time. In order for it to take the desired position, it sometimes takes about two to three weeks and special underwear. Warn the patient that the scar after the operation will thicken and turn red for the first two months, and only after six months it will turn into a white thread. This is absolutely normal.
Rule ten: there are complications
What complications the surgeon is responsible for: bleeding on the first day after the operation in the cavity where the implant is located. You need to quickly orient yourself, stop it, and in this case there will be no negative consequences.
Infection is considered a more serious complication. It can be difficult to recognize it right away. But if the fact is obvious, then the implant should be removed, and until the wound heals, it should not be put again. This may take 1-2 months. Fortunately, these complications occur no more than in 4-5% of cases.
For which, conditionally, the surgeon is not fully responsible, but shares the degree of responsibility with the patient. This complication is called constrictive fibrosis. The fact is that a capsule is formed around any foreign body in the body. This is the norm. But sometimes this capsule behaves aggressively, thickens, thereby causing the implant to tighten, soreness, and changes in the contours of the breast. According to various authors, this can occur in 1-7% of cases, if we talk about modern implants. Even 10 years ago, when domestic prostheses were mainly used, the frequency of this complication reached 40%. What should you do if this happened? No attempts to "crush" the capsule. It is necessary to get the implant, once again evaluate the adequacy of its volume, the correctness of the chosen location and the volume of the formed space. As a rule, by eliminating one of the listed shortcomings, you can get a good result. Here, as in everything else, it is important that the surgeon is competent.
Rule 11: Implants are eternal, but the results of the operation are subject to change
The fact is that modern materials and technologies for the production of implants allow us to consider them almost eternal. We can no longer talk about the flow or perspiration of the filler through the shell, especially about its breaks. The filler is now also unique, it is not liquid, but very soft to the touch, gives the return of the implant shape even with very strong compression. But the chest is in constant motion in the literal and figurative sense. Therefore, the patient must be prepared for the fact that one day she will have to go to the doctor about the changes in her appearance that have appeared.
Rule Twelve: The decision to perform the operation is up to the patient
This rule should be inviolable for both the patient and the doctor.
According to the materials of the magazine "Beauty and Health"
Plastic surgery today has reached such a level that allows specialists to literally sculpt the desired contour of the face and body. VIPS - Virtual Plastic Surgery - a new direction in plastic surgery, born on the verge of art and 3D technologies:
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