Breast augmentation - Causes, symptoms and treatment. MF.

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Breast enlargement was first done by injecting liquid paraffin in 1889, and attempts to implant various substances began in 1895.In the first decades of the 20th century, attempts were made to apply ivory, glass balls, rubber, ox-cartilage, fatty tissue, wool, gutta-percha, polyethylene tape, polyethylene and polyvinyl sponges( including polyethylene bags), polyester foam, polystyrene foam,polyurethane, polyester and teflon-silicone prosthesis.

Similar operations led to negative consequences - occurrence of infections of various severity up to sepsis, tumors, deformities of breasts, fat necrosis, development of a cancer of a mammary gland. Implantation of fat did not cause a positive effect, as it was quickly reabsorbed by the body. Often there were reactions of graft rejection, with the development of long-term non-healing purulent wounds.

In modern plastic surgery for implantation under the breast, silicone implants of various firms are used, most of them are European and American manufacturers who have proved themselves in this field for decades. The implant is a bag( implant shell) made of a silicone elastomer and filled with a cohesive gel. This is a viscous gel that does not flow even when the prosthesis breaks and does not move, ensuring the patient's safety. In one such box is one silicone implant.

In fact, they are used not only for breast augmentation of healthy women, but also as prostheses in cases when for medical reasons it is necessary to remove the mammary gland( cancer, etc.).

There are two types of implant - a round and contour-profile( anatomical shape).The operation uses the one that is more suitable for the patient, it depends on the individual characteristics of the breast.

Now on the market there are many manufacturers of breast implants. The most important in the selection of implants is their safety and reliability, which can be confirmed only by long-term clinical studies, because they show the real likelihood of complications associated with the implant. And it's also important to get a natural result, so it's difficult to determine if there are implants inside or not.

In this box, only the implant templates that the doctor tries on the patient before the operation.

The doctor marks the operating area with a marker. The dashed lines drawn from the top down are made to determine the symmetry. In fact, the incision will be made in the lower part of the breast, although incisions under the arm and in the lower part of the nipple are practiced. It also depends on the characteristics of each patient's chest.

The arrow indicates exactly the area where the implant will be located - in the lower part of the breast, under the mammary gland. That is, if, say, a woman is breast-feeding, the implant does not interfere with it. Below, under the chest, the boundaries of the cut are marked with dashes - approximately 3-4 cm. This implant is carefully placed in this comparatively small incision.

Before the operation, the patient signs a series of papers indicating the areas of responsibility of the doctor and the patient for the consequences of the operation.

In the operating room the doctor carefully processes his hands on the elbows with special disinfectant solutions.

Plastic surgeon's assistants prepare the patient on the operating table, fix their hands, connect the respirator and infusomat - a special electronic device that allows intravenous administration of drugs intended for prolonged infusion. In this case, combined anesthesia( intravenous anesthesia + intubation of the trachea) is used. The doctor treats the operating area three times with a special antiseptic solution. Then the operating field is wiped with a dry staple.

Left respirator, right monitor, which records the blood pressure and pulse of the patient, as well as saturation of tissues with oxygen and carbon dioxide.

Near the surgical table there is a surgical suction( far left), designed for sucking blood, pus and other biological fluids. It is often used for more complex operations, but this time we'll do without it. In the middle of the infusomat, on the right - a defibrillator( for every "fireman").

A few anesthetic cubes guarantee a couple hours of undisturbed sleep during surgery.

Last preparations completed.

Earlier, during operations, scalpels were used, but now their place is actively occupied by coagulators, which work with the help of high-frequency current. This apparatus performs a dual function: it "cuts" the tissue and immediately cauterizes it( coagulates), causing blood to clot, so that the surgeon sees the surgical wound and the patient does not bleed.

Controlled by the pedal.

Strictly along the contour, previously marked, the surgeon makes incisions on the chest.

The physician mobilizes( uncouples) the tissues under the mammary gland, without touching it in the thickness of the subcutaneous fat.

The surgeon must prepare enough space for the implant, no more so that it seals the space under the mammary gland sealed. The wound is checked with a finger, it is checked whether there is enough room inside. If necessary, make another section inside.
After manipulations with the right breast, cuts are made on the left breast. The blood is rather small, because the coagulant heals wounds immediately after the incision.

Before placing the implant under the breast, an antiseptic solution is added to the surgical wound to disinfect tissues.

Then a special sizer( fitting implant) is placed in the incision, which is filled with saline through the tubule. This is necessary in order to understand exactly what size the implant will be used.

After trying on the saiser, it is removed, the cavity is treated with an antiseptic. Finally, the implant is taken from the package, it is placed in the same antiseptic solution, which was treated with wounds.

An important step in the operation is the installation of the implant into the formed bed.

After the opening of the wound, an implant is inserted. The surgeon gently pushes the implant inward with his fingers, without injuring the edge of the wound and the surface of the implant.

Then the doctor checks the correctness of the implant installation, accurate filling of all the walls of the pocket.

With the second breast, the same thing happens.

Then a drainage tube is inserted into the wound, it is carried out under the mammary gland and through it will be sanitized with antiseptic solutions in the postoperative period after the surgical wound. Now you can fix the drainage to the skin with a suture material.

After the surgeon has checked the symmetry of the breasts, he sits the wound of the deep tissues( fascia, subcutaneous tissue), without touching the skin( to avoid the development of gross scars).

The cutaneous edges of the wound are compared with a very thin ligature by the intradermal cosmetic suture.

The thread will resolve itself in two and a half months. Wounds are sewn, after which they are sealed with strips.

On top are applied aseptic bandages. At the end of the two-hour operation, a compression bra is put on the patient to maintain the shape of the implant in the postoperative period.

In this underwear, the patient will walk for another two months - a rehabilitation period. In 2 months she will be able to lead an active life as before.

After 2 weeks, the breast looks like this.