Increase of breasts
One mamoplastia of increase consists of correcting the volume of the breast judged insufficient by implants of a prothesis behind the mammary gland. Mamoplastia of increase helps to improve the size and the form of the feminine chest. It is the perfect intervention for those women with an excessively small chest, to correct a difference of size between both breasts or to reaffirm the chests fallen after the months of lactation. With this surgery we were able to increase to the size of sines one or several sizes.
Different surgical techniques exist, and will be the surgeon who will advise the patient one on the most adapted being based on the form of the chests, the anatomy and the quality of the skin.
What is the mammary hypoplasia?
Prothesis mammary or Plastia of increase
The mammary hypoplasia is defined by an insufficiently developed volume of breast in relation to the morphology of the patient.
She can be primary (small breasts after the puberty) or to appear secondly, after an important thinning or of a followed pregnancy of lactation.
She can be isolated or be associated to one ptosis, that is to say one fall of the gland and a distension of the skin.
One mamoplastia of increase consists of correcting the volume of the breast judged insufficient by implants of a prothesis behind the mammary gland.
All the you implant at the moment mammary used are compound of a covering and a product of filling.
The covering always is constituted by elastic silicone (silicone elastomer). It can be smooth or rough (texturado).
As far as products of stuffed the most used it is the silicone gel for almost 40 years.
The silicone gel is gotten up to the prothesis in factory, reason why the range of the different volumes is determined by the manufacturer.
Advantages and disadvantages
Silicone gel: More or less smooth gelatinous substance (cohesividad). It can be:
- It signs (cohesive gel) Limits the appearance of you fold. It eliminates the risk of being deflated.
- Consistency approximated to the one of a normal breast.
- One does not expand in the weaves that surround to them in case of rupture.
- Nonabsorbent product by the organism in case of rupture of the covering.
- Risk of retractable (hardening) a little more stop than with those of physiological serum.
- It can extend in the weaves that surround to them in case of rupture.
- Firmer and heavier consistency.
- Physiological serum: Solution of water and salt to a concentration similar to the one of the organism.
- It can be filled up in factory or at the time of the intervention (v¡vula).
- Natural absorption by the organism in case of rupture of the covering.
- Less retractable index of capsule (hardening) Possibility of appearance of you fold.
- Deflated of the prothesis of gradual way or abruptly.
Before the intervention
The location of the scar, the situation of the prothesis in relation to the muscle, the type and the size of the prothesis will have been decided in consultation, based on the anatomical context and of desires expressed by the patient. It is arrived thus, after an explanation clear of the different methods, to choose what better it agrees upon each case.
Analytical preoperative the habitual one is realised according to the prescriptions. It can be useful to verify the studies of existing images (ecographies and mammographies).
No medicine that contains Aspirina must of being consumed ten days preceding at least to the intervention.
Anesthesia and hospitalization
Anesthesia type: Normally a classic general anesthesia is made, during which you sleep completely.
Modalities of hospitalization: A day of hospitalization is sufficient.
Each surgeon has an own technique that adapts to each case to obtain the best results. Anyway there are bases common.
It implants is introduced by one short located incision: in the areola, in the axillary region or in it folds submammary.
Location of implants
The pocket realised by the despegamiento within which it is going away to implant the prothesis is located:
Behind the mammary gland and in front of the pectoral great muscle, or behind the gland and the pectoral great muscle.
In case of ptosis mammary (fallen breasts, low areolas), he is preferable to associate an act of reduction of cutaneous covering that implies a more important scar (to periareolar, vertical).
Possibly 24h will be left a drainage. after the intervention so that the blood or the liquid that can accumulate is eliminated. At the end of the intervention, a modelante bandage with bandage elastic with bra form is realised.
Based on the surgeon and of the necessity of complementary acts associates, the intervention will last of some to two hours.
The postoperative one can be painful the first days, mainly when it implants is located behind the Greater Pectoral muscle, reason why it resorts to the treatment with analgesic.
In some cases, the patient will feel a tension strong feeling.
The oedema (swelling) and the bruises (cardinals), of the breasts, and the annoyance when rising the arms are frequent at the outset.
The first bandage retires after the 24 either 48 hours and is replaced by a slight bandage the more, realising a species of elastic bra to size.
The hospitable discharge occurs to the 24 or 48 hours after the intervention, and the patient is reviewed in consultation two or three days later: then a bra is put that provides a good containment. This bra is recommended to take it during a month day and night.
The suture threads if they are not reabsorbibles, retire between the 8 and 15 postoperative days.
He is advisable approximately to anticipate a convalescence and a loss of work of 8 to 10 days.
He is advisable to hope one or two months to retake a sport activity.
Duration of the intervention
The mammary increase by prothesis although is realised essentially by aesthetic motivations, is a true operation, which implies the risks related to all medical act by small which it is.
The anesthetic techniques, products and the methods of monitoring have done immense progresses in the last 20 years, offering, an optimal security, mainly when the intervention is realised without urgency and in a person completely it heals.
In relation to the surgical act: choosing a qualified and competent plastic surgeon, formed after this type of interventions it limits the risks to the maximum, without suppressing them completely.
The postoperative one is generally simple, of all ways the complications can happen some inherent ones to the mammary interventions and other ligatures to implant of a strange body in the breast: the specific risks of you implant them mammary.
Inherent complications to the mammary interventions:
Infections, dealt with antibiotics and sometimes with surgical drainage.
Hematoma, can need would evacuate.
Alterations of sensitivity, essentially of the nipple, can be observed, but normal sensitivity reappears in a period of 6 to 8 months.
The evolution of the scars not always has so that to be favorable being able to even exist hypertrophic scars and keloids, of unforseeable appearance and evolution that can jeopardize the aesthetic aspect of the result and requires specific local treatment lengths.
Specific risks of you implant them mammary:
They are of three types who vary based on the nature of the product of stuffed of implants.
One is the formation of you fold or waves, the production of a periprot©rica capsular contraction and the deflated risk of rupture or of:
- Formation of folds or aspect of waves: It implants so that it is never smooth fills to tension. By this fact, you fold them of the covering of the prothesis can be visible under the skin, producing then aspect of waves coverall in the external part superior and inferior of the breast. This more imperceptible aspect in the part superior in case the prothesis is On guard placed to retromuscular. This phenomenon is much more frequent when the prothesis is stuffed of physiological serum, still more if is texturada. This sets out still greater risk of rupture and deflated, by premature cost of the covering concerning it folds.
- Capsular contraction and fibrous capsule: The formation of a fibrous capsule around always implants happens. It is a normal reaction of the organism that produces a membrane species around any strange body to isolate it and to protect itself (membrane or capsule of exclusion). In certain cases, this membrane has a comparable unfavorable evolution to the cutaneous keloids: it increases of thickness, a true fibrous capsule is dissuaded and formed around implants. One is the capsular contraction. Four stages of hardness are distinguished that go from the undetectable normal aspect, until the severe forms of capsule with hard, round breast, fixes sometimes and painful. The frequency of this complication cannot be considered generally since it varies based on the indication, the type of prothesis and the operating technique. This complication is more frequent in case of silicone stuffed gel prothesis.
The capsule does not increase the risk of rupture but it exposes to a complication of aesthetic type. An operation can correct this complication sectioning the capsule (capsulotoma). Different authors have offered technical solutions to limit the appearance of this contraction:
- To place implants behind the pectoral muscle.
- The manufacture of rough walls in the external part of implants (prothesis texturadas).
- The use of you implant physiological serum fillings.
Deflated rupture and
This type of accidents happens consequently to an alteration in the covering of the prothesis that is to say, of the continent (silicone elastomer). The phenomenon of porosity, or the punctiform opening or a true breach can be the cause and to appear as a result of a violent traumatism, a defect of manufacture, but mainly due to the antiquity of the prothesis (use effect).
The deflated one in the prothesis that contains physiological serum can be a problem of lost by the filling valve. This type prothesis has fast total or partial deflating.
If one is a stuffed prothesis of silicone gel, the gel remains within the fibrous covering that surrounds implants (intra-capsular flight). The flight then does not have any clinical repercussion. Nevertheless, the intra-capsular exudate can favor the appearance of a periprot©tica capsule.
With less frequency, in case of important breach in relation to a violent trauma or a puncture with needle, the gel escapes beyond the fibrous capsule (extracapsular rupture). In small amount, the gel can bring about the appearance of a granuloma or strange body under the nodule form (siliconoma). In case of important capsular rupture (traumatism), the gel spreads to neighboring weaves, the breast takes a very soft consistency, and can happen inflammatory reactions: in these cases it implants surgical is necessary.
The result can be appreciated from the third month, necessary period for the softening of the breasts and the stabilization of the prothesis.
In addition to the aesthetic improvement, the psychological benefit is very important.
The imperfections of the results
It is possible that the scar has an abnormal evolution, increasing itself or retranyendo itself.
The pains in the breasts and the alterations in the sensitivity of the nipple are also possible.
On the other hand, the dissatisfaction of the aesthetic result can motivate the previous reintervenci³n warning of the surgeon.
Duration of life of implants
A prothesis, or is stuffed of silicone gel or of physiological serum it lasts of indetermine life not being able to consider a priori since she depends on the possible complications. In such a way that the duration of life of implants it cannot be guaranteed.
A carrying woman of implants is exhibited to the risk of a complementary intervention to replace the prothesis so that the beneficial effect stays. Nevertheless it is necessary to know, that she implants of good quality does not last of limited life: there is no a term from which there is obligatorily to change the prothesis. Thus, in the absence of complications or of rupture, she implants can conserve as much time as the patient wishes it.
Is possible lactation?
The positioning of implants behind the gland seems not to have influence in lactation.
Favor does the prothesis mammary the appearance of breast cancer?
The relation between the cancer of breast and the prothesis has been investigated without putting in evidence no bond enters both and it implants of a mammary prothesis does not increase for anything the risk of cancer of breast. The surgeons of mammary anticancerous centers frequently use the prothesis in the reconstructive surgery.
Is the monitoring of the breast possible?
Considering that the prothesis is behind the mammary gland, the clinical monitoring is simple. The presence of implants can modify the capacity of X-rays to detect a breast cancer. The carrying patients of you implant mammary must need it to the radiologist so that it can use specific and adapted methods (ecography, digital mammography).
Why so they were controverted the silicone prothesis some years ago?
The silicone gel prothesis mammary stuffed was accused to trigger autoimmune diseases in some patients. Nowadays, the work set scientific in this respect has presented the evidence that is no a significant increase of the risk of carrying autoimmune disease in women of implants mammary and in particular those fillings of silicone gel.
There is a monitoring after implants of a mammary prothesis?
It is necessary to be put under post-operative visits based on the prescription of the surgeon. Later, the presence of a mammary prothesis does not imply to realise additional examinations to habitual the medical monitoring but he is indispensable to need the doctor who you are carrying of implants mammary. It is imperative in case of modification of a breast (hardening or on the contrary softening) to consult the doctor (gynecologist, surgeon) who will be able to judge if it is necessary to resort to a radiological or ecogr¡fico examination. In summary, it is not necessary to exaggerate the risks, but simply, to be conscious that an operation, still apparently simple, always implies a small random part.
To resort to a qualified plastic surgeon assures to him that this it has the formation and the required competition to avoid these complications, or to treat them effectively on the contrary.
These reconnaissance groups are given in complement to their consultation, we advised to him to conserve it, and to read it kindly after the consultation and to reflect envelope he with cold head.
These reflections will cause, perhaps new questions, for which it waits for complementary information. We are to its disposition to discuss them in a consultation.