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Women who have little or no bust can generally feel self-conscious.
For centuries the breasts are considered as female sexual icon. Currently a harmonious body is one whose proportions are balanced. The bust and buttocks must meet adequate volumes, and the professional must evaluate the figure of the whole patient to a successful outcome.
BREAST IMPLANTS OR PROSTHESIS
Chest as an organ of female identity is a symbol of femininity. This symbolism generates psychosocial changes in patients with deformities or imperfections.
The implantation of silicone prosthesis has brought many benefits to patients with hipomastia (small breasts) o amastia (breastless).
MAMOPLASTIA DE AUMENTO
There are situations in the development of women where the shape and size of breasts is not proportional to the shape of the female form and does not correspond to the image to the aesthetics of contemporary women.
Breast augmentation (mamoplastia de aumento) It is one of the most common surgical procedures in plastic surgery.
It is based on the placement of an implant behind the breast to enhance breast volume achieving excellent results and high patient satisfaction.
INDICATION
La mamoplastia de aumento, also known as breast prosthesis surgery, It is indicated for patients with small breasts or, after breastfeeding had a large reduction in breast volume, without there being breast ptosis (breast fall).
For some time it was speculated that silicone implants could harm the health of women (breast cancer, rheumatic diseases, etc.).After extensive studies conducted in the United States, the absence of these myths was found.
It is recommended to periodically change the breast prosthesis to prevent wear of the same. Due to the increasing quality of the prostheses, it is estimated that the change should be made in about 15 – 20 años.
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Breast augmentation or breast requires careful assessment of breast morphology and anatomy of the chest wall.
It is necessary to make a consistent pre-operative study mammograms, cardiorespiratory assessment and patient characteristics: width based glandular, Adequate skin coverage and capacity of previous tensile strain skin and away from the areola and nipple to inframammary groove under maximum stress.
In addition, it is important to assess the long-term implant and soft tissue evolution and dynamics.
Other variables to consider are the size and shape of the implant, the approach and the location and dimensions of the pocket; and to assess the shape of the breast and if dropped, to associate lifting it prior to placement of prostheses (mastopexia). It should take special care in cases of asymmetric breasts and those with a thin skin coverage, poorly at the bottom with ptosis.
If the patient is a smoker, should quit at least 10 days before and after surgery, to avoid complications and sequelae. In addition, during the days before surgery it is convenient to use a germicidal soap to wash the whole body.
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SURGICAL TECHNIQUE.
Three techniques can be used to place an implant:
- Subglandular: behind the mammary gland
- Retromuscular (behind the muscle).
- Retromamario / Subfacial (behind the mammary gland with or without muscle fascia).
- Biplanar (a combination of both).
All techniques have demonstrated their effectiveness and their benefits when they are selected under strict scientific criteria and experience according to individualized assessment of each patient.
APPROACH ROADS (Introduction of the implant)
To insert the implant three main routes used:
- Periareolar: making an incision in the interface located between the skin and areola.
- Axillary: making an incision in the axillary region.
- Submamaria: making an incision in the groove beneath the breast.
Usually more frequent periareolar approach because the scar to be between the skin and the areola goes virtually unnoticed in most cases.
The remaining two approaches are used for patients who have a lower areola 3 cm where an implant could hardly introduced.
Scars depend on the type of healing of each person but in most cases will be very satisfactory.
Other routes are less used through the umbilicus (TUBA) and through a tummy tuck (TABA).
TYPE OF IMPLANT
implants (misnamed prosthesis) They can be of different types according to their shape (round or anatomical), cover (The smooth textured polyurethane), projection (low profile, moderate, high or extra high) and composition (cohesive gel silicone, hydrogel or saline)
They are often used to smooth the silicone gel or textured high profile and extra high.
The silicone gel implants with polyurethane cover are increasingly used and have a number of benefits among which a very low rate of capsular contracture. The rest is used rarely even have their well-defined indication.
TYPE OF ANESTHESIA
Local with sedation, Epidural General.
SURGERY TIME
It will depend on the technique to be used and the anatomical characteristics of each patient. Usually the time will 45 minutes to two hours.
RISKS
No surgery is without risk because each body reacts differently.
In the vast majority of cases the evolution is completely satisfactory but a small group of patients may present some alteration treated early should not pose major inconvenience.
Is a right of every patient to know the risks inherent in surgery and is a duty of the doctor to explain them during the consultation. Feel free to ask any doubts about this because the better informed best result will.
capsular contracture: All "foreign body" produces a reaction in the body. Those that can not be reabsorbed (and this is the case of the implants) They are enclosed by a capsule that is completely normal and expected. In rare cases this capsule can thicken, deform and / or generate pain and this is known as capsular contracture. When contracture is important (grade III or IV) It should reoperation to remove or extend the capsule and solve the problem with the patient. The chances of capsular contracture down to less than 1% using polyurethane implants.
Hematomas: there is a low risk of bleeding after surgery. If it were to occur reoperation may be necessary to locate the source of the hematoma and control. Once solved the box will be satisfactory evolution.
Dehiscence of heridas (Wound opening): In rare cases the body can not react as expected when suture material or vectors tension and opening may arise somewhere in the wound. In this case you can proceed to the immediate surgical closure or, not be suitable, the spontaneous closure with subsequent plasty (arrangement) Scar. The final result will be satisfactory for the patient.
infections: extremely rare but should be mentioned. Most cases are superficial infections of the wound properly respond to antibiotics and do not represent major drawback. In rare cases the infection is still in contact with the implant and in those cases there is the possibility of having to remove it and wait a few months to place a new one.
Sensitivity: a small percentage of patients report increased or decreased sensation in the nipples. This will usually disappear in a short time.
There was no link between silicone implants and cancer. This has been amply demonstrated worldwide in research of high scientific level.
It has not managed to show a link between silicone implants and connective tissue diseases such as lupus. However given that there is insufficient evidence about it is preferred not to use such implants in patients with these diseases.
Breast augmentation does not affect breastfeeding.
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- During the first hours after surgery you may feel moderate pain that is easily controlled with painkillers.
- Similarly you can feel a slight tightness in the chest that does not compromise breathing.
- The pain will improve within a span of 48 a 72 horas.
- It is important to keep the bandage holding the prosthesis in the right place. This bandage should be maintained and for a week since it prevents rotation of the prosthesis.
- Sleeping on your back during 1 a 3 months.
- Using post-surgical bras or bra they are recommended by the surgeon to keep breast implants in the right place. Use may vary from 1 a 3 months.
- The small stitches are removed between 7 and 14 days later.
- Edema yield between 3 and 6 weeks after mammoplasty
- No heavy lifting during the next three weeks.
- Do not drive over the next 3 weeks
- It should be performed as recommended by Dr. postoperative therapy to avoid encapsulation of the implants, It is consisting of lymphatic drainage and ultrasound.
- The drawback to sports or recreational activities will be approximately 1 a 3 months taking into account the use of sunscreen.
- Work activities can be restarted in such a short period as 3 days depending on the evolution.
The doctor. Nadir Salaues Antonio Hurtado and his entire medical team are at your disposal, monitor the progress of each patient and ready to answer all your questions and colaborarla all you need.
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