Mammoplasty: know the types of plastic that model the breasts
Mammoplasty is all plastic surgery that transforms and modifies the shape of the breasts, aiming to make it more harmonious and proportional to the rest of the body.
Types of mammoplasty
Despite being given the same name, the purpose of mammoplasty means that the features and processes used are different. Understand how each is made:
It is usually the women who have very small breasts who resort to surgery for silicone implant placement in the breasts. Although many also seek to increase the breasts to stiffen and because larger breasts are associated with sensuality. A prosthesis is used that guarantees firmness, shape and natural appearance of the breast. The technique used is the silicone implant and the incision can be in the mammary, areola or armpit groove. It can be placed under or over the muscle, meaning the implant can be inserted below the gland or muscle. The indication of placement of the prosthesis in front of or behind the pectoralis muscle varies according to the type of breast of the patient. If the woman has a small gland, she usually puts herself behind the muscle so that the implants do not become very apparent. When the patient has an amount of gland to cover the implant satisfactorily, it is placed in front of the muscle.
For very voluminous, disproportionate breasts that due to weight cause discomfort and pain in the spine. Very large breasts also tend to promote their fall, often early and consequently it is still associated with sagging caused by excess breast fat. In addition, the weight and volume can cause back pain, as well as sharp marks on the shoulders because of the bra. The technique removes excess fat, glandular tissue and skin to achieve a breast size proportional to the patient's body. The scars are the inverted T (in the mammary groove), the periareolar and still L. But it all depends on the woman's breast, the surgeon needs to take into account the amount of flaccid skin removed and the type of incision.
Repair mammaplasty can also be classified as mastoplasty. In this type, the accentuated breast asymmetries, the reduction of the areola, among other cases are treated. The surgery corrects the difference in size, shape or position of the breasts and / or areolas, but the process of the procedure will depend on the need and the case of each patient. That is, you can implant the smaller breast, reduce the bigger breast, reposition them, etc. Therefore, everything will be related to the type of asymmetry that exists and each one will have the application of a certain technique.
This technique is indicated for those who have breast cancer and it is necessary to remove part of the breast or it completely (the so-called mastectomy). The surgeon resurfaces the breast and in many cases it is necessary to remove tissue from other regions of the body (such as the back, abdomen) to rebuild it. Breast reconstruction usually has two variants: surgery after removal of the breast (s) or can be performed at the same time as the mastectomy. Thus, patients need not even go through the trauma of surgical kneading. The simple placement of an implant has a much shorter recovery and usually follows the same conditions as other techniques that use this feature.
Also known as a breast lift, it is the technique that lifts the sagging breast tissue (with ptosis), and is also generally associated with sagging. Many patients who undergo this technique also place silicone prostheses. The use of silicone implants will depend on the texture, excess skin or density of the breast tissue and not just the fall of the organ. The scar of breast lift surgery, with or without a silicone implant, may be just vertical, ie, from the areola to the breast sulcus, or associated with another scar in the breast groove, also called an inverted T. >Mammoplasty Indications
Mammoplasty is indicated for women who have breast problems, such as sagging breasts, very large or very small. Reconstructive mammoplasty is only done in case of removal of the breast due to a tumor.
Who is the professional able to perform the mammoplasty?
Plastic surgery, such as mammoplasty, should only be performed by plastic surgeons.
Prerequisites for breast augmentation
Ideally, breast augmentation should be done on patients whose breasts are more or less defined, usually from the age of 18 years. But it is necessary to evaluate the situation carefully, because there are special cases of girls with the already formed breast that can also be submitted to intervention, when there is, for example, a severe asymmetry (as in the case of sizes between the two very different and visible breasts ) some type of anomaly, or very large breasts that cause problems in the spine, etc.
In addition, it is important to evaluate the conditions of the breasts, checking, for example, if they have many nodules.
Contraindications for mammoplasty
Patients with specific conditions in the breast, health problems that may lead to complications during surgery, and breasts not fully developed, with the exception of exceptions, are contraindicated to do breast augmentation. In addition, smoking may be a prior factor of complications during surgery, since it changes the vascularization and also the cicatrization.
Preoperative of mammoplasty
In the preoperative period of mammoplasties, laboratory tests, mammography or ultrasound of the breasts, electrocardiogram, as well as diagnose and monitor clinical conditions that would prevent the surgery. Depending on the case medical opinions refer, for example, patients who had mastectomy.
It is important to suspend cigarette and alcoholic beverages in the days prior to surgery is also essential. In addition, an absolute fast of solids and liquids must be performed within 8 hours of the procedure. In case of flu or malaise, the doctor should be advised.
Post-operative of mammoplasty
The postoperative period of mammoplasty depends very much on the technique. In the case of augmentation mammoplasty with placement of silicone prosthesis (simple inclusion), it is approximately 15 days. In the other techniques, they are 30 to 90 days, with some restrictions.
The patient must use at least one month a post-surgical bra that is adjusted throughout the thoracic region in the mammoplasty of increase. In others the use is about three months. Its use should be daily, including for sleeping. In addition, it is recommended, especially in the first week, not to move the arms (especially lifting them above the shoulders), not to comb and wash the hair alone and still not to do physical exertion and to take weight.
In reduction mammaplasty and mastopexy , in the first month can not sleep face down. In the second month of belly up and third of side. Only in the fourth month is released sleeping on the stomach. You also can not practice sports activities for at least 90 days. Exposure to the sun only after three months or when the scar becomes white.
It is also recommended to start lymphatic drainage from the second week after surgery.
Duration of mammoplasty
The length of time varies according to the technique employed: a breast augmentation lasts on average from 45 minutes to one hour, but it depends the patient, the incision. The reduction mammoplasty lasts on average one hour and half to two hours. Reconstructive reconstruction depends on the technique used, can be from two to three hours, on average.
Possible complications of mammoplasty
In the case of prostheses, the most common is capsular contracture, which is a kind of rejection to the implant. That is, the body reacts by forming a capsule around this implant, this formation being a normal mechanism of defense of the body. This process of capsular contracture causes pain, hardening and deformation of the breast. However, the implants are increasingly resistant and with less chance of complication. It is important not to smoke before and after surgery, because the cigarette promotes damage to the capillary vessels, making it difficult to oxygenate the tissue, thus causing complications in the anesthetic procedure, in the scarring and may even cause necrosis of the tissue.
There are also risks of bruising, infection, suture dehiscence, loss of sensitivity, prolonged edema and other complications arising from any surgery.
Before and after mammoplasty
Following mammography, there is a considerable improvement in the breast contour, which may be due to the presence of the breast, according to the proposed and the technique used. In general, the goals are decreased sagging of the breasts, beautification of the cervix, which is more projected, elimination of ptosis, increase or reduction of breast volume with firm and steep breasts, increase of self-esteem among other aspects.
However, the result is not definitive. Loss for years, but certain factors such as pregnancy, excessive weight gain, genetic inheritance beyond the natural aging process may influence over time.
Plastic Surgeon Edmar da Fontoura Lopes (CRM 229,730), titular member Plastic Surgeon André Eyler (CRM-SP 51769), member of the Brazilian Society of Plastic Surgery
Plastic Surgeon André Eyler (CRM-SP 51769) RJ: 667,862), member of the Brazilian Society of Plastic Surgery and American Society of Plastic Surgery
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