Gel breast implants. Breast augmentation. Breast implants, why are they dangerous? The course of the rehabilitation period

In this article, we will do without digressions into history. The only thing that matters is the generation of implants used. Modern third-generation implants are significantly different from those implants that were used 7-10 years ago. They differ both in the materials used and in a number of characteristics that determine the service life and comfort of using products.

The main differences between third generation implants

• The use of a fundamentally new silicone gel.

It is also called cohesive gel or paragel. Such a gel adheres to the implant shell and, if the integrity of the prosthesis wall is damaged, remains in the prosthesis cavity. Silicone gel from implants of previous generations could freely migrate from a ruptured prosthesis and spread through the intermuscular spaces to the arm, back, and along the anterior abdominal wall with the formation of silica. Silicomas can only be removed surgically.

• The use of a new type of silicone shell implants.

Ever since the implants of the first and second generations were installed, there has been an opinion that breast prostheses should be changed every five years. In early prostheses, the silicone wall was worn out due to constant flexion and extension during respiratory movements of the chest. Modern silicone shells also wear out, but this happens much more slowly.

So much so that it is enough for one and a half human lives. That is why the question “How often should implants be changed?” now we can safely answer that a planned replacement is not provided, this is no longer necessary. An exception may be a serious chest injury, in which the prosthesis capsule may crack or rupture.

• Absolute impermeability of the shell.

Modern silicone implants do not decrease in size due to the penetration of silicone gel through the shell. This is the merit of the shell, which has three or more layers and the so-called barrier layer and the gel itself, which does not have fluidity.

• High elasticity of implants.

To install even a very voluminous implant of the third generation, a skin incision of only 3-4 cm is enough.

• The lineup.

There are so many shapes and sizes of implants that you can choose the optimal prosthesis for any woman and at the same time honor the features of her physique.

Video: Implants for breast augmentation

Types of breast implants

According to the filler, prostheses are divided into:

• salt prostheses;
• silicone breast implants;
• breast prostheses with biocompatible hydrogel;
• prostheses filled with silica gel balls;
• complex prostheses.

Salt Implants

Salt prostheses are cheaper than silicone ones, therefore they are still in demand on the market, despite their shortcomings. The disadvantages include the fact that when transfusing the liquid in the implant, splashing and gurgling can be heard at a distance. Such a long presence on the market of saline implants, with all their shortcomings, can be explained by a large number of press reports about the consequences of breast augmentation with silicone and about the dangers of silicone for the human body.

In the States, a moratorium has even been introduced on the use of silicone implants for cosmetic purposes until such time as their harmfulness is proven or refuted.

Already by 2006, the absolute safety of silicone endoprostheses was proven and the moratorium was lifted. But rumors are still being reprinted from one yellow edition to another.

Bioimplants

The hydrogel is a substance based on a natural polymer - carboxymethylcellulose. Breast implants based on hydrogel are not inferior in elasticity to silicone prostheses, they are more expensive, but they have their drawbacks:

• the hydrogel flows out of the implant cavity when the wall is damaged;
• Gradually, such implants "dry out" - they lose their volume due to the seepage of fluid through the shell.

Silicone gel implants have been developed to reduce the weight of the prosthesis and thus stop breast drooping (mastoptosis). The weight of the new implants is almost a third less than conventional silicone prostheses of a similar volume.

Complicated in structure, prostheses are a two-chamber structure. The outer chamber contains silicone gel and the inner chamber contains a saline solution. Complex prostheses are valve and valveless. Valve prostheses are most often used to enter them through a skin incision in the navel. After the implants are in place, they are filled with sterile saline. Their convenience is that during the operation, due to the ability to dose the introduction of liquid, it is possible to change the volume of prostheses in order to obtain a symmetrical breast of a beautiful shape.

This is the disadvantage: if more fluid is injected, the prosthesis will feel too tight to the touch and will not create the illusion of a completely natural breast.

According to the quality, there are two types of silicone gel: standard cohesive and high cohesive. Highly cohesive gel does not have the ability to flow, but at the same time fully retains the elasticity inherent in the tissues of the natural breast. It is also called a shape memory gel, since after curing the gel always restores the shape that was once given to it. The gel retains its shape even when the implant shell is damaged. The highly cohesive gel is only used in anatomical McGan implants. Produced according to the form:

• round implants;
• anatomical implants;
• high profile anatomical implants.

Drop-shaped anatomically shaped implants. If you put a conventional anatomical implant and a high-profile implant next to each other, it turns out that the second one has a much greater thickness. Accordingly, the increase in the volume of an implant with a high profile will be more noticeable visually. By the nature of the surface, implants are:

• smooth;
• textured;
• with a spongy surface structure.

Textured implants have bumps or villi on their surface. They are needed so that the connective tissue capsule, which in any case develops around foreign bodies of the body (and the implant is a foreign body), when compressed, presses the villi of the implant, but does not deform the implant itself.

The use of implants with a spongy surface structure reduces the likelihood of rotation or displacement of the implant. The connective tissue grows into the spongy structure of the shell and perfectly fixes the implant in one place. By size, breast implants are:

• fixed;
• adjustable.

Fixed are non-valve prostheses, the volume of which cannot be changed during surgery. Regulated have a valve through which saline can be injected into them.

How to determine which volume to choose

• Breast implants are measured in cubic milliliters.
• One size is approximately 150 cubic milliliters.
• To determine the size of the breast after surgery, do not forget about the size that you have now. This means that if you chose 150 ml implants, and your own breast is the second size, then after the operation you will get a strong C grade.
• There are implants of various volumes, which can differ from each other by 10 ml. In order to choose the optimal size for their patient, plastic surgeons often use special computer programs that accurately simulate the results of breast augmentation depending on the shape and volume of implants used.

Best before date

Manufacturers provide a lifetime warranty on their products. In order to protect yourself, you need to overcome the desire to save money on implants. Currently, among the clients of plastic surgeons, there is a vicious practice when, in order to save money, implants are bought not in a clinic or from an official representative of manufacturing companies, but in firms with a dubious reputation and breast prostheses from unknown manufacturers. Unfortunately, breast implants are not the case when you can save on a well-known name or brand.

You don't have to look far for examples. Peep's implant scandal has been unabated for several years now. In short, the implants were filled with technical silicone, and their shell did not provide complete tightness. Such implants turned out to be dangerous for those women to whom they were installed.

Now in all those countries where Pip implants were sold, clinics are looking for women who received them and are replacing prostheses. The exact number of such women is unknown.

Video: About the types of breast implants

The prostheses are so dangerous that a number of countries finance the replacement of implants for their citizens. This is done by France, Venezuela, Israel.

As it turned out quite recently, the number of dangerous implants may be much larger than expected. And they could be installed even after a ban on their sale and use was issued. It so happened that intermediary firms sold Pip implants under their own name M-implants.

In order for the new breast to bring only positive emotions in the future and not to care about the consequences of installing low-quality prostheses, it is better to choose a manufacturer with a worldwide reputation, which does not benefit from losing sales markets for the sake of one scandal.

What are the contraindications for hormonal breast augmentation? Details in the article -. How is breast augmentation performed with own fat? How many stages does the procedure go through? Read all about it. Do you think it is possible to enlarge breasts at home? Details at the link.

Manufacturers

We will dwell on the manufacturers of breast prostheses and the main characteristics of their products in more detail.

mcgan

McGan Medical is part of the Inamed transnational holding and is the world leader in the production and sale of thoracic endoprostheses. The company's factories are located in the USA and Ireland. In 2007 McGan merged with Allergan Inc. The company formed after the merger became Allergan, and McGann remained as a product trademark. McGan's breast implants are high-end products. This is due to a large number of prostheses of different sizes and shapes, as well as to the properties of the implant shell, which prevents the rotation and displacement of prostheses after surgery.

Implants McGan have International quality certificates ISO 9001 and ISO 9002, Certificates of the European Community EN 46002 and CE 0459. In Russia, implants are certified by the State Standard and registered with the Ministry of Health. The official distributor of McGann in Russia is Medical Test.

Mentor

Mentor manufactures implants in factories in the US and the Netherlands. One of the advantages of Mentor breast prostheses is the low risk of developing capsular contracture, which develops in only 1.1% of cases.

Breast endoprostheses Mentor have European and International quality certificates, in Russia they are registered with the Ministry of Health. The official representative of Mentor in Russia is the Clovermed company.

Polytech Silimed

Polytech is the largest European company producing soft tissue implants for reconstructive and aesthetic medicine. In the European and Russian markets, the company presents saline, silicone and double-lumen implants, implants with a smooth and textured surface, as well as with a polyurethane foam surface. The official representative of the Polytechnic University in Russia is the Bonamed company.

How to choose an implant

In principle, the woman herself does not need to thoroughly understand the shapes and sizes of breast prostheses. It will be enough to choose high-quality implants, the manufacturer of which has a good reputation. To get the result closest to the natural shape of the bust, you need to follow a few simple rules:

• the height of the chest may slightly exceed its width, but the difference should not be significant;
• the chest begins at the level of the 3rd rib and slopes down, increasing the thickness;
• the lower pole is a well-filled oval;
• the nipple is the most prominent area of ​​the breast when viewed from the side;
• breast thickness (the distance from the chest to the nipple) should be approximately one third of the full height of the breast (from the level of the 3rd rib to the lower pole of the gland).

It is very difficult to independently select implants in such a way as to comply with all or at least most of the above parameters, correlate them with the structural features of the body, such as the width of the chest and others.

Video: Breast plastic surgery, types of accesses and implants

It is better to trust the plastic surgeon, who needs to clearly convey what kind of result you want to get after the operation. And he himself will decide which implants are the best in order to make your dream come true.

Prices

The price range for breast endoprostheses is $570 to $2,200 each. In Russia, the average price of implants ranges from 20 to 45 thousand per piece. Manufacturers and distributors often do not advertise the prices of their products. Therefore, a number of clinics also make their own additional margin.

Here is an opportunity to save money. If the price of an implant in the clinic seems high to you, then you can contact the official representative of the implant manufacturer in Russia and purchase a pair for yourself at the price of a representative office.

Not always the cost of implants by plastic surgeons is overestimated. Some surgeons sincerely recommend this or that company, since it is their products that provide this surgeon with the best effect of the operation and delight clients with excellent results.

For many women, voluminous and elastic breasts are the object of many years of dreams, for others it is a forced necessity, due to purely medical indications.

In any case, modern surgical methods for installing breast implants, which are tightly integrated into the routine practice of any plastic surgeon, allow to solve all problems.

The essence of breast correction

Initially, liquid paraffin, silicone and other substances were injected into the area of ​​the mammary glands, which led to serious consequences and even loss of the organ. Subsequently, such methods were banned and are not currently practiced. Silicone-based implants were first created and used at the beginning of the second half of the 20th century.

They went through several stages of their development before they reached their current qualities. Plastic breast correction using silicone implants consists in their installation under the breast tissue or pectoral muscle and is its partial prosthesis.

The implant itself is a medical product consisting of a dense shell and internal contents. The shell is made of silicone material, can be smooth or porous. Fillers for the implant are either silicone gel of various consistency or isotonic saline solution.

A surgical incision is often made under the thoracic skin fold, sometimes in the periareolar zone (along the edge of the nipple) or in the axillary region. The patient is under general anesthesia during the procedure. The procedure takes on average about 1.5-2 hours.

Silicone breast before and after surgery is a huge difference in terms of their appearance. With an adequate and correct choice of the shape, size and method of implant installation, the mammary glands acquire a completely natural shape and beauty.

Variation in the placement of breast implants

There are several types of operational approaches to the establishment of implants. They depend on various factors, for example, on the initial location of the mammary glands, the degree of ptosis (omission), the state of the musculoskeletal apparatus and its tone, the elastic properties of the skin, the size of the subcutaneous fat layer, deforming changes in the ribs and sternum.

The implant can be placed in the following places:

• completely under the tissue of the gland;
• under the fascia of the pectoralis major;
• combined: one part under the pectoral muscle, the other under the mammary gland;
• directly below the pectoralis major muscle.

The technique of the operation may differ in the following options:

• the implant is installed ready-made and takes the necessary shape;
• only the implant shell is inserted, then a sufficient amount of filler is pumped.

With both technologies, they try to use the thinnest and shortest access possible, and the smallest number of sutures. The postoperative wound is sutured using a cosmetic type of sutures and does not require the installation of devices for additional outflow of fluid.

If necessary, breast augmentation is combined with other interventions: breast skin tightening, removal of excess fat layer, reduction mammoplasty (for congenital asymmetries, etc.).

List of required tests

Any surgical intervention requires a preliminary laboratory and instrumental examination, and the installation of silicone implants is no exception.

The list of requested analyzes and diagnostic tests is presented below:

• complete blood count with platelet count;
• general urine analysis;
• fasting blood glucose;
• biochemical analysis of venous blood;
• coagulogram (indicators of the speed and quality of blood clotting);
• Wassermann test, Australian (Hbs) antigen test;
• blood type, Rh factor;
• fluorography / radiography of the chest;
• mammography (x-ray of the mammary glands) for women over 40;
• Ultrasound of the mammary glands.

In the presence of concomitant diseases, the patient must visit the appropriate specialist to exclude potential contraindications for implantation.

Preoperative and operational periods

There are several rules that are recommended to start 1-2 weeks before surgery.

These include: giving up bad habits, especially smoking and drinking alcohol, observing a sparing, easily digestible diet (on the eve and on the day of surgery before general anesthesia it is strictly forbidden to eat and drink), temporary cancellation of drugs that have the property of thinning the blood, and hormonal drugs (only after consultation with your doctor).

In addition, before the operation, the results of the research are evaluated, the need for this or that method is justified, the woman is given explanations about all the advantages and disadvantages, as well as the possible risk of complications. During the operating period, the surgeon performs a preliminary marking of the future incision in two positions of the patient: standing and sitting.

The woman is then taken under the control of an anesthesiologist who provides general anesthesia and is by her side during the plastic surgery. What silicone breasts look like before and after surgery can be evaluated by numerous photographs of patients. By following all the rules and principles of implant surgery, you can achieve amazing results and significantly improve the quality of life.

Silicone breast: reviews and rare complications

It should be remembered that not all women are shown arthroplasty of the mammary glands.

Common diseases for which plastic surgery cannot be performed are:

• malignant oncological processes of any localization;
• acute infections;
• pregnancy and breastfeeding period;
• blood diseases with clotting disorders.

In addition, the operation is not performed on persons under the age of 18.

The course of the rehabilitation period

The recovery period usually does not take long. With a successful course of plastic surgery, a woman can be discharged home the very next day.

Special pressure bandages are applied to the mammary glands. During the first week, the patient may experience pain in the area of ​​the postoperative wound due to swelling and mechanical damage to the soft tissues, as well as a feeling of skin tension. In this case, painkillers (analgesics, non-steroidal anti-inflammatory drugs) are prescribed.

On the 7th-10th day, the sutures are removed, a dense bright red stripe remains in place of the scar, which then turns into a thin, barely noticeable line. The entire month following the operation, the woman must wear compression underwear. This is necessary to improve blood circulation, the disappearance of edema and accelerate the formation of a fibrous capsule around the implant.

It is advisable at first to limit physical activity, sports, do not lift weights, give up hot baths and saunas, sleep on your side and back. About what kind of recovery process characterizes silicone breasts, the reviews of most women boil down to one thing - the safest and most successful due to the implementation of all recommendations.

Possible postoperative symptoms

In the early postoperative period, in addition to pain, some complications may occur: subcutaneous hematomas (hemorrhages), infectious inflammation of the wound, loss of skin sensitivity in the affected area.

The hematoma, as a rule, resolves itself, but if it is located more deeply, then additional drainage may be required.

When infected, body temperature rises slightly, pain in the wound, redness, and swelling increase.

In such situations, broad-spectrum antibiotics and local treatment of sutures with antiseptic solutions are used. Violation of sensitivity does not require any treatment, as it recovers on its own within a few months.

Rare Complications

In women with silicone breasts, reviews do not mention serious violations after surgery. But, despite this, they have a place to be. Among the rare complications include the displacement of implants, their rupture, the development of contractures, seroma, violation of the integrity of the mammary ducts of the gland.

Displacement of the implant to a small extent is almost always observed. However, in cases of violation of the mode of wearing compression underwear, early loads, the displacement can be significant and lead to the need for a second operation. The appearance of cracks, ruptures and other defects in implants is possible when using low-quality models, after wearing them for a long time. Modern implants have a two-layer shell and silicone filler, which, even in case of injury, does not spread and does not leave the product.

Any organism perceives the implant as a foreign body. That is why a capsule of connective tissue is gradually formed around it.

However, for the majority, this does not appear in any way: the chest is still soft to the touch and has a natural shape. In a small percentage of women, for unknown reasons, the fibrous capsule can compress and deform the implant, which requires additional intervention. A seroma is a cavity near the implant in which serous fluid accumulates.

It visually disproportionately increases the size of the breast. Eliminated by suction of the liquid with a syringe under ultrasound guidance. Damage to the ducts of the gland is observed only in two cases - if the incision was made around the nipple and if the implant was placed under the tissue of the gland. Unfortunately, these changes are irreversible.

Over the past 20 years, the field of aesthetic surgery has been actively developing. Increasingly, it is the fair sex that resort to plastic surgery. Of course, the leading positions are occupied by operations to increase the mammary glands. Only during 2017, more than 156 thousand of these surgical interventions were performed.

Why do you need mammoplasty

The main criteria for breast correction:

1. The desire to have a beautiful and taut bust shape.
2. Elimination of the consequences of injuries.
3. Correction after operations.
4. Elimination of the consequences of incorrectly performed plastic surgery.
5. Correction of congenital irregular shape of the mammary glands.

All the ladies who are going to change the shape and size of their breasts are interested in the answer to the question of what breast implants are better. The doctor will help with the choice, as well as provide the following information regarding implants:

• Their filling.
• Shell material.
• The form.
• Location in the region of the mammary glands.
• Manufacturers.
• The size of the implants.
• Risks and complications.
• Rehabilitation.

Breast implants are prostheses made from a biocompatible material, which are a shell filled with a specific composition.

Filling of implants

There are several drugs that are used in mammoplasty to fill the shell of implants.

1. Saline solution.

Implants filled with this drug appeared in 1961. Ingredients: shell made of silicone material and sodium chloride solution inside. The breast implant shell is filled with saline before or after surgery.

The disadvantages of such products are:

• Possibility of rupture or damage.
• Change in the shape of the breast some time after the operation.
• Softness.
• Unnatural.
• The sound of the movement of the solution.

If saline implants rupture or lose their shape, they must be replaced.

Among their advantages, only a small incision and minimal scars after the operation can be noted, as well as good compatibility (if the solution enters the body after damage to the membrane, there will be no harm to internal organs). Currently, such implants are practically not used.

2. Silicone.

Silicone breast implants have been used since 1992. They are filled with Softtouch gel or cohesive silicone gel. Such materials have a dense consistency (comparable to jelly), so if damaged or ruptured, you should not be afraid of undesirable consequences. The gel retains its position and does not spread. Silicone implants are safe, retain their shape, which is why they are so popular. They also have other benefits:

• The natural appearance of the breast.
• Inability to determine the presence of an implant.
• No visible borders.

Of course, they also have disadvantages. Among the main ones are:

• The need to undergo mandatory MRI every 2 years to determine the integrity of the breast implant shell.
• Large incision during surgery.

Breast prosthesis shell

Like fillers, the shells of such products are also different.

1. Textured.

The surface has the smallest pores, so there is no risk of fouling of the implant with connective tissue. Such prostheses take root better, which reduces the possibility of complications. The implant with a textured surface holds perfectly in the breast and does not move.

2. Smooth surface.

Implants with a smooth surface are practically no longer used, since the likelihood of complications after their installation is high. We are talking about the formation of a shell of fibrous tissue in the chest or its deformation.

Shape of the breast prosthesis

There are two types of breast implants:

1. Round.

This form of implants is used to correct the shape and eliminate asymmetry in case of loss of breast volume, its “sagging”, for example, after breastfeeding or losing weight. They lift the chest and make it as voluminous as possible. The first impression is that with a round implant, the breast looks unnatural. But later, the soft gel of round implants takes on a teardrop shape under the influence of gravity, so it looks quite natural. They are easier to install than drop-shaped implants, and the cost is usually cheaper.

2. Anatomical.

Breast prostheses come in low and high profile. A drop-shaped implant differs from a round one in that its lower part is slightly larger in volume. It is believed that anatomically they are more suitable, as they are as close as possible to the natural shape of the breast.

• higher cost.
• tendency to round.
• Risk of displacement (if the lower and upper parts are interchanged, then this does not look quite aesthetically pleasing)
• Difficulty of installation.
• The possibility of the appearance of irregularities around the edges of the implant in thin girls.

This question is decided only by the doctor who performs the operation. The prosthesis can be located in such places:

1. Above the pectoral muscle, under the mammary gland.

It is recommended with sufficient volume of the mammary glands or with a noticeable sagging of the breast. There is a risk of the breast implant dropping, as well as the appearance of noticeable wrinkles. The edema subsides in a fairly short period of time, the rehabilitation period passes easily and quickly. The least traumatic option. Loads on the pectoral muscle (for example, during intense sports) do not deform the implants, but fouling with a dense connective capsule is possible, which makes mammographic examinations difficult. Also, with this installation of the prosthesis, its edges may be noticeable.

2. Under the fascia of the pectoral muscle.

This arrangement of the implant fixes it more reliably than in the case of installation under the mammary gland. This is observed for the reason that it fuses better with the fascia. Of the disadvantages - the likelihood of displacement of the prosthesis and the appearance of folds.

3. Under the pectoral muscle.

More complex and lengthy operation. After its implementation, time is needed for rehabilitation, since a partial dissection of the muscle occurs. It is considered the most favorable option in terms of possible consequences. Deformation is possible due to contractions of the pectoral muscle, but the passage of mammography is not difficult, a dense capsule is not formed. The implant is less visible.

Manufacturers of breast prostheses

The most commonly used silicone implants of such companies:

1. mentor.
2. Allergan.
3. Natrelle.
4. Eurosilicone.
5. Arion Polytech.
6. Ceroform.

As a rule, the website of each clinic indicates which manufacturers it works with. Prostheses of all manufacturing companies are quite reliable. Over the past 10 years, there has been a rather small percentage of patients who applied to the clinic because of any problems after mammoplasty.

Dimensions

In order for breast implants to look aesthetically pleasing, it is necessary to choose their volume correctly. Consider that approximately 150 ml of gel filler adds one size to that which a woman has. If breast augmentation with implants needs to be performed by 2 sizes, then more voluminous prostheses are selected. The filler in them should be 600 ml.

By size, endoprostheses are divided into fixed (installation of an implant of a predetermined size) and adjustable (the volume of the filler may change during the operation).

There are many types of breast implants. Their choice is influenced by such factors:

• Body size and shape.
• Desired result (volumetric version or more natural).
• The original shape and size of the breast.
• Physical activity and lifestyle of the patient.
• The presence of sagging breast skin (after feeding).
• Integrity and volume of breast tissue (after pregnancy, natural aging, or after previous diseases such as breast cancer).

There are cases when the filler is introduced into the shell during the operation. In this case, the surgeon makes an individual decision on the amount of gel to be injected.

Consider the option when the patient wants 4 With the available second size, this will not be a problem. An implant volume of about 300 ml is selected. If the breast is very small, not every plastic surgeon will be able to increase it to size 4.

Access for implantation

This medical term means where the incision will be made in the breast to place the prosthesis.

1. Inframammary (incision under the breast).

The most commonly used method for implantation. A 3-4 cm incision is made under the mammary gland. Due to this, an implant is placed. The main advantage of this access is the simplicity of the operation, but the contours of the breast implant may be exposed. But it is possible to use implants of any shape and size. This is the least traumatic method for breast tissues.

2. Periareollar (incision along the edge of the areola).

Almost invisible cut. It is produced along the border of the skin of the chest and areola. An implant is placed through the resulting incision. The main advantage of this access is that the scar is practically invisible, and implants of both anatomical and round shapes can be installed. The disadvantage of the method is that with a small size of the areola, the installation of an implant is impossible.

3. Axillary (incision in the armpit).

The incision is made in the armpit at a right angle to the arm. Technically, this installation option is more complicated than the previous two, so the main advantage of axillary access is the absence of a visible scar on the chest. The main disadvantage is the complexity of the operation. In this way, only round-shaped implants can be installed, and anatomical ones are difficult to position correctly. There is a risk of the implant moving up.

4. Transumbilical (through the navel).

This method is now practically not used due to the complexity of its implementation. It consists of making an incision inside the navel. The method has many disadvantages, for example, the possibility of improper placement of prostheses, the installation of only round-shaped implants filled with saline. The advantages are the absence of a scar on the chest.

The recommendations of plastic surgeons in choosing implants are approximately the same. They say that it is possible to choose an implant and the installation option on your own, but it is better to consult a specialist, since there are quite a lot of nuances of a future operation that affect what shape, size, and company to choose. The doctor and the patient must come to a joint decision about all factors. At the moment, in many clinics there is a 3D modeling that allows you to evaluate the expected result.

Choice of clinic

We will also consider the issue of choosing a clinic and a specialist in mammoplasty in Moscow and in the regions of Russia. The larger the city, the more clinics offer such services. It is often easy to get confused in such a variety, because only in Moscow mammoplasty is performed in 185 clinics. You need to take the choice responsibly, because there is a risk that instead of beautiful breasts you will get health problems and litigation. The fundamental point for making a decision should not be the cost of the service, because a job well done cannot be paid low. The average cost of breast augmentation with implants is from 150 to 450 thousand rubles.

The main criteria for choosing a clinic:

1. This institution has the necessary permits, specialized licenses, and the specialists have completed the necessary training and have notarized copies of graduation from universities, as well as advanced training courses.
2. The operation is performed by a surgeon, as well as a resuscitator and an operating nurse.
3. The cost of services includes post-operative care and supervision.
4. The clinic is quite well-known, respected in medical circles and has good reviews from patients.
5. Availability of the necessary equipment, especially intensive care and resuscitation devices.
6. You are asked to pass the necessary tests and examinations, thoroughly check your health before an operation is scheduled.
7. The doctor tells in detail about the operation, about possible complications.
8. If several clinics refuse to perform mammoplasty for medical reasons, do not look for the one where they will help you, as there is a risk of encountering non-professionals.

Risks of mammoplasty

This operation is classified as complex. After it, the following undesirable consequences may occur:

1. Deformation of round breast implants. It occurs due to an incorrectly installed implant, as well as due to the fact that the patient does not wear compression underwear.
2. Rupture of a silicone implant. Rare cases arising from defects in the prosthesis or in violation of the recommendations during the rehabilitation period.
3. The formation of a dense connective tissue capsule.
4. Loss of sensation in the areola and nipple. It occurs due to a violation of the integrity of the nerve endings.
5. Edema in violation of the outflow of lymph.
6. The formation of rough scars.
7. Accumulation of fluid or blood around the implant.

Rehabilitation

This process is one of the important factors affecting the final result. During the first day after the operation, it is necessary to be under observation in the clinic. The rest of the recovery period takes place at home. Within a few days, you need to take painkillers and antibiotics to prevent inflammation. You can't raise your hands. Sleeping is allowed only on the back. Be sure to take antibiotics, as well as drugs for possible thrombosis. The stitches are removed after two weeks. Special care for scars and wearing compression underwear is required. You can turn on your stomach only after six months. Physical activity is prohibited. Within three months it is not recommended to visit the sauna, gym, swimming pool.

According to statistics, plastic surgeons perform more than one hundred thousand operations to increase the size of the mammary glands per year. Modern breast implants can improve the size of the breast, slightly change its shape, eliminate signs of asymmetry and (sagging). It is not surprising that augmentation mammoplasty or breast arthroplasty is one of the most popular plastic surgeries in the world.

Classification of implants

Breast implants (endoprostheses) are medical devices made of high-quality material that is biocompatible with the tissue of the human body and designed to increase the size and improve the shape of the mammary glands in women.

Manufacturers produce several types of breast implants, which consist of an elastomeric (silicone) shell, but differ from each other in different shapes, sizes, surfaces and fillers.

Types of filler

According to the filler, implants are divided into:

Saline implants are so named because they are filled with saline isotonic sodium chloride solution. They are valved and valveless. The first type of implants is installed in the patient’s chest already filled, and the second is “empty” (they are filled with sodium chloride solution after placement in the breast tissues through a diaphragm, folding or twisting valve).

Advantages: relatively low (in relation to the price of endoprostheses with silicone filler) cost of products and the possibility of filling the implant with saline after installation, which allows making a small skin incision.

Disadvantages: softness of products and a high risk of rupture of the shell, after which the filler enters the soft tissues (this condition does not threaten human life, but requires an urgent re-endoprosthetics operation).

Silicone implants consist of a multilayer elastomeric shell and a viscous gel that fills it. They are distinguished by the density of the filler:

• standard cohesive gel - similar in consistency to jelly, well imitates the natural shape and texture of the mammary glands, biodegrades (absorbs) in case of rupture of the shell;
• high-cohesive gel - has a low degree of deformation and a solid structure due to which the breast acquires a pronounced artificial shape;
• gel “soft touch” – the consistency resembles jelly, when the shell of the prosthesis breaks, it does not flow into the surrounding tissues, it has a “memory effect” (quickly restores its shape when compressed).

Video: "Cohesive Gel Safety"

Advantages: high elasticity of the filler (over time, the prosthesis does not lose its shape), a wide range of models, minimal risk of capsular contracture development and “naturalness” of the material (it is almost impossible to identify the presence of silicone gel by touch).

Disadvantages: plastic surgery is traumatic (for breast augmentation with silicone, the doctor makes a relatively large incision) and the need for regular magnetic resonance imaging in order to detect possible violations of the integrity of the membrane (it is almost impossible to determine the presence of a defect by touch).

Bioimplants or hydrogel implants consist of a natural polymer - carboxymethylcellulose.

Advantages: bioabsorbability (in case of damage to the shell of the product and the hydrogel enters the tissues, it breaks down into glucose, carbon dioxide and water), minimal risk of developing contractures, a wide selection of sizes and shapes, permeable to X-rays, which does not complicate the examination of the mammary gland and chest organs cells.

Disadvantages: high cost (compared to silicone or saline endoprostheses), gradually such implants lose their volume due to fluid seepage through the shell.

Silica gel ball dentures are implants that are filled with microscopic silicate balls (compared to other types of fillers, they are much lighter).

Basic shapes, profiles and surface types

Breast endoprostheses come in two forms:

• round - used to correct and enlarge the mammary glands with signs of mastoptosis (round prostheses are easier to install and have a relatively inexpensive cost);
• anatomical (drop-shaped) - repeat the natural shape of the mammary glands, (most often anatomical prostheses are used to increase a completely flat chest).

Anatomical and round implants are produced with a low, medium, high, and extra high profile (projection). The required profile height is chosen by the plastic surgeon, it depends on the client's physique.

Endoprostheses are classified according to the type of surface, which can be smooth or textured. After installation, a smooth implant is overgrown with a capsule of connective tissue, the uncontrolled growth of which can lead to deformation and compaction of the mammary glands (capsular contracture), but it has a thinner and more durable shell.

Textured prostheses have a finely porous shell, which prevents the development of contracture, provides reliable adhesion of the product to the surrounding tissues and reduces the likelihood of its displacement.

Video: "Implant Shapes, Incision Options and Locations"

Volume and service life

The dimensions of endoprostheses are calculated by the volume of fillers (in milliliters). One natural breast size corresponds to 150 ml of saline or gel. The volume of implants can be fixed and adjustable (the surgeon fills the shell with a filler after the device is installed). In case of overfilling, the risk of visual wrinkling of the prosthesis increases and it becomes too hard to the touch, and in case of underfilling, the integrity of the product may be violated due to the constant friction of the folds.

The choice of the shape and size of the prosthesis takes place during a consultation with the surgeon, during which the doctor warns the patient that subsequently the implants will make it difficult to diagnose breast cancer. The doctor takes into account all the wishes of the client, the proportions of his body, the elasticity and firmness of the skin, the initial size of the breast, and then offers several options for endoprostheses. Some surgeons, before choosing breast implants, simulate the result of mammoplasty on a computer (3D breast modeling), this helps the patient to more clearly imagine the shape and volume of the mammary glands after the operation.

Modern manufacturers of implants guarantee a lifetime of products, but most often endoprostheses are changed every 10-15 years.

Pregnancy, gravitational changes (ptosis) of soft tissues, the consequences of aging of the body entail changes in the shape and appearance of the breast (asymmetry of the mammary glands appears, signs of mastoptosis or the development of capsular contracture), in such cases, the replacement of implants with new ones (breast replacement surgery) becomes necessary.

How to choose and which ones are better?

When choosing breast prostheses, the following factors should be considered:

• height and body weight;
• the initial volume of the mammary glands and their density;
• condition of the skin;
• figure proportions;
• chest volume.

On the market of medical devices for aesthetic cosmetology and plastic surgery, implants from different companies are presented, but the products of the following brands are most widely known:

• Allergan (USA);
• Mentor (USA);
• Polytech (Germany);
• Eurosilicone (France);
• Nagor (Great Britain);
• Arion (France).

It is impossible to say exactly which breast implants are the best, because products from different manufacturers have certain advantages and disadvantages, but prostheses manufactured by Mentor, Eurosilicone and Arion are considered the most popular today.

The results of the installation of breast implants: photos before and after

Estimated prices for breast implants

The cost of breast implants depends on their technical characteristics, the manufacturer and additional margins of the plastic surgery clinic. Patients receive information about how much breast implants cost at the surgeon's consultation (manufacturers do not disclose their prices). The table shows the estimated cost of endoprostheses depending on the filler.

The choice of endoprostheses for augmentation mammoplasty must be taken as responsibly as the final result of the procedure depends on the shape, size and texture of the product. It is very difficult to choose breast implants on your own, so you should trust the opinion of a plastic surgeon in this matter.

Breast implants allow the modern woman to get the desired, seductive bust shape. They are made from high quality materials. They are inserted under the skin or muscle during surgery. There are many types of implants that have their own advantages and disadvantages.

Breast augmentation is one of the most common plastic surgeries performed today. Why do the operation, each woman has her own motives. Silicone implants are used for augmentation.

Before surgery, a woman needs to be tested and examined to exclude possible contraindications. It is necessary to refuse breast augmentation with implants in case of diabetes mellitus, oncological diseases, poor blood clotting.

Breast augmentation is done under general anesthesia and can take up to three hours. The prosthesis can be installed in the chest either under the skin or under the muscle. When installing, incisions are made in the crease under the breast, along the extreme line of the areola, or an incision is made through the armpit.

Modern breast implants are made of high-quality material, durable shell and do not react with neighboring tissues, therefore lifelong wearing is ensured.

When inserting implants, you must follow all the recommendations of the surgeon. Recovery after surgery lasts approximately one month. At this time, it is imperative to wear compression underwear, limit physical activity, anti-inflammatory drugs and ointments can be prescribed for the rapid healing of scars.

The consequences of mammoplasty may not always be pleasant. Hematomas can form, the sensitivity of the nipples is lost, infection enters the postoperative sutures, and scars form. Sometimes the dentures themselves can become deformed, torn, or dislodged.

Breast implants are not placed during pregnancy. But if they are already installed and pregnancy has occurred, then this will not have any negative impact on its course. What can you say about the shape of the chest. Against the background of hormonal changes throughout all 9 months, there is an increase in the mammary glands and a high probability of developing ptosis.

The service life of breast implants is now significantly increased. How long you can walk with implants depends on many factors. If you choose a quality material, you can wear them all your life, but there is no guarantee that weight will not change over time, injuries will not occur, or other factors will not occur.

What are the best breast implants, a description of the varieties

To increase the breast, silicone must be chosen correctly. Which implants are best suited, you need to know their main characteristics. Breast implants differ in shape, size, have differences in the quality of the filler. They also differ in surface features.

• The shape of breast implants are anatomical and round. What does the bust look like after implantation?

With anatomic prostheses in the form of a drop-shaped bust, the bust will look as natural as possible in a sitting or standing position. Drop-shaped prostheses can be chosen by women with very small breast sizes. But there are also disadvantages. With anatomical prostheses, the silicone breast in the prone position looks unnatural, it is difficult to install, there is a risk that over time the prosthesis will move and the bust will deform.

Round implants are spherical in shape. They are able to greatly increase the size of the bust and are easily implanted. However, breast augmentation with round implants does not bring the maximum effect of naturalness and there is a risk of displacement of the prosthesis.

It is advisable to choose round silicone implants if you need to significantly increase the size of the breast, there is a strong ptosis or asymmetry of the mammary glands.

• You can put prostheses with a filler based on silicone gel or saline solutions.

Salt fillers were the first to appear. They are absolutely harmless, the incision is required to be minimal and the condition of the implants can be corrected even after the operation. The downside is the weak resistance to mechanical damage. Their service life is limited and they are unnaturally soft to the touch.

The latest developments in silicone gel manufacturing are: hydrogel (natural and pleasant to the touch, but not strong), Soft Touch gel (elastic to the touch and does not flow out after the shell breaks), cohesive filler (hard to the touch, but a strong shell does not allow leakage contents to neighboring departments if damaged).

• Breast implants are measured in milliliters.

The choice of size depends on the individual desire of the patient. It is believed that every 150 ml of filler increases the bust by one size, but the original size is also taken into account. For example, a woman with the first breast size, installing a 400 ml implant, will have a fourth bust size as a result.

If an implant with a volume of 300 ml is installed by a woman who has a second bust size, then as a result the size will be at number four.

From what shape, filler, texture was chosen, it largely depends on how much it costs to make a silicone breast. Round dentures are considered cheap. The price will be about 60 thousand rubles. Breast augmentation with anatomical implants will cost the most. The approximate price is about 110 thousand rubles.

• For breast augmentation, prostheses with a textured or smooth surface can be chosen.

The textured surface has small pores into which the connective tissue enters, and does not grow around the implant. This reduces the risk of complications. Prostheses with such a surface rarely move and deform the breast.

Smooth prostheses today in surgery are chosen less and less. After implantation, the connective tissue fuses around the prosthesis, forming a capsule. The silicone breast becomes dense to the touch and can be deformed.

Breast prosthesis companies

When choosing implants, you need to take into account the reliability and fame of the manufacturer. Below is a rating of the most popular and good new generation manufacturers.

1. America offers an extensive catalog of Mentor implants. Breast implants Mentor have an anatomical and round shape with a textured surface. The filler is a highly cohesive gel. Mentor prostheses are the most durable and resilient.

Among other advantages of Mentor prostheses, the following can be noted: the elasticity of the structure allows you to make small incisions on the skin, the shell consists of three layers, which provides increased strength, rupture is not possible, and a long period of use.

Mentor manufactures anatomical implants with saline filling, which allows you to adjust the shape during and after surgery. For those who are interested in how much Mentor implants cost, we can say that the average price is about 50 thousand rubles.

1. France is known for prostheses from Arion. Anatomical and round endoprostheses intended for breast augmentation with silicone are filled with a gel or hydrogel. The shelf life of implants is very long, and damage to the shell is minimal.
2. Germany offers varieties of Polytech prostheses. Gel-filled implants do not deform. The surface is textured or smooth.
3. Motiva ergonomix implants are often chosen, which have an anatomical shape with a textured surface. The shell consists of two layers, which provides high protection against tearing. Motif implants are filled with gel.

1. The English company Nagor offers a wide variety of shapes and sizes of breast prostheses. All of them have a long service life, are not damaged, and are safe. They mainly have a textured surface and a gel filler.
2. The leading position is occupied by the company for the manufacture of breast implants - Allergan. You can choose prostheses that take into account all the structural features of a woman's body. The shell consists of several layers, the filler is biogel. “I have been walking for the ninth year with Allergan implants. The chest is still beautiful, attractively shaped and pleasant to the touch.

Implants from these manufacturers will remain popular in 2018. The shape of the made breast becomes lush, voluminous. In most cases, it remains soft and natural to the touch.

Removal and replacement of breast endoprostheses

All women who are going to or have already installed endoprostheses are interested in the question of whether they need to be changed after some time. High-quality implants can last a very long time, more than 18 years. Therefore, there is no need to change after 10 years. Why might another surgery be needed? A second operation, when it is necessary to change the implants, can be carried out for several reasons.

• The appearance of a desire to change the size and shape of the breast.
• Replacement with a more modern material from which the prosthesis is made.
• It is necessary to make a correction due to a sharp change in body weight.
• The reasons may be related to age-related changes in the mammary glands.
• The fusion of connective tissues becomes a mandatory indication for changing implants. The woman begins to feel tightness in the chest and pain.
• Asymmetry of the mammary glands.
• It is also necessary to urgently change breast prostheses in case of their rupture or displacement.
• Development of deep wrinkles or stretch marks.

Removal of breast implants can be done permanently, but it should be understood that the appearance of the breast will be changed. The shape of the breast after the removal of implants does not change for the better. Stretch marks, folds appear, ptosis is observed.

The reviews note: “I removed the endoprostheses after a long time of use. The skin was stretched and the chest looked saggy, so I had to.”

How difficult it is to change implants depends on the reason for the need for this procedure. If the implants are installed correctly, and the replacement is only an aesthetic plan, then the procedure is easy. Since there is already a recess in which the old implant was placed, you only need to make adjustments. Recovery will take a little time.

If a second operation is performed due to complications, then it is longer and more traumatic. The recovery period is also long.