Hematomas after plastic surgery of the mammary glands. Induration in the breast after implantation. Possible specific complications of mammoplasty - ways to eliminate the consequences of breast plastic surgery. Life after surgery

Complications after breast augmentation, as a rule, can occur in the following cases:

• incorrect selection of implants (size or shape);
• errors of the surgeon during the preparation period during the operation (did not take into account something, placed the implant incorrectly, put the suture in the wrong way, did not “notice” the contraindication, etc.);
• non-compliance with recommendations during the rehabilitation period.

Incorrect selection of implants

When choosing an implant, the width of the chest (the size from the anterior axillary line to the sternum) and the thickness of the soft tissues of the mammary glands must be taken into account. What else matters and counts? A competent surgeon chooses implants taking into account a huge number of factors: the technical possibility of insertion, the location of the implant in accordance with individual characteristics, the height and weight of the patient, the degree of development of skin tissues, skin elasticity, the possible "behavior" of the breast in the future during pregnancy, feeding, with age and etc.

Large implants can cause overstretching and tissue thinning, which in turn leads to insufficient tissue coverage of the implant and visualization of its contours. In addition, “out of size” implants often cause breast ptosis (drooping) and look unnatural.

And undersized implants will not solve the problem of drooping breasts, since not the entire cavity will be filled.

What are the surgeon's mistakes during the preparation period and during the operation

The slightest inaccuracy or failure to take into account, at first glance, an insignificant factor can cause a number of complications:

• capsular fibrous contracture (dense capsule around the implant, deforming the breast);
• calcification (aseptic inflammation leading to the deposition of calcium salts in limited areas);
• violation of the integrity or rupture of the implant;
• specific deformity of the breast (the appearance of a double fold);
• displacement of the implant;
• visual fusion of the mammary glands (symmastia), etc.

All of the above complications are eliminated only by surgery - that is, a new operation is required.

Add to this such possible “troubles” as the appearance of scars, rupture of sutures, sepsis, the appearance of seromas or hematomas, allergic reactions ... Now you understand how important it is to choose a surgeon and a clinic?!

Complications after: breast augmentation is not happy

In this case, there is only one way out: contact another surgeon and correct the mistake. Be prepared that this will require a new operation.

You can avoid complications if you immediately contact a trusted clinic to an experienced specialist. In our clinic, mammoplasty is performed by surgeons with vast practical experience, all the wishes of the patient are taken into account, special attention is paid to the preparation for the operation. You can sign up for an initial consultation by any of the contact numbers.

The desire for ideal forms is natural for any woman. When what nature has given is not enough, and physical exercises, cosmetic procedures and other methods are ineffective, mammoplasty and other achievements of plastic surgery come to the rescue.

Breast augmentation is one of the most popular plastic surgeries that allows you to give the bust the desired volume and give a woman self-confidence. Quite often, immediately after it, the implants are located above the natural level. Such an unpleasant temporary effect usually occurs after the submuscular placement of silicone inserts. But by the end of the postoperative period, the bust should “sit down” in place. It usually takes four to six months for the breasts to return to their normal position. During this time, the pectoral muscles relax, the implant descends, the lower part of the mammary gland acquires a natural roundness, and the upper pole loses its unnatural fullness.

Non-synchronous lowering of implants

It is rather unpleasant for a woman to find out after that that she looks asymmetrical, since one of the implants turned out to be higher than the next one. This occurs when the silicone insert on the dominant side is lowered more slowly. This is observed due to the more pronounced volume of the pectoral muscles on the corresponding side in the "left-handers" and "right-handers". The problem resolves by itself during the first few months of the postoperative period.

Unnatural placement of the bust and excessive volume become even more noticeable due to swelling after the operation, which is especially pronounced when the surgeon places the implant submuscularly.

When will the implants come down?

After the operation, the implants take some time to "sit down" properly. Especially high and full chest looks at the peak of swelling in the first 2-3 weeks of the postoperative period. But after one and a half to three months, the swelling gradually decreases and the mammary gland looks more symmetrical and natural.

How to speed up the process?

In order for the implants to fall into place as quickly as possible, surgeons recommend using relaxing massages and exercises. Gentle pressure on the pectoral muscle along the implant margins is especially helpful, but care must be taken to ensure that the silicone insert does not move. You can perform massage movements three to four times a day during the first month of rehabilitation.

The fastest normalization of blood circulation and elimination of edema is facilitated by wearing compression underwear, which promotes engraftment of implants in the desired position.

Compression underwear helps to lower the bust into place faster, thanks to two fasteners. One of them is located under the breast, the second - above. The top clasp can be moved to the back to reduce pressure on the silicone insert.

For the entire rehabilitation period, you should forget about push-up bras or hard underwires, which interfere with the normal healing of the seams and the lowering of the chest into place.

What woman does not dream of perfect breasts? Only the one that has it by nature, and there are only a few such lucky ones. The rest have to accept and admire the chic busts of models in magazines or resort to the services of plastic surgeons.

It seems that everything is simple - I chose a form, lay down on the table, closed my eyes and woke up already a gorgeous woman. But ... before each operation, surgeons give you a paper to sign about possible risks and complications, although they can, of course, hide part of the truth from you, because the operation is not cheap and you can change your mind. But you yourself must carefully and with a cold head evaluate all the pros and cons, because implants also have negative sides.

Complications during the operation

With breast augmentation, every tenth operation proceeds with complications, and this is a large percentage for surgery, out of these ten, every tenth woman has to go under the knife again and correct what she has done, sometimes up to amputation of the breast. Moreover, these repeated operations are stretched for up to six months, which will not add to your beauty. The success of the operation depends on the experience of the surgeon, and he is unlikely to admit to you that you are one of the first with him.

Problems with the implant

Often, with an incorrect axillary incision, the asymmetry of the installation of breast prostheses is obtained. The implant then moves under the influence of the force of the muscles up and towards the armpit. You can fix this by re-operating with another doctor.

Another problem can be a duplicated bulge on the chest if the surgeon does not take into account the sagging and softness of the skin and breast tissue. If the implant is placed under the muscle, it will be ugly - the breast will be bumpy, in such cases a second operation is performed, moving the implant and placing it above the muscle.

Another nuisance after the operation - in addition to the sutures themselves,

Naturally - there may be a loss of sensitivity on the nipple and areola. It can take up to six months or more to recover, and sometimes, if the prosthesis compresses a branch of the intercostal nerve, sensitivity may not be restored at all.

Seromas and hematomas

These are accumulations of ichor or blood in the area between prostheses and body tissues. They do not become infected, but create discomfort and protrusions in the area of ​​​​the surgical suture and wound, and can temporarily distort the shape of the chest.

Seromas are formed in response to tissue injury by surgery and the introduction of a foreign body, blood plasma and lymph accumulate in the tissues, blood elements - lymphocytes and leukocytes. A protrusion similar to a hernia appears in the area of ​​operation.

A hematoma is an accumulation of blood around the implant from a vessel injured during surgery.

Sometimes at big x removal of blood with a stop of bleeding is required.

The most dangerous

Of course, operations are carried out in compliance with all the rules of sterility, but it is impossible to achieve 100% sterility during the operation. Therefore, there is always a risk of infection during operations, including when implants are inserted. If an infection forms around the prosthesis, even antibiotics will not help, it will have to be removed. And the complications of the infection should be treated in a surgical hospital.

A second operation is possible no earlier than six months later, then it will be possible to put a new implant. And for half a year you will have to walk around with one large, another small breast - rarely the infection is bilateral. Many women usually refuse a second prosthesis, so as not to experience discomfort.

Infection may develop immediately after surgery,

So within two months from the moment of the operation, the chances are especially high in women with omia and chronic diseases.

Breast-feeding

In principle, with the correct placement of the implant, prostheses cannot affect breastfeeding in any way. With accesses that touch the areola and nipple, this always interferes with feeding. If you plan to breastfeed in the future, discuss this with your surgeon in advance.

Injuries and deformities of the implant

Typically, old implants that have a thin wall, a defect in the manufacture of the prosthesis, as well as those patients who have had injuries during surgery, are subject to rupture. Implants also rupture due to compression and trauma.

When the contents of the implant leak into the breast tissue, inflammation and pain begin, and it becomes unpleasant to touch the breast. Such situations require removal of the implant and fluid from the breast tissue. However, if the implant is gel, even when the shell is damaged, it retains its shape.

The implant itself has no effect on the body, since it is chemically and biologically inert. This fact was confirmed by many years of research, which resulted in certification and permission for the use of implants in all countries of the world.

The reason for “rejection” can be health problems that the patient either kept silent about because of the fear of being refused the operation (for example, endogenous infection, autoimmune and endocrine diseases), or if an insufficient preoperative examination was performed. Former patients of regional non-specialized centers, including foreign ones, most often come to our clinic with such complications. The probability of "rejection" of the breast implant is excluded with a thorough preoperative examination and impeccable sterility of the operating rooms. The main thing is to report all health problems, honestly answer any doctor's questions and choose only specialized plastic surgery clinics or reconstructive and plastic surgery departments of well-known state centers with a good reputation.

How not to get breasts in the shape of a nesting doll (or what is a "double-bubble")?

"Double-bubble" - an ugly "matryoshka" effect, in which it seems that one breast is planted on the other. The risk of a double fold occurs during surgery by an inexperienced plastic surgeon who does not take into account the initial features of the structure of the mammary gland. In the “special risk group” are women with tubular, cone-shaped breasts (“goat breasts”) and mammary glands of the “regular shape” with naturally elevated inframammary folds. In such patients, the operation is supplemented with special stages: the elimination of tubularity, plastic surgery of the lower pole of the gland, and lifting. Fortunately, this defect is easily fixed. If a “strange” patient comes to us with a “double-bubble”, a second operation is performed: the breast tissue is carefully dissected and straightened on the implant, then a submammary fold is formed and fixed in an anatomically correct place.

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According to statistics, 97% of patients are satisfied with the result of breast plastic surgery.

Is asymmetry a risk factor?

Almost every woman has a slight difference in the size or location of the breasts. With a small size, the asymmetry of the areola is almost imperceptible. However, with an increase in the size of the bust, these features can be aggravated, and the asymmetry will become apparent. An experienced plastic surgeon carefully measures all parameters and takes into account both the different diameters of the areolas and the differences in location relative to the dimple between the collarbones.

The doctor, of course, immediately sees the asymmetry and warns about it. In this case, a timely correction is carried out: with a large asymmetry, implants of different volumes are placed, “equalizing” the sizes of the right and left breasts, or the diameter of one areola is reduced.

How does the "ripple" appear on the chest

"Ripples" - visible folds on the skin, sometimes occurring in thin girls due to a lack of soft tissue volume on the implant.

The cause of the defect lies in improperly selected implants that do not correspond to the physiological parameters of the patient's chest. The doctor is obliged to explain to the patient that the maximum volume with a narrow chest and in the absence of a sufficient amount of own tissues will cause problems. Sometimes "ripples" appear with a sharp decrease in weight, since the implants were selected based on the current parameters. When gaining mass and restoring the initial situation, the ripple disappears.

What to do if one breast is higher after plastic surgery?

Different breast height is a temporary phenomenon due to uneven postoperative edema from different sides. It often goes away without the intervention of a doctor, but sometimes one implant is fixed slightly higher than the other.

In such a situation, elastic bandaging is sufficient in the first weeks after the operation. In a later period, a slight correction of the implant location is carried out without a subsequent stay in the hospital. To prevent this problem, it is important to visit the surgeon on time and follow his recommendations.

Despite the many horror stories on the Internet, the intractable consequences of breast augmentation are rare. According to statistics, 97% of patients are satisfied with the result of breast plastic surgery. But even a small risk can be minimized by choosing the “right” clinic and an experienced doctor, such as

When a woman decides to undergo an operation to correct the shape of her breasts, she does not expect to get serious health problems instead of a beautiful result.

But any plastic surgeon will tell you about the possible risk of complications at the first appointment.

Sometimes postoperative consequences cannot be avoided, and the patient should be informed about all the complications after mammoplasty, as well as ways to solve them.

General idea of ​​the procedure

Mammoplasty is a surgical restoration of the size or shape of the breast by installation of specially designed implants in the mammary gland. The operation is performed under general anesthesia, the incision is made with a surgical scalpel.

To place a foreign body in the chest, it is necessary to form a pocket by separating the tissues from each other. Such an intervention does not pass without a trace for the body and requires certain reserves from it for a quick recovery.

The average rehabilitation period after mammoplasty lasts about 1-3 months, depending on the health of the patient. The full result can be assessed after six months.

Limits of the postoperative norm

Throughout the recovery period, a woman must follow all the recommendations of a plastic surgeon. This will minimize all possible risks.

Of course, it is impossible to do without postoperative complications. For example, about a week after the intervention, the patient will be disturbed by palpable pain. Such discomfort is the norm and is eliminated by specially selected analgesics.

You can not do without bruises and swelling - they are an acceptable consequence after mammoplasty, if not accompanied by severe pain and fever.

To control the situation, it is necessary to regularly visit a plastic surgeon throughout the entire rehabilitation period.

Complications and solutions

In some cases, a woman notices that the implant in the breast is not positioned correctly or any movement of the body brings unbearable pain.

Most complications develop in the first hours and days after surgery, but sometimes disorders can appear months or even years later.

If discomfort occurs, it is important to consult a specialist in a timely manner in order to immediately begin treatment, if necessary.

puffiness

With normal recovery of the body, the edema disappears 3-5 days after the operation. This is the maximum period for which excessive hyperemia and tissue swelling must pass.

Edema is pathological if:

• there was a feeling of bursting;
• the skin around the chest is very reddened;
• local subfebrile condition (skin is hot to the touch);
• increased body temperature;
• pain is not relieved by analgesics.

When such signs appear, you should urgently seek the advice of a doctor.

Excessive puffiness is eliminated by physiotherapy, the application of cooling compresses in a hospital setting. It is not recommended to act on edema on your own. If the pathology is accompanied by the formation of pus under the implant, surgical treatment is prescribed.

Seroma

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Seroma is the accumulation of lymphatic fluid in the subcutaneous fat. Such a complication can be provoked by incorrect actions of the surgeon during the operation, too large implants for a particular breast, or non-anatomical tissue dissection.

When to suspect gray:

• the chest is very swollen;
• a clear liquid is separated from the unhealed scar of the swollen mammary gland;
• the pain is permanent;
• scar reddened a lot.

To eliminate the serous fluid, drainage of the postoperative wound or its dissection is prescribed, followed by pumping out the biological material. Anti-inflammatory drugs are prescribed in the complex.

Dangerous hematomas

Hematoma is called an ordinary bruise, that is, subcutaneous hemorrhage. It may appear due to trauma to the breast that has not recovered, improper bleeding control during implant installation, and unskilled actions of medical personnel during the rehabilitation period.

Small bruises are normal and resolve on their own. But in some cases, medical attention is required.

When consultation is needed:

• the hematoma is very extensive, can spread under the chest or in the shoulder area;
• the symptom is accompanied by an increase in body temperature;
• the pain does not go away a week after the operation.

The first step is to stop the bleeding. To do this, the specialist uses hemostatic agents, drugs to lower blood pressure (if necessary) and the application of ice compresses.

In the future, an extensive hematoma must be removed using tissue drainage.

sagging chest

Sometimes sagging occurs a long time after surgery, as a natural process of tissue aging. But if we talk about complications, we should mention ptosis.

It is artificial and expressive. In the first case, sagging occurs due to an implant that is too small, in the second case, tissue descent is a feature of the body and its reaction to a foreign body.

How to determine ptosis:

• nipples are above average breast level;
• the mammary glands are strongly lowered down;
• the distance between the collarbones and the beginning of the chest has increased.

Correcting the sagging of the mammary glands is possible only with the help of repeated plastic surgery. The specialist must select implants that are larger in size and perform the operation based on the characteristics of the body.

Implant contouring

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This complication most often develops in those women who have too thin a layer of subcutaneous fat. When the implant is placed not under the muscle, but directly under the mammary gland, its contours can be seen through the surface of the epidermis.

How to define contouring:

• the contours of the implant can be seen visually and palpated;
• the chest protrudes unnaturally.

To eliminate such a complication, the specialist will suggest the introduction of special corrective fillers. In some cases, lipofilling is indicated.

This procedure involves taking sebum from suitable areas on the patient's body and then transplanting them into the chest area.

Implant displacement

Implant displacement is another unpleasant complication after mammoplasty. Most often it develops due to its incorrect selection of endoprosthesis or illiterate actions of the plastic surgeon during the operation.

How to determine offset:

• the implant protrudes unnaturally away from the main position;
• mammary glands look asymmetrical.

In the early stages, you can correct the situation by wearing a special corrective corset and a certain position of the body during sleep. Also, when the implant is displaced, all physical activity is temporarily excluded.

Inflammation, suppuration

One of the most dangerous complications is suppuration of the postoperative suture. This can happen due to non-compliance with the rules of asepsis and antisepsis during surgery, the patient's failure to follow the doctor's recommendations and improper treatment of the scar.

How the complication manifests itself:

• the chest is very swollen, burning;
• in a short time, body temperature rises to high levels;
• the skin around the breast turns red;
• pus is separated from the seam or nipple itself.

In the initial stages, inflammation can be stopped by taking antibacterial agents and enhanced treatment of inflamed skin.

If the process is not amenable to medical control, surgical intervention is prescribed.

Loss of sensation

In the first time after the incision on the skin, it loses its sensitivity. This is not a pathology and with the help of physiotherapy is quickly eliminated.

But sometimes the patient does not feel the breast tissue or the nipple itself for a long time. Such a complication occurs due to incorrect actions of the surgeon during mammoplasty, due to which the neural network can be damaged.

To combat the problem, the specialist prescribes a complex of physiotherapy and massage.

Capsular contracture

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After the implant is placed in the mammary gland, connective tissue begins to form around it. In the normal state, it does not exceed a tenth of a millimeter, and the growth stops there..

But due to the characteristics of the body, this process can progress, which provokes the formation of capsular contracture.

How to identify a complication:

• the endoprosthesis and its contours can be felt by hand;
• breast deformity occurs;
• seals, dents or defects appear on the mammary gland;
• when touched, the patient feels pain.

The second stage of capsular contracture is eliminated with the help of physiotherapy, massage, the use of vitamin E and a complex of anti-inflammatory injections.

Stages 3 and 4 are corrected only by surgery. To do this, the specialist completely removes the implant, removes the contracture and installs it again. Sometimes a smaller endoprosthesis is selected.

Rippling or skin rippling

Rippling, also called skin rippling, is a fairly rare complication after mammoplasty. This can happen due to the characteristics of the patient's body, the wrong type and size of the implant, as well as the illiterate actions of the surgeon.

How to identify the appearance of skin ripples:

• predominantly, the defect is noticeable when the body is tilted forward;
• peculiar folds appear on the skin of the chest, similar to fingerprints.

Most often, breast lipolifting is used to eliminate the defect. In some cases, the specialist may advise replacing the implant with an endoprosthesis with a denser structure.

Preventive measures

To minimize the risk of possible complications, first of all, you will need to responsibly approach the choice of a plastic surgeon.

The specialist must have the appropriate qualifications, have a diploma and certificates confirming regular professional development.

This will eliminate the problems that most often arise due to the wrong actions of the doctor during mammoplasty.

What can be done for prevention:

• wear corrective underwear for the entire recommended time (1-3 months);
• reduce physical activity to a minimum;
• do not lift weights;
• carefully treat the seam and the chest area with antiseptics;
• do not injure the mammary glands;
• regularly attend doctor's consultations until the tissues are completely healed;
• the entire rehabilitation period should not drink alcohol, smoke;
• take antibacterial agents after surgery as prescribed by the doctor.

With the right actions during the rehabilitation period after mammoplasty, most serious complications can be avoided.

Of course, some problems may appear due to the individual characteristics of the organism. But a good doctor will definitely warn about all possible troubles, based on the history of a particular patient.

The video provides additional information on the topic of the article.

Every woman dreams of a luxurious bust. But not everyone is lucky with the size and shape of their breasts. Not surprisingly, the services of plastic surgeons are in high demand. However, there are complications after surgery. They are rare, but be sure to familiarize yourself with the possible consequences.

What are the complications?

There are several types of complications that patients may experience after surgery:

• capsular contracture. During healing, the formation of capsules occurs. When they are very thick, overgrowth of capsules around the implant can occur. This is pathology. In addition, there is a deformation of the breast, painful sensations develop. When the prosthesis is made of a rough (textured) surface, the risk of this adverse reaction is reduced.
• Seroma. It can develop due to the accumulation of excess fluid between the prosthesis and the capsule. As a rule, accumulation occurs in the implant pockets that have appeared. This process is accompanied by inflammation, disturbances in the functioning of the endocrine system, and a decrease in immunity.
• Double bulge. This complication causes displacement of the implant located under the chest fold. It may be that the phenomenon goes away on its own, but in some cases reoperation is required.
• Rejection of breast implants. There is always such a possibility, since implants are foreign bodies in the human body. It has been proven by doctors that rough dentures never actually cause this reaction. Because of this, many modern companies produce these implants.

However, scientists have found that bad habits increase the possibility of rejection. They examined data from more than 15,000 women under the age of 60 who underwent breast reconstruction after mastectomy surgery. The main reasons for this rejection are obesity and smoking.

In the study, it was found that people who are obese increase the risk of rejection by 2 times. Moreover, the higher the degree of obesity, the greater the risk. But in smokers, this risk is higher and can start three times faster.

Some patients experience certain problems after mammoplasty. This article will discuss the most popular of them.

asymmetry- when one implant is higher or lower than the other. And also, if it is located closer to the center or to the side.

Sliding of the implant along the chest wall down - ptosis of the prosthesis. This happens more often with implants placed over the muscle.

- fusion of the mammary glands. This happens when breast implant pockets communicate with each other.

Problems with breast tissue.

Slipping of breast tissue from a fixed implant. Such a complication occurs with an initial significant stretching and volume of breast tissue.

Mondor disease- Phlebitis of the superficial veins of the mammary glands. In the treatment, anti-inflammatory drugs and a warm compress are used.

Thinning of the breast tissue as a result of age-related changes, pregnancy and breastfeeding can cause the implant to become more visible.

Decreased skin elasticity with age-related changes, abuse of sunburn and smoking, it can lead to sagging of the implant.

Top complications and problems with implants

Implant rupture. This becomes noticeable as the implant falls off within a few days. Although the saline solution is absorbed by the body without consequences, it is necessary to replace the implant within a few weeks so that the pocket in which it is located does not shrink. In the case of a silicone implant, the rupture can only be detected by ultrasound or MRI. Most implants today have a guarantee, which saves the patient from paying for a second operation.

- the formation of scar tissue around the implant. It can occur both on one and on both sides, and is accompanied by a change in shape, discomfort, and breast compaction. Rarely occurs with the installation of saline implants.

Dissatisfaction with the size of the implant(either too small or too large) is the most common reason a woman decides to have a second operation. But this problem is easy to avoid even at the stage of discussion with the doctor.

Combined problems.

Double bubble deformity. This complication creates the appearance that the patient's breast has grown to the top of the implant. This can be either a problem with the breast tissue or improper placement of the implant.
Ripples on the skin. It occurs as a result of changes in breast tissue (thinning). As a result, the implant becomes visible and easy to feel on palpation.

Solution of problems

No matter what problem arises after breast augmentation surgery, a solution can be found. There are general corrective procedures.

What can be done if problems arise after mammoplasty:
Replacement of implants. The surgeon changes the implants to others smaller or larger, of a different shape, with a different surface, or changes saline implants to silicone ones or vice versa.

Capsulectomy. Excision of the capsule around the implant. This is the only treatment. The new implant is placed partially under the pectoral muscle to reduce the impact on breast tissue.

Mastopexy(breast lift). The operation consists in lifting and fixing the mammary gland with the removal of the areola and nipple to a new position. The iron is set in the center to the required level. Then excess skin is removed, the optimal position and beautiful shape of the new breast are determined.

Simastia requires repeated surgery and the installation of a smaller implant.

Implants of a different size or shape solve the problem of asymmetry.

Related publications:

• Subglandular location of the implant (in front of…

Before breast augmentation surgery, the surgeon must not only explain to the patient the risks of surgery, but also make sure that her expectations regarding the aesthetic result are reasonable. Then the doctor takes linear measurements to determine the initial size of the breast.

The modern technology of preoperative 3D modeling allows more accurate measurement of breast volume, determining the location of the gland, assessing the projection and symmetry of the breast. With the help of laser beams, the breast is divided into several areas, the parameters of which are then used to create a three-dimensional image, which allows modeling the future breast, taking into account the implantation of prostheses of various sizes and configurations.

3D modeling also helps to predict in advance the position that the implants will take after installation. Numerous studies, for example, have shown that the volume of breasts achieved with high projection implants is 20-23% lower than advertised. Given these data, 3D modeling systems allow you to individually select the shape and size of the breast. In addition, thanks to such images, patients know in advance what their breasts will look like after surgery.

During the operation

To place the implant in the breast and straighten it, the surgeon must make an incision, and in a place where the future scar will be the least noticeable. The size of the incision depends on the type of implant and its location. For example, in the USA, the most popular is the submammary approach, the scar from which is hidden in the crease under the breast.

Many surgeons prefer submammary or periareolar approaches when installing implants. However, in the first case, there is a possibility that the breast will not be large enough to hide the scar underneath. In addition, according to the results of one study, patients with implants placed through an incision under the breast are more likely than others to undergo a second operation to correct asymmetry, ptosis or replace prostheses. The periareolar insertion method also has its drawbacks, such as the likelihood of a visible scar, a higher risk of capsular contracture, and reduced nipple sensitivity. A limitation for the use of this method may be that the areola is too small for implant placement.

Patients, on the other hand, often ask surgeons to install implants through the axillary approach, that is, through the armpit, since in this case the scar is less noticeable. However, despite its attractiveness from an aesthetic point of view, this method of placement does not always allow for accurate placement of implants and threatens with an increased risk of capsular contracture and damage to surrounding tissues.

To minimize the length of the incision and facilitate the placement of implants, the Keller funnel™ sleeve for non-contact placement of breast prostheses has been developed.

Breast implants are usually placed under the pectoral muscle or breast. When implants are placed under the muscle, the risk of capsular contracture is reduced, but patients with significant breast ptosis are more likely to develop the so-called “double bubble” effect, or double fold. In addition, due to the natural process of contraction of the pectoral muscle, implant displacement may occur. All these effects are excluded when installing an implant under the mammary gland. But with a deficiency of the patient's own tissues, the prosthesis placed under the gland is highly likely to be easily palpable or even visible visually. In addition, the stability of the position of the implant with this method of placement leaves much to be desired: it can rotate or fall below the crease under the breast. Placement of the implant under the fascia of the pectoral muscle reduces the risk of deformities, displacement, contouring and the formation of visible waves on the surface of the breast. But this approach requires considerable skill of the surgeon.

Also, some surgeons practice a combined implant installation method, in which the upper part of the prosthesis is placed under the pectoral muscle, and the lower part is placed under the gland. Among the advantages of this approach are the low risk of capsular contracture, the non-palpability of the implant, and a more natural breast shape. Some experts believe that the combined approach increases the likelihood of implant deformity and visible retraction of the pectoral muscle. However, this way of placing breast implants is becoming more and more popular.

Complications

• Seromas and hematomas
  Accumulations of blood and serous fluid are common complications after surgical interventions involving the formation of a cavity. Both seromas and hematomas can lead to swelling and tenderness. Hematomas form in 0.9-3% of cases, and their formation does not depend on the age of the patient, the type of implant or the surgical approach used. Seromas resolve spontaneously in most cases, but sometimes ultrasound-guided drainage is required.
• infections
  Breast augmentation through the armpit carries the highest risk of infection. This is due to the many manipulations required to install the implant. In addition to soreness and implant rejection, even moderate infection can cause capsular contracture. With regard to the use of systemic antibiotics, the results of various studies and reports on the effectiveness of antibiotic therapy before surgery are very controversial. Therefore, there is no unequivocal opinion regarding the significance of antibiotic therapy for the safety of breast augmentation.

• Capsular contracture
  This is a contraction of the fibrous membrane around the implant, which leads to painful, palpable and visible deformity of the breast. Capsular contracture is one of the most common complications after breast augmentation with implants. There are several ways to prevent the formation of capsular contracture, including irrigating the surgical pocket with an antibiotic solution and placing an implant under the pectoral muscle. To eliminate capsular contracture, various methods are also used: removal of the implant, capsulotomy, stretching of the capsule, reconstructive surgery using a cell-free dermal matrix. Non-surgical ways to reduce the manifestations of capsular contracture - capsule massage, ultrasound and shock wave therapy - are not effective in all cases.
• Systemic diseases
  As you know, in the United States in the period from 1992 to 2006 there was a moratorium on the use of silicone breast implants, the cause of which was the latter's suspicion of increasing the risk of developing systemic diseases. In the course of multiple studies, scientists have not been able to establish the relationship between the installation of silicone implants and the occurrence of symptoms of systemic diseases. Specialists have identified pro-inflammatory proteins that, when attached to the surface of a silicone implant, stimulate the formation of capsular fibrosis, and can also cause autoimmune diseases in patients with a predisposition to them. However, the exact relationship between such pro-inflammatory proteins and systemic diseases has not yet been established.
• Loss of nipple sensation
  Decrease in sensitivity or soreness of the nipple and areola are common consequences of breast augmentation. According to experts, the site of the surgical incision is a key risk factor for the formation of paresthesia of the nipple-areolar complex, the likelihood of which increases threefold when the implant is placed through an incision in the areola. Despite this, this method remains the most popular among patients.
• Lactation
  Many women who decide to have breast augmentation surgery are worried about how the implants will affect their ability to breastfeed in the future. Possible surgical procedures to eliminate complications such as infection or capsular contracture carry additional risks of damage to the breast. However, despite the fact that an experienced surgeon is able to minimize all possible complications after breast augmentation, the installation of implants increases the likelihood of hypolactation by 10%. As for the safety of breast milk, implants do not affect its quality in any way.

Patient satisfaction

Numerous studies have found that, on average, 99% of patients 1 month after breast augmentation surgery experience extreme satisfaction with its results. After 6 years, this figure is 95%. The level of satisfaction of patients includes an assessment of their own attractiveness, psychological state and sexual life.

But despite these high patient satisfaction rates, numerous studies have shown that the suicide rate among women who have undergone breast augmentation is almost three times higher than among women with natural breasts. The risks are especially high in the age group over 40 immediately after surgery or after a long time after it. Among the probable reasons for this relationship, experts point to the presence of significant psychological problems before the operation, unreasonable expectations from its results and psychological difficulties in the event of postoperative complications.

Many women who dream of breast augmentation or changing its shape do not dare to do this, fearing possible complications after surgery. For them, a beautiful bust remains a dream ...

Of course, there are complications after breast surgery, there is no point in denying this fact. For various reasons, complications occur after any surgical intervention, including after. But, as statistics show, if all the instructions of the surgeon are followed, complications after mammoplasty occur much less frequently than after other surgical interventions. If the percentage of negative consequences were high, aesthetic breast surgery would already be banned.

Whether complications will appear is determined by a number of reasons: the peculiarities of the anatomy, previous operations, the technique of plastic surgery, the body's reaction directly to the operation and the endoprosthesis, and, of course, how accurately all doctor's prescriptions are observed during the rehabilitation period. You need to know that the implant remains in the required position for a long time only due to the elasticity of the soft tissues surrounding it, which were injured during the operation. Only after 2-3 months, when the inflammation subsides, a connective tissue layer forms around the implant, which securely fixes it in the surrounding soft tissues. That is why during the first months after plastic surgery on the breast, it is necessary to wear compression underwear and follow all the instructions of the surgeon who performed mammoplasty.

BREAST COMPLICATIONS: WHAT ARE SIDE EFFECTS

By the way, not everything that happens to the mammary glands in the postoperative period is complications. There are direct complications that do not necessarily have to happen, and side effects that are present in everyone and go away over a different period of time.

Side or undesirable effects of surgical intervention are usually called symptoms that appear in the operated area always and in everyone. These undesirable effects occur due to tissue injury and will certainly disappear as the wound heals. But the rehabilitation period for different people can last for different times - this is determined by the individual characteristics of the organism.

The inflammatory process is the body's natural and indispensable response to any wound or injury necessary for tissue regeneration. Such a reaction occurs even if there is no infection - this is aseptic inflammation.

COMPLICATION OF THE BREAST PHOTO

HOW THE COMPLICATIONS MANIFEST AFTER BREAST ENLARGEMENT OR ANY OTHER MAMMOPLASTY

After any surgical procedure, the following local undesirable effects occur:

• Edema - is formed by the end of the first day after the operation and gradually increases, reaching the maximum size by 3-5 days. For 2-4 days, the edema remains unchanged, and then slowly subsides. On the 3-4th week after surgery, the edema disappears, but from time to time it may reappear: in the second period of the monthly cycle, after taking salty and spicy foods, after drinking alcoholic beverages, as a result of high physical activity. That is why only 3-4 months after mammoplasty, you can see its final result.
• Consequences of vascular damage: bleeding, bruising, hematoma. They can occur immediately after surgery, or only after a few days, gradually becoming noticeable against the background of edema. The bruises go away within a week. Hematomas go a little longer, and this period largely depends on their size.
• Redness in the area of ​​the seams (spots or in the form of "marbling"), which occurs during the first days, goes away on the 2-3rd day. If intense redness appeared later, then an infection has occurred and must be treated separately.
• Discomfort or pain, manifested with different strengths. How much pain is felt is determined by each individual's individual pain threshold. But in any case, the pain is felt more strongly after the operation, which is accompanied by detachment of the pectoralis major muscle. Discomfort and pain can last 3-7 days, but they are removed with the most elementary painkillers.
• A change in sensitivity, and it can be either an increase or a decrease. There are a huge number of nerve endings in the soft tissues of the breast, especially near the nipple. They can be injured during surgery or squeezed by edema later. After 3-6 months after surgery, the sensitivity is necessarily restored.
• Formation of a postoperative scar at the incision site. It is necessary to ensure that the seams remain dry, and for the first 7-10 days treat them with a solution of potassium permanganate. Later, starting from the 3-4th week, the healed sutures should be lubricated with silicone ointment (Dermatix, Kelokot) or covered with Mepiform adhesive tape. This must be done for 3-4 months until the seams become pale.

Let's take an example of what happens to the simplest wound, even if it's a finger cut. Even a very small wound heals in 7-14 days - the longer it is, the deeper and larger it is. Inflammation will be in any case: redness, swelling, possible bruising or discharge, and, of course, pain. Then there is a slow cleansing and tightening of the wound, and in the center there will be a scar (an area of ​​​​connective tissue) - it is formed if the epidermis does not have time to “converge”. Marginal epithelization - the so-called regeneration of the upper layer of the skin - can be 5 mm. If the damage occupies a large area, then a scar is necessarily formed, since the cells of the connective tissue are more active and divide more quickly. At first, the scar is very dense and bright red in color, the sensitivity in this place is impaired (it is stronger or, conversely, less). Little by little, the scar becomes pale and decreases in size, it becomes softer - this is how it “ripens”, and over time it is completely or almost invisible. You need to know that if you take sunbaths while the scar is bright red, it becomes pigmented. Perhaps, over the course of 1-3 years, the pigment will lighten, or perhaps not - it may remain forever. Such a sequence of the recovery process (healing of any wound) is absolutely natural and normal. But if there are disturbances in the functioning of the connective tissue and the immune system in the body, hypertrophic and keloid scars are formed.

BREAST COMPLICATIONS: WHAT ARE COMPLICATIONS AFTER BREAST ENLARGEMENT

Complications after surgery are manifestations that occur in the postoperative period and are the result of an operation or an atypical reaction of the body to a foreign body (implant). The development of complications is not a natural process at all.

Reasons that can lead to the development of complications after breast surgery:
1. Pathological reactivity of the organism, that is, individual characteristics present in any organism.
2. The response of the body to the endoprosthesis, which is a foreign body.
3. Previous surgical operations.
4. Non-compliance by the patient with the terms of walking in
5. Non-compliance with the rules established by the doctor in taking medications, diet, lifestyle.

TERMS OF COMPLICATIONS AFTER MAMMOPLASTY

Taking into account the timing of occurrence, all complications after surgery are usually divided into early and late.

• Early complications occur a couple of hours after the operation or within 5-7 days after it.
• The appearance of late complications is possible 7 or more days after surgery.

TYPES OF COMPLICATIONS AFTER BREAST ENLARGEMENT

List of complications that may occur after breast surgery:

1. Hematoma It is formed when, due to bleeding from damaged vessels, blood accumulates in the soft tissues surrounding the implant. The appearance of a hematoma in the early postoperative period can be triggered by an increase in blood pressure, it can appear due to blood clotting disorders or against the background of diabetes mellitus. To prevent the formation of a hematoma, drains are placed in the implant bed - they must drain fluid on the first day after breast surgery. In later periods, the formation of a hematoma can be caused by premature cessation of wearing compression underwear, violation of the regimen recommended by the doctor, high physical activity, and sex in the first postoperative days. Since the hematoma may result in displacement of the implant, it must be eliminated - for this it is necessary to do a puncture and aspiration, and sometimes a revision of the postoperative wound.
2. Infection of the postoperative wound manifested by high body temperature, increased edema, redness around the seam, pain. As a preventive measure during surgery, antibiotics are administered.
3. Seroma- this is the accumulation of tissue fluid around the implants. It occurs due to the dissolution of a volumetric hematoma or the reaction of soft tissues to the implant. Since the seroma can become infected or lead to displacement of the implant, it must be removed - this is usually done by aspiration or drainage.
4. Rotate or implant displacement can occur due to a nearby hematoma or accumulated seroma, as well as in violation of the regimen. The consequence of the displacement of the implant is a change in the shape of the breast. An operation is needed to correct the situation, but it can be done only 3-6 months after the previous one.
5. Allergy, occurring on silicone implants is an extremely rare phenomenon.
6. Big postoperative scar (hypertrophic or keloid) are rough, thick and clearly visible scars. Such a scar can form if the patient has a genetic predisposition to this - a tendency to hypertrophy (thickening). To eliminate hypertrophic or keloid scars, additional treatment is required, and preventing their appearance is much easier: when the wound heals, you need to use compressive bandages, drying antiseptics and healing drugs.
7. Wavy, rippling, rippling, contouring edges implant- these are all the names of one type of complication, in which the implant becomes "wavy", and its contours are clearly visualized. Contouring and waviness may be noticeable when the chest is in a relaxed position, or only during movements or when the torso is bent. This type of complication occurs more often in thin women with a small volume of integumentary tissues and poorly developed breasts if they have had a soft gel endoprosthesis. To remove ripple, you need to do a second operation and install an anatomically shaped implant filled with a dense gel or with a polyurethane coating, and simultaneously do lipofilling.
8. Secondary If natural causes lead to the appearance of primary ptosis, then augmentation mammoplasty leads to the formation of a secondary one. The fact is that the chest, as a part of the body that is in limbo, is affected by gravity: the greater the weight, the stronger the force of gravity. Secondary ptosis requires surgical correction.
9. "Ball in a sock"(ball in sock) or accelerated development of secondary ptosis. The occurrence of secondary sagging often occurs if the implant is located under the mammary gland, especially if the original ptosis was present before mammoplasty. After an increase in the volume and mass of the breast, it quickly descends along with the endoprosthesis. You can correct the situation by performing a second operation: you need to reinstall the implant under the pectoralis major muscle and make a breast lift on the prosthesis.
10. Prosthesis ptosis(bottoming out) - sliding of the implant down the chest wall. If during implantation there was a destruction of the submammary fold without its subsequent fixing, then the implant can go below it and slip out. And the chest will remain in its original state.
11. Rupture of the implant shell- an extremely rare phenomenon, the cause of which can be trauma to the chest. If the gap is spontaneous, that is, it happens without an external message, the manufacturer provides a new implant for free. Absolutely all companies producing silicone endoprostheses provide a lifetime warranty period for them.
12. "Double bubble"(double-bubble). After augmentation mammoplasty, a transverse strip is formed on the lower slope of the breast - this is the appearance of the former submammary fold, which was preserved after understatement. This defect can be eliminated by simultaneously performing lipofilling and rigototomy, or by performing a second operation.
13. "Waterfall"(snoopy or waterfall deformity) - a complication in which soft breast tissue slides off a fixed implant. “Waterfall” can occur if initially there was increased stretch and a large volume of soft tissues, and at the same time the prosthesis was installed under the pectoralis major muscle. To eliminate this defect, it is necessary to re-operate, and it is possible to use a larger implant and move it to a lower position, as well as a breast lift on the implant.
14. Breast fusion or synmastia(sinmastiya) can occur if too large an endoprosthesis was used or if the surgeon wanted to reduce the interthoracic space too much. Synmastia can be eliminated only during a second surgical operation, by narrowing the implant bed and installing a smaller prosthesis.
15. "Tomato"(tomato breast) - flattening of the cone of the chest, similar in shape to a tomato. Such deformity can occur after a periareolar lift with arthroplasty.
16. Excess skin in the region of the submammary fold after vertical mastopexy with endoprosthesis replacement.
17. Fibrous or capsular contracture. Naturally, the implant is perceived by the body as a foreign body, and the body creates a protective layer of connective tissue around it. This is the fibrous capsule. After the installation of endoprostheses, the fibrous capsule is always formed (!!!), but in some patients it remains thin and elastic, and in some it becomes so dense that it compresses the implant. In the latter case, discomfort occurs, there may be pain, the breast hardens and changes shape, waviness and contouring of the endoprostheses are created.

BREAST COMPLICATIONS REVIEWS

"You are the best! I will only recommend your clinic to all my friends. I myself came on the advice of the girls from my city. They spoke with such admiration, and now I myself was convinced of this. I had breast augmentation surgery with a lift! I can't wait to see new, beautiful breasts" Galina, 27 years old and others