Mammoplasty — is a complex breast plastic surgery which is designed to change the size and shape of the breasts, as well as reconstruction after removal of the mammary gland.
Indications for mammoplasty:
- loss of breast shape and elasticity (pendulous breasts - mammoptosis);
- pronounced asymmetry of the breasts;
- small breast size (micromastia);
- overly large breasts (macromastia, gigantomastia);
- gland removal due to cancer or other diseases;
- breast growth in men (gynecomastia).
Contraindications for mammoplasty:
Preparing for mammoplasty
Preparation for breast augmentation surgery includes preoperative examination, which is comprised of:
- mammography, ultrasound, MRI;
- laboratory tests (general and biochemical blood tests, coagulation, urinalysis);
- analysis on hepatitis viral antigens;
- surgeon’s consultation;
- electrocardiography;
- anesthesiologist’s consultation.
According to doctor's recommendation each patient should stop smoking, taking medications and hormonal contraceptives for 2 weeks prior to the surgery. Each patient should stop smoking one week before the surgery.
Breast enlargement (augmentation mammoplasty)
Breast augmentation is performed to correct the asymmetry, improve the appearance and shape of the breasts. The increase is carried out with the help of endoprosthesis (implants). Modern plastic surgeons use these types of implants:
- saline with normal saline solution;
- cohesive-gelled.
Implant insertion is performed with a small incision (up to 4 cm), which can be made around the areola line, in the inframammary region, in the armpit, or with the midsection (through the navel). Implant size, its texture, and incision type is determined individually, depending on the anatomy of the breast and the patient's wishes.
Breast reduction (reduction mammoplasty)
The breast reduction is applied to reduce the size of overly large breasts, the weight of which causes back pain and other senses of discomfort.
Reduction mammoplasty is often accompanied by mastopexy, or in other words, breast lift.
Immediately prior to the surgery, the surgeon marks the incision line (patient is in the upright position). During the procedure, excess skin, fat and glandular tissue are removed; areola and nipple are moved to a higher position. Thus, a new shape of the breast is crafted.
Breast reconstruction
Breast reconstruction is carried out after mastectomy with no cosmetic object. Its purpose is to recreate a natural breast appearance.
Restitution can be:
- single-step — carried out after malignancies removal in a single operation;
- tardive — performed after complex treatment.
Breast reconstruction may be conducted with a range of methods, which differ in kinds of tissue used for the restoration.
Self-tissue methods:
- restoration of mammary volume through fat redistribution (on condition that there is enough fat after mammectomy);
- reconstruction with local tissues;
- reconstruction with distant flaps (relocated from the back or abdomen).
If surgeons have removed all the skin and adipose tissue of the mammary gland during tumor excision, breast restoration with person’s own tissues is difficult to perform.In such cases, a reconstruction with silicone prosthesis is a procedure of choice. In order to make enough room for the implant on the place of removed gland, the doctor sets the expander, meaning a silicone container with a special port for filling the implant with saline. The following gradual skin stretching makes possible to install a permanent silicone implant.
How is mammoplasty performed?
Breast plastic surgery is carried out in the morning hours in fasting state. Due to the use of general anesthesia, the patient needs to stay under medical supervision for at least 24 hours after surgery. Duration of mammoplasty depends on the type and complexity and usually lasts 1-3 hours.