MAMMOPLASTY INCREASE

The mammoplasty increase is achieved through the inclusion of high cohesiveness silicone gel prosthesis in the subglandular or submuscular space with the aim of giving greater volume and sometimes correct some flabbiness in the breast. (The slight flabbiness can be corrected through the inclusion of a prostheses) because when there is a large excess skin, as well as the inclusion of the prosthesis the loosen skin must be withdrawn. The prosthesis is inserted through transareolar (incision around the areola), or via axillary (by an incision in the fold of the armpit) and eventually by an incision into the furrow of the breast. The location of the prosthesis can be between the gland and the muscle or below the muscle so it does not do so notorious the upper edge of the implant, however, in very thin patients is possible that in the lower and internal area the edge of the prosthesis becomes evident because the muscle the muscle does not reach to cover these areas. In some cases they may feel the natural folds of the implant, which without being notorious can be perceptible to the touch. Upon placing the prosthesis under the muscle can generate more pain in the post operative and generate momentary displacement of the prosthesis when there is a strong muscle contraction.

Another of the undesirable effects is that in some patients after the placement of the implants, veined enlargements be seen, since the increase of size produces a vasodilatation which manifests itself in this way.

With regard to the types of prosthetic types we use all the prosthesis that exist in the market; we only use those of high range and that comply with all market requirements, new prostheses from the Chinese, until the American and Dutch.

The Duration of the implants according to the manufacturers is from 10 to 15 years but in practice implants of indefinite duration are seen.

Therefore the patient must interrogate the plastic surgeon on the scar and benefits of each one of the ways for inclusion; must also discuss the size of the prosthesis, because the objective is to achieve a harmonic result without making evident that is secondary to plastic surgery. So the best result is achieved without doing it so obvious.

The patient must know the size of brassier that desires (the size that wants in their breast) and the form in which desires the furrow of the breast: very round given by the very high profile prosthesis, or more natural aspect breasts when placed low profile prosthesis. Moderate to severe skin excesses produce falls of the breast and to correct them one must withdraw the excess skin leaving scars of different form. The patient should define with the plastic surgeon the form and extension of the scar. Not always the small scars are the ones that give better results on the shape of the breast.

The procedure has a duration that various from 2 to 3 hours depending on the used technique; typically is carried out with epidural anesthesia in which the patient is conscious but sedated (similar to the spinal but more superficial without reaching the spinal channel) or with general anesthesia, to define that part a preanesthesic evaluation will be carried out, in which the patient will meet with the anesthesiologist and there will explain in detail the type of anesthesia that most suits him. The anesthesia always will be administered by an anesthesiologist who accompanies the patient during all the surgery and recovery.

The incisions are points with sutures and covered by tape. At approximately 1 to 2 weeks removed points and healing are reached in a period of 3 to 6 months which are almost imperceptible unless they are exposed to the sun. The incisions remain with stitches and covered by tapes. In approximately 1 to 2 weeks the stitches are withdraw and the scar formation of the injuries are reached in a period from 3 to 6 months after they remain almost imperceptible unless they are exposed to the sun.

POSTOPERATIVE CHANGES

After a mammoplasty of increase the final result is reached (more or less to the sixth month) being obtained natural results and without having no impediment for subsequent lactations, passing for the following phases:

- In the first two weeks the pain and swelling are progressive causing that the breasts increase in size and consistency, may appear a purple mark in the chest area.
- It is also common to present headache and dizziness in the first week, and in some cases can be presented vomiting in the first days.
- In the first week an alteration in the frequency of the intestinal depositions can be presented due to the rest, it can be solved by increasing the consumption of fiber, eating fruit as pitahaya, and taking plenty of fluids.
- From the second week the swelling and the bruises (purple) go diminishing and the breast begins to return to the normal size
-Then the skin continues being contracted until the six months when the final result is reached and the smoothness and cutaneous softness is recovered and the final size is reached.

The swellingComplicaciones. - The mamoplastia of increase is susceptible to present the complications of any surgery. - Approximately a 3% of the prosthesis they produce contraction capsular or infection in the breast as reaction to foreign body, doing necessary the retreat of the prosthesis.

COMPLICATIONS

- The increase mammoplasty is susceptible to present the complications of any surgery.
- Approximately a 3% of the prosthesis produces capsular contraction or infection in the breast as a reaction to a foreign body, doing necessary the retreat of the prosthesis.
- It´s possible the apparition of grooves. As in any procedure where a breast volume increase happens (for example: the embarrassment). Among larger the size of the breast, the greater the weight and stretches of the skin, with increased risk of producing grooves and fall of the breast Postoperative care.
– Do not to expose to the sun until the ecchymosis disappear, generally from 3 to 6 months.
– Use a postsurgical brassier for a period of a month to as long as possible according to the plastic surgeon recommendation.
- Take the medicines and cares as indicated in the medical prescription by the time indicated.
- Wash with soap and water the area of the stitches (usually covered with tape), dry and clean with alcohol.
- The controls with the surgeon are carried out to the 7, 15, 30 or 90 days according to the preference of the surgeon.
- The sports and labor activities can be resumed according to the degree of pain of each patient, generally in 2 weeks. - Do not raise the arms in the first 2 weeks. - In case of any doubt, call the plastic surgeon.
- Call the plastic surgeon in case that fever be presented (over 38.5 degrees), in case of abundant bleeding, strong pain in the chest (is common tolerable pain in the thorax and light difficulty to breathe), a lot of difficulty for breathing or abundant secretion by the surgical injury.