What mammoplasty is
Breast augmentation surgery became the most popular plastic procedure several years ago, according to the ISAPS (International Society of Aesthetic Plastic Surgery). Mammoplasty makes it possible for you to change the shape and volume of the mammary glands, adjust age-related or acquired changes, regain self-confidence.

Indications
An augmentation procedure for mammary glands with the help of implants is performed in the following cases:
● “Emptying”, loss of volume and shape of the breast due to pregnancy or as a result of sudden weight loss.
● Underdeveloped breasts.
● Prominent asymmetry. The mammary glands may vary in size or two due to congenital anomalies or consequences of breastfeeding.
● Age-related sagging of the breast (ptosis of the mammary gland).
Often, mammoplasty is performed in patients who have undergone breast removal in the process of treatment of malignancies.

Contraindications
● under 18 years of age;
● any term of pregnancy;
● menstrual bleeding at the time of surgery;
● lactation period or less than 6 months after breastfeeding;
● exacerbated diabetes mellitus;
● incomplete treatment of breast tumours;
● oncological diseases (in the presence of benign tumours in the chest, their treatment shall be carried out first);
● blood coagulation disorders;
● taking anticoagulants;
● scleroderma, lupus.

What results can be achieved with breast augmentation
Mammoplasty allows you to get a beautiful shape and volume of the breast (the most popular size is C), lift the mammary gland. Make the breasts “perky”, sexy, raise the upper pole of the breasts or, if desired, emphasize the naturalness of the breasts (tear-drop shape) using a special implant. This procedure allows women feeling confident, desirable, sexy.

Possible complications
It is important to carefully choose the clinic and plastic surgeon to avoid complications due to medical errors or individual characteristics of the body:
● Haematomae and soreness. Such complication arises from a violation of the rules of rehabilitation. A rapid movement or neglect of compression underwear leads to the accumulation of blood in the area of implant placement. Large haematomae are removed using surgery, smaller — with special ointments.
● Formation of a thick capsule around the implant (capsular contracture). Although the implants are made of the most inert material (silicone), the body can individually respond to a foreign body. Symptoms: heaviness in the breasts, soreness with sudden movements.
● The “double bubble” effect. A double fold is created on the chest, since the implant drops below its original placement. This is due to the individual placement of the submammary fold under the breast or the desire to use a bigger implant contrary to recommendations. Also, such a complication can occur due to a violation of the rehabilitation period — the patient does not wear compression garments to fix the implant in the right position and place, they go in for sports, lift heavy objects moving the implant.
● Asymmetry. This is not the case of mild asymmetry, which is considered normal and imperceptible. Asymmetry (descent or displacement of an implant) can be provoked by active sports, especially the load on the pectoralis major muscle, and failure to wear compression underwear immediately after the surgery. Asymmetry can be corrected only with the help of a surgery.
● Sensitivity disorder in the areolae. A complication occurs most often when the subareoral method is used for implant placement. Loss of sensitivity typically resolves within 6–12 months. If this does not happen, a plasma therapy procedure is recommended (injections of patient’s own plasma enriched with growth factors).
● Large scars. Such complication is an individual reaction of the body or a result of lack of doctor’s experience, which often happens in patients predisposed to development of keloid scars. To avoid the sclerosis of connective tissue, patients are advised to wear special silicone pads and use smoothing creams.
Surgeon Pavlo Denyshchuk would like to remind that smoking significantly increases the risk of complications after mammoplasty. Therefore, at least 2 weeks prior to the day of intervention, the patient shall completely avoid smoking.

Preparation to surgery
● No smoking or drinking alcohol 2 weeks prior to the day of the procedure. This will help avoid complications, such as haematomae and necrosis.
● One week before the procedure the patient shall undergo an ECG, a mammogram, a blood test, have a consultation with a plastic surgeon, and undergo an examination by a gynaecologist.
Ten hours before the surgery, the woman stops taking food. In the morning before mammoplasty, the patient shall not eat or drink.

How is the procedure done
In order for the result of implant breast augmentation to satisfy the client’s request as much as possible, during the consultation surgeon Pavel Denishchuk:
1. Discusses the desired size of the future bust. A-cup — a 150–200 mL implant.
2. Measures the thickness of subcutaneous fat.
3. Takes measurements of the breasts (the distance between the breasts is measures. Normal distance is 1.5–2 cm).
4. Uses sizers to choose the proper size.

For mammoplasty, surgeons use different types of implants:
● In height. High are chosen for tall patients, low — for shorter ladies.
● By profile (protrusion): low (anatomical), medium (anatomically high), high (round).
On the day of surgery, after the patient was prepared and underwent general anaesthesia, silicone implants are placed. There are the following methods:
● Installation of an implant under the gland. This is the simplest and most physiological method. Silicone is laid under the gland. The method is used for women with a large amount of subcutaneous fat. Advantages: suitable for correction of a lowered gland, a short rehabilitation period.
● Installation of an implant under the muscle. The most popular method for correction of the shape and size of the breast. Advantages of the method: it is possible to adjust the shape of the breasts in bodybuilders.
● Placement of an implant under the fascia of the pectoralis major. Advantages: muscle integrity is not violated, the contours of the implant are invisible. Also, this method is suitable for patients with unexpressed subcutaneous fat.

What is the rehabilitation process like
Immediately after surgery, patients experience swelling, numbness or hypersensitivity of the areolae and nipples, breast asymmetry. This is a normal body reaction to the procedure. When wearing compression underwear, oedema resolves within 1–2 weeks, numbness or hypersensitivity, asymmetry — within a month.
On Day 2–3 after mammoplasty (depending on the complexity of the procedure), the patient will be discharged to go home. On Day 3, 5, 7, and 10 the patient shall visit the office for change of dressing. If healing goes well, after a week or a week and a half after the operation, the sutures will be removed.
The key recommendation during the rehabilitation period — avoid physical straining of the shoulder girdle for 6 weeks. It is also forbidden to sleep on the stomach.
Throughout the healing period, starting with the first day after the operation, a woman with implants shall wear special compression underwear, even at night. This is necessary to support the breast in the correct position, to prevent complications (asymmetry, haematomas).

After mammoplasty, it is prohibited to:
● Injure the breasts.
● Visit massage parlours without special rollers. In lying position, the patients with silicone implants shall ask for two rollers that are placed under and above the breasts.
● It is not recommended to sleep on your stomach.
● Improper training (straining or uneven exercise for the shoulder girdle). Excessive load on the shoulder girdle and pectoralis major muscle can displace the implant.

Why should you choose Pavlo Denyshchuk?
Dr. Pavlo Denyshchuk, a surgeon with 30 years of experience, author of international scientific patents and know-how in plastic surgery, is in charge of mammoplasty at the ANACOSMA clinic. The doctor has his own YouTube channel, where he tells in detail about all intricacies of the procedure for augmentation of the mammary glands.
The doctor managed to transform a thousand of busts and help many women regain their confidence and beauty.

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