First, what are the breast augmentation operations?
1, through the axillary incision
Before operation, the patient took a standing position or a sitting position, and the incision and peeling range of the operation were marked on his chest skin with gentian violet. The anatomical lower boundary should reach 65438±0cm below the nipple fissure, the inner boundary is the parasternal line and the outer boundary is the axillary front line. No matter what size breast prosthesis is used, it should be peeled off to this range, especially to separate the inner lower edge of pectoralis major from the attachment of the sixth rib and rectus abdominis fascia, otherwise it will affect the shape of the breast.
According to the preoperative design, the skin and subcutaneous tissue at the top of armpit were cut along the dermatoglyphic direction to reach the surface of deep fascia. The incision is 4cm long or can be inserted into the side-by-side index finger and middle finger. Note: Do not cut the fat pad under the armpit, so as not to damage the blood vessels, nerves and other important structures under the armpit. Pull the skin incision inward to expose the lateral edge of pectoralis major. Here, the deep fascia is cut, and it is blunt peeled off with fingers and enters the posterior space of pectoralis major. When cutting deep fascia, pay attention to avoid the arterioles and nerves descending here.
Below pectoralis major is a potential cavity of loose connective tissue, which is easy to peel off and hardly bleeds. However, only fingers can peel off the upper part of the cavity, so special instruments are needed to peel off the whole cavity.
When cutting skin, subcutaneous tissue and deep fascia, electrocoagulation can be used to stop bleeding, but it is not necessary to stop bleeding or block the posterior space of pectoralis major (do not leave cotton yarn ends in the cavity)
Using a small gooseneck retractor to pull up the deep fascia incision requires some skills when using the fluidity of silicone rubber solution and silicone rubber capsule. If handled properly, it can be completed in a short time.
2, through the breast fold incision
Most patients with breast augmentation have high breasts. When cutting, the incision line should be drawn below the breast line 1 ~ 4 cm. As for the scope of stripping, it can be carried out from the top to the second rib to the bottom to the sixth rib, from the inside to the parasternal line, and from the outside to the axillary front line. The incision line usually bends slightly outward from the vertical line of the nipple, and is about 3cm long.
(1) cut the skin and subcutaneous fat according to the incision, reaching the muscle fascia.
(2) The myofascia is cut off, which is only the lateral edge of the starting point of pectoralis major in most cases. After a little sharp separation, you can use your index finger to enter the deep surface of pectoralis major for blunt separation. Note: The peeling gap must be large enough and free of fiber knots.
(3) Implanting the breast prosthesis into the separated space. The operation of implantation is often difficult for beginners. A better method is to pinch the wall of silicone rubber capsule with two fingers of the left hand and send it into the gap. Squeeze the back of the capsule with two fingers of the right hand, and squeeze the silica gel solution in the capsule into the capsule that has entered the gap, so as to make steady progress until all the prostheses enter the gap.
(4) suture the incision in layers.
(5) Postoperative dressing change and postoperative treatment are the same as axillary incision.
3, through the areola incision
Make a semicircular incision with a length of 3 ~ 4 cm below the areola, and cut the skin, breast sac, breast and mammary duct to the fascia on the surface of pectoralis major; A circular cavity with a diameter of 10 ~ 12 cm is separated between the lower part of the breast and the costal fascia of the chest. Implanting the folded hollow breast prosthesis into the cavity, and then injecting physiological saline into the hollow capsule to expand the hollow capsule to a suitable volume; Finally, close the incision.
Second, the precautions before breast enhancement
1, arrange the operation time 30 days before the operation.
Don't expect too much from the effect of breast correction and plastic surgery. Breast correction and plastic surgery can improve the image to some extent, but the effect is still restricted by objective conditions and may not be completely transformed into the expected appearance. Understand the recovery period. After breast correction and plastic surgery, stitches are usually removed around 1 week, and it tends to be natural around 1 month. It takes 3- 12 months to achieve a stable effect. The operation was arranged after menstruation 1 week. Any plastic surgery should avoid the physiological period of women, otherwise it will easily lead to difficulties in hemostasis and wound healing, which will affect the surgical effect.
2, preoperative 15 days to recuperate the body.
Control inflammation. If there is inflammation in the breast correction and plastic surgery site, it is more likely to cause postoperative infection and affect wound healing, so it is necessary to control the inflammation before operation. For example, conjunctivitis should be cured before eye and chest correction and plastic surgery; Nasal breast correction and plastic surgery should be avoided during the attack of rhinitis. Stop using drugs that affect blood coagulation. Drugs that affect the blood mechanism, such as aspirin and vitamin E, as well as birth control pills, are prohibited in the first half of the operation to avoid excessive bleeding during the operation. Quit smoking. Most doctors will advise patients to quit smoking at least 1-2 weeks before operation, because nicotine in cigarettes not only affects the healing and swelling speed of wounds, but also interferes with the action of anesthetics and stimulates the increase of tracheal secretions. In order to achieve better results, the time to quit smoking generally lasts until the third week after surgery.
3, preoperative 1 day to prepare for surgery.
Prepare postoperative diet. The first day after operation 1 day, it is better to take liquid food to ensure the normal operation of the stomach, especially the nasal and mandibular angle grinding. Therefore, some liquid foods, such as milk, juice and broth, should be prepared 1 day before operation to avoid eating hard and spicy food. Stop eating before general anesthesia 12 hours. If the next morning's operation requires general anesthesia, you should fast within 12 hours before operation to prevent aspiration pneumonia caused by food reflux in the stomach under anesthesia. Have a good rest. A good rest means a good physical condition to better meet the operation.
4, do a good job of cleaning on the day of surgery.
Take a shower and wash your face On the day of the operation, it is best to take a bath and wash your face first. Do not apply skin care products before operation to reduce the number of bacteria and prevent postoperative infection.
Third, matters needing attention after breast enhancement
1. After breast augmentation surgery, there is usually pain and swelling in the chest, and the degree varies from person to person, depending on the method, nature and personal physique of the operation. The pain usually lasts about two to three days, and it can be controlled by taking medicine on time according to the doctor's advice. The swelling will subside in a week or two.
2. Rest for two to three days, and you can usually resume your daily activities two to three days after the operation. You can go to work as usual five to seven days after the operation. Avoid holding your arms high and carrying heavy objects in the first week after operation. Steam bath and swimming should be avoided for two weeks. Strenuous exercise can only be performed two weeks after the operation.
3. There will be a simple dressing for the wound after operation, and there will be a bandage to fix the position of the breast. You can go to the doctor for a follow-up visit in two or three days, and then you can take a normal bath. Arrange follow-up for another week, month and half a year. The suture of the wound will dissolve automatically within ten days.
4. In the first month after operation, you should wear either a fitted soft bust or a positioning chest strap according to the doctor's instructions, or let the chest tissue form naturally without wearing a bust. The breast will feel swollen and soft at first, and after one to two months, the texture and shape of the breast will be more natural. When you mentally integrate it into your body and stop paying attention to the existence of the prosthesis, you will fully recover.
5. Don't wear iron wire through the chest circumference within half a year after operation, so as to avoid capsule twinning (capsule fibrosis) caused by chest deformation.
6. Sexual behavior should be avoided within two weeks after operation, so as not to damage the breast.
7. If you are going to get pregnant, it is best to wait for the breast shape to stabilize six months after the operation. Breast augmentation surgery generally does not affect breastfeeding ability.
8. Start breast massage one week after the operation. The method is to push the breast upward, inward and outward as far as possible, keep this posture for ten seconds, and do the left and right breasts for five minutes respectively. Twice in the morning and evening in the first month. Once every two months and once a year. After one year, I changed to irregular massage. Breast massage can loosen the capsule fiber tissue around the prosthesis and effectively reduce the occurrence of capsule twins, so it should be persistent.