Whose fault is it that a double fold appears after mammoplasty? Complication of double bubble mammoplasty: causes, options for solving the problem, prevention Who had a double bubble after mammoplasty

This is a specific complication that can occur after breast augmentation.

This complication is associated with several factors simultaneously:

• incorrect technique of the plastic surgeon during the operation;
• quality of selected endoprostheses;
• individual;
• anatomical features of the mammary gland.

What it is

Double bubble – translated from English means double breasts. In the first paragraph it was stated that this is a specific complication, so the following definition can be given.

This is a complication after breast augmentation using low-quality implants, resulting in breast deformation in the form of a double fold or double bubble.

Double bubble after mammoplasty is a general surgical complication and quite rarely develops after breast surgery.

A double fold is a breast deformation that occurs after breast replacement when the implant and bust cannot form a single whole and, as a result, the implant acts as an additional roundness.

Features of the female breast

The mammary gland is a paired organ that consists of glandular tissue.

The mammary gland consists of the following components:

• glandular lobules, which consist of adipose and connective tissue;
• nipple - a pigmented, rough formation, the color of which can have different shades;
• areola, which can also be of different shapes;

The mammary gland is covered with smooth skin. Under the skin there is a fat layer. Under the fat layer is the body of the mammary gland, which is covered with a connective capsule.

In turn, the connecting capsule is suspended on the collarbone. The chest is located at the second and third level of the ribs.

The nipple and areola are approximately located at the level of the fifth and sixth ribs. The inframammary fold is located at the level of the seventh and eighth ribs.

The body of the mammary gland is located in a connecting sheath, which is formed from the superficial fascia. The fascia divides into two plates that surround the gland.

Photo: Mammary gland

A large number of connective tissue “Cooper’s ligaments” are directed from the anterior surface of the mammary gland to the deep layers of the skin, which maintain the shape and structure of the mammary gland.

Between the posterior surface of the fascia and the pectoral muscle there is a loose layer of fatty tissue that tightly covers the body of the mammary gland.

What does it look like double bubble after mammoplasty

As already mentioned, double bubble means the appearance of a double fold on the chest.

Depending on the deformation of the breast, it may have a different appearance.

But at the same time, there is always an aesthetic aspect, which, in any type of double fold, makes the breasts ugly, deformed and, of course, requiring surgical intervention to correct this complication.

This complication may look like this:

• breasts are superimposed on one another;
• an implant located in the chest can act as an additional roundness;
• the breast may look as if the mammary gland is flowing down the implant, while the nipple and areola are lowered down; experts call this type of complication the “waterfall effect.”

This complication is characterized by deformation of the mammary gland, when a double fold is formed after installation of the implant.

The prosthesis looks like additional roundness. This has the appearance of a bifurcated mammary gland or double bladder. This complication ranges from 30% of all breast augmentation operations performed.

Photo: Before and after surgery

Causes

A double bubble can occur for several reasons, and this complication is also associated with the technique of breast surgery.

The main reason for the appearance of a double bubble after plastic surgery is a reduced, underdeveloped lower pole of the mammary glands.

In this case, the main part of the glandular tissue is located in the upper pole of the mammary gland.

At risk are patients with:

• tubular;
• cone-shaped;
• or a normally formed mammary gland;
• but at the same time with exaggerated inframammary folds.

This reason for the appearance refers to the early appearance of a double fold.

The tubular breast shape has an excessively narrow base and large areolas in diameter, and the inframammary fold is too high. With this form, the glandular tissue is concentrated in the upper pole and has a tube structure.

Cone-shaped is a shape in which the breast is three to four times wider than the nipple-areolar complex of the breast, while the shape of the mammary gland has the appearance of a pyramid.

The main reasons associated with the appearance of the late “double bubble” effect are as follows:

• mammary fibrosis;
• gland sliding off the implant or “waterfall” effect;
• lowering the implant below the formed fold.

With mammary fibrosis, the capsule contracts, the prosthesis contracts, and the soft tissue of the mammary gland rises to the top, while the implant itself moves down .

What to do

To eliminate this defect, additional surgical intervention is necessary, in which it is necessary to excise the breast tissue, straighten it and form a fold in a new place.

The operation of correcting a double bladder is, on the one hand, very simple, but on the other hand, it requires care and respect for the mammary gland.

What is difficult about this operation is that you need to carefully straighten the breast tissue in order to fix it correctly and form a submammary fold in a new place to obtain an aesthetically beautiful result.

The main goal of the operation is to move the inframammary fold down to the correct position. First, a skin incision is made, the gland tissue is released, isolated from both sides, then the gland is dissected.

After straightening and unfolding the folds of tissue, the gland is sutured to a new submammary fold. As a result, the deformation is eliminated, and the submammary folds become smooth and symmetrical.

Also, when correcting a double fold, the following can be done:manipulations:

1. capsulotomy;
2. removal of the prosthesis;
3. installation of a new prosthesis;
4. breast lipolift.

This complication may be preceded by complications in the form of capsular contracture - the formation of a thick fibrous capsule, which seems to squeeze out the implant and, as a result, a “double bubble” effect is formed.

To do this, the plastic surgeon performs a capsulotomy process, excising the excess fibrous compaction around the implant.

Sometimes the process of removing the implant becomes inevitable. This happens mainly due to the individual characteristics of the patient’s body, for example, a caused allergy to the material from which the prosthesis is made.

As a result of such an allergic reaction, swelling of the breast tissue occurs and with such swelling the implant is compressed and the breast is deformed and it looks like a double bubble.

In this case, it is necessary to immediately remove the implant, since the caused allergy threatens not only the aesthetic appearance, but also the health of the patient.

Also, if low-quality prostheses were chosen when choosing an implant, they also need to be removed, because the breasts will be constantly deformed and the woman will not feel beautiful and confident.

Photo: Breast lipolift

Breast lipolifting is one of the most popular solutions for eliminating double folds and even breast enlargement, without the use of implants.

This operation is performed by transplanting the patient’s own adipose tissue from places where there is a lot of it.

When performing breast correction using lipolifting, fat is injected into the anatomical area of ​​the breast and the specialist who performs this procedure can correct and create an individual breast shape in each case separately.

In order to avoid a double fold, a combined installation of the implant is needed, or in other words, the formation of a two-plane bed for it.

With this process, the upper part of the implant is installed under the pectoralis major muscle, while pressure is exerted on it from top to bottom and with this arrangement the prosthesis is in a straightened state and has a constant shape, which allows the formation of a normal lower pole of the mammary gland.

If the prosthesis is completely under the muscle, including the lower pole, then due to this work of the lower muscles, the implant is squeezed upward and the “double bubble” effect is obtained. .

Methods of prevention Speaking about methods of prevention can be divided into three stages.

The first stage includes all the actions that are carried out before the operation itself regarding breast plastic surgery, these include:

1. choosing a plastic surgeon;
2. passing all necessary tests;
3. compliance with all recommendations of the plastic surgeon;
4. choosing a clinic;

The second stage is directly related to the operation itself and there must be correct manipulations by the plastic surgeon himself.

These include:

• correct anesthesia ratio;
• choosing the location of the implant;
• correct application of the necessary cuts;
• suture technique;

The third stage of preventing the “double bubble” complication, in which all responsibility falls on the patient’s shoulders, since this is a rehabilitation period in which the patient must behave responsibly in relation to her health and the aesthetic appearance of her figure.

During the rehabilitation period, the following recommendations should be followed:

• wearing compression garments;
• limiting physical activity;
• compliance with the recommendations of the attending physician ;

Video: Correction of complications

Shapewear should be made of dense elastic fabric. There should be no seams or hard edges on the linen.

Many doctors write that after surgery, physical activity should be limited. Always check with your doctor about what exactly is included in these restrictions.

The main restrictions on physical activity may include the following:

• raise your arms high;
• tilt;
• rise to your feet quickly;
• to drive a car;

Also, it is important to know that after correction and elimination of the “double bubble” effect, the old fold will remain due to the presence of skin memory, but within a week it will disappear.

If the implant has already been installed and does not require removal or replacement, then the rehabilitation period after re-correction will proceed quickly and practically painlessly.

There is no need to be afraid of the pain that will be present after breast surgery. Your doctor may prescribe you to take painkillers to reduce pain.

You can also use ointments or various gels to speed up the healing process, but only with the permission of a specialist.

In order to avoid a double bubble on the breast after mammoplasty, you must also be very careful when choosing endoprostheses. The implant must be made from high-quality materials; you should also pay attention to the shape and filler of which the implant is composed.

It is the correct choice of prosthesis for future surgery that can prevent the risk of developing complications of mammoplasty and even such a “double bubble” effect.

The problem of “double folds” always remains an urgent problem and sometimes it depends on the qualifications of the plastic surgeon, experience and ability to perform plastic surgery or on the increasingly new forms of implants that manufacturers offer.

For 15 years now, plastic surgeons have been discussing the problems and complications that arise after breast surgery.

This also applies to such complications as the “double bubble” effect, its prevention and ways to eliminate it.

And I would like to wish all patients and doctors that such complications avoid them, and if such a problem nevertheless arises, that both women and plastic surgeons have enough intuition, health and experience in eliminating such a complication.

Double bubble is a condition in which the installed breast prosthesis and the mammary gland do not create a single holistic picture, but have obvious signs of incompatibility. Similar situations can arise immediately after endoprosthetics and even several years later.

There is a risk group of women who are more likely to have a double bubble effect after mammoplasty. But even absolutely healthy girls can experience such a postoperative complication. Why does this situation arise, who is affected and can the defect be corrected?

Read in this article

Reasons for the appearance of double bubble after mammoplasty

A synonym for the concept of “double bubble” is “double fold or bubble” (direct translation from English). Indeed, in most cases, the endoprosthesis, moving from its intended place, forms an additional protrusion in the submammary area. Its size and configuration depend on many factors. The overall frequency of the effect is approximately 3 - 5% of all implantations performed.

The double bubble does not lead to any serious complications, for example, disruption of blood flow, lymphatic drainage, etc.

But such a double fold has a serious cosmetic defect, which over time can develop into a psychological problem for a woman.

Early double bubble

Immediately after surgery, a woman may be puzzled by the fact that the shape of her breasts does not correspond to her expectations. In most cases, this situation can be corrected only with repeated intervention. The main reasons for the early double bubble effect are as follows:

• Poor quality and incorrectly selected in shape.
• The plastic technique is incorrect in this situation, especially if the access is poorly chosen.
• If during plastic surgery fatty tissue is removed in the area of ​​the lower submammary fold. Subsequently, a pocket can form here, where the implant is then lowered.
• If the fold under the mammary gland is pronounced, and the woman’s skin is very thin and stretchable.

As a result, after plastic surgery the defect remains noticeable. The own lower skin fold of the mammary gland is expressed, and a new one is added - from the edge of the implant. As a result, a kind of “lumpy” and double bubble is created.

To prevent the formation of a double fold, surgeons often resort to forming a two-plane implant cover. This prevents it from moving excessively. In this case, the upper part is under the pectoralis major muscle, and the lower edge is free. This allows you to form the correct bottom fold.

Late double bubble

After a year, two, and sometimes even after 5 to 10 years, implants may also lose their correct anatomical position. The result is double folds, which pose a serious aesthetic problem for women. The main reasons for the late double bubble effect are as follows:

• If the mammary gland “slides” over the implant for some reason, for example, due to non-compliance with the rules of use, injury, etc. In this case, you can often observe the “waterfall effect”, when the nipple and areolar part are much lower than expected, stretched, and irregularly shaped.
• If the implant moves on its own or under the influence of some factors falls below the newly formed inframammary fold.
• Most often, in the event of a double bubble, one has to deal with fibrosis of the capsule in which the implant is placed. As a result, strong pressure is put on him, and under this action he “goes” to where there is less resistance - down.

Watch the video about complications of the double bubble:

Women at risk for double fold formation

The double bubble effect can develop even in women with normal breasts with any plastic surgery with implants. But most often this complication appears in the following groups:

• In women with . The peculiarity of the structure of such breasts is a narrow base, a wide areolar area and nipple. Therefore, when installing an implant, the plastic surgeon should choose the optimal access so that the own submammary fold is completely gone and a new one is formed.
• Girls with cone-shaped breasts are pyramid-shaped. At the same time, the nipple and areola area are very narrow compared to the base. If excess skin and fatty tissue are not removed, the implant may “fall” into its own large submammary fold.
• Girls with normally developed mammary glands, but with a high submammary area, should also be wary.
• Organ asymmetry can also contribute to inaccurate surgical calculations. As a result, the likelihood of a double bubble effect will be higher.

What is the danger of a double fold after mammoplasty?

The double bubble effect, both early and late, will not bring any serious complications to the woman, such as suppuration, leakage, etc. But the appearance of a double fold after mammoplasty entails serious cosmetic discomfort for the woman. After all, initially she turns to a plastic surgeon to solve the problem, to give beauty and shape to the mammary glands.

Not every woman can afford a repeat operation like this, and a double bubble can bring a lot of anxiety and psychological problems. Therefore, before deciding on breast correction, you must carefully select a clinic, doctor, etc.

How to fix double bubble after mammoplasty

The only method of correcting a double fold is repeated surgery. In most cases, it is not as extensive and traumatic as the plastic surgery itself. But the scope of the operation and the methodology depend on what led to the formation of the double bubble. The following methods are used:

• Removal of double contour using lipolifting. The essence of the procedure is that adipose tissue (for example, from the waist or hips) is transferred to the submammary fold. As a result, a new contour can be formed.
• Removing the implant, installing a new one if necessary. This is the most traumatic of all corrections. It is used when the implant is chosen incorrectly, or it is made of low-quality material, and also if the girl is allergic to the latex used.
• Capsulotomy– dissection and removal of fibrous formations around the prosthesis, which create increased pressure on it.

If a woman decides to undergo breast correction, this issue must be approached carefully, having carried out a serious selection of clinics and doctors. You should be guided not only by prices, but also by reviews, the reputation of institutions, the frequency of complications they have, etc. Other recommendations include the following:

• It is necessary to follow all recommendations for wearing during.
• It is necessary to limit all kinds of physical activity during adaptation.
• Together with a specialist, you should choose the right endoprosthesis according to its shape, taking into account that there are no allergies.

The double bubble effect, although a rather rare complication, brings a woman a lot of inconvenience and psychological discomfort. To avoid this problem, you should carefully and individually approach the surgical plan for each woman. A double fold can only be corrected surgically.

Today, the article was written for those who are not happy with their bust and want to undergo an operation such as mammoplasty - improving the appearance of the breast. After reading the article to the end, you will learn how to choose a surgeon, why there is such a wide price range for breast surgery, when and why a doctor may refuse or delay your operation. And also, why you need to wear compression underwear and how long you can’t sleep on your side and stomach and other interesting things for those who want unearthly beauty for their bust with the help of a plastic surgeon’s scalpel.

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If previously mammoplasty (correction of the breast, its shape and size) was the lot of Hollywood stars, today any resident of a large city can sign up for the operation.

Thanks to the variety of modern prostheses, accompanied by a lifetime guarantee, errors are minimized, and breasts after plastic surgery look beautiful and almost natural. The main thing is to choose the right implant and find an experienced plastic surgeon.

Types of mammoplasty, photo

When talking about mammoplasty, many ladies mean exclusively breast augmentation. It just so happens that a significant part of women are dissatisfied with the volume of their décolleté and hope to change it to a greater extent. However, there are other types of interventions in the mammary gland that are also in demand today:

1. Mastopexy– lifting sagging breasts. It can be combined with the installation of prostheses or done independently. In fact, during the operation, excess skin and fatty tissue are simply removed.
2. Augmentation mammoplasty– traditional and widely popular breast augmentation using prosthetics.
3. Reduction mammoplasty– a more rare, usually performed for medical reasons, breast reduction. Using liposuction, the surgeon removes all unnecessary fat, glandular tissue, and so on.
4. Aesthetic correction of the nipple-areolar complex. It is possible to reduce the size of the areola (pigmented circle) or restore the appearance of the nipples after other operations.

Now you know all the popular types of interventions with a plastic surgeon’s scalpel. I suggest you look at a series of photos that famous movie and show business stars went through.

If you decide to have surgery, you are interested in many of the nuances that are shown in the video: how a consultation with a plastic surgeon takes place, the course of the operation itself and its result after rehabilitation.
Those who is more than +18- follow the link to YouTube and you can watch it there.

Indications and contraindications for mammoplasty

Like any operation, there are also indications and contraindications. Let's consider them when planning to improve your breast condition.

You may also find useful an article about how to treat it with medications and folk methods, the reasons for its appearance or if you want to know, as well as what it is. Good advice is waiting for you in the article - just follow the links. You will learn a lot of new things from the article where it is described or.

Indications for plastic surgery

Each lady who decides to undergo surgery has her own motives. Sometimes she just wants to meet the world's beauty standards set out on glossy covers. Sometimes she dreams of remaining sexually attractive to her man even after the birth of three babies.

It happens that youth complexes are to blame, and breast surgery allows girls to love their body. But there are also very specific indications for mammoplasty - medical or aesthetic.

From point of view medicine The following indication situations are distinguished:

1. mastectomy (removal of the mammary glands requiring subsequent reconstruction)
2. gynecomastia (visually voluminous breasts in men)
3. implant replacement
4. loss of part of the breast due to injury
5. sagging breasts (ptosis)
6. macromastia (“swelling” of the breasts to incredible, uncomfortable sizes)
7. asymmetry, as well as various anomalies and defects in the development of glands

Cosmetic indications include all the nuances associated with the aesthetic side of the issue. They are extremely subjective, and each lady decides for herself whether it is worth enlarging her breasts in this situation or not. Main cosmetic indications for mammoplasty:

• difference in the size of the right and left breasts after completion of lactation
• unaesthetic sagging of the breasts due to pregnancy, prolonged breastfeeding or sudden weight loss, violation of its shape
• micromastia (naturally tiny breasts)

Now you know the medical and aesthetic indications for breast surgery. What about the contraindications for such intervention in the mammary gland?

Contraindications to mammoplasty

The list of contraindications to mammoplasty is very extensive. It contains both mandatory items characteristic of any operation, as well as specific, original ones. Breast augmentation is rarely mandatory, so a surgeon who has doubts can quite easily refuse a potential patient.

However, in reality the situation looks different. In only 2-3% of cases, the doctor actually does not agree to perform mammoplasty. All other issues are resolved individually, during consultation, when analyzing specific conditions. For example, with restored liver function and stable functioning of the immune system, surgery can be performed even on a carrier of HIV infection or someone who has suffered from dangerous types of hepatitis (B, C).

Serious contraindications to mammoplasty:

• diabetes mellitus (decompensation, subcompensation)
• immunodeficiency
• pregnancy
• malignant tumors
• exacerbation of chronic diseases
• mental illness
• school age
• breast diseases
• acute infection with high fever
• benign neoplasms in the breast (in case of incomplete treatment)
• scleroderma and other connective tissue diseases
• all kinds of blood clotting disorders, taking anticoagulants
• some endocrine diseases
• lactation and the first six months after its completion

In most cases, you just have to wait: postpone surgery, treat the infection, wait for the compensation stage, finish breastfeeding.

Review of prices for mammoplasty in Moscow

On average, in the capital, the operation itself costs 120-200 thousand rubles (excluding the cost of prostheses). Correcting the size of the areola or the shape of the nipples is slightly cheaper, about 36-50 thousand rubles. If you have planned endoprosthetics with a one-stage lift, then such mammoplasty will cost you much more (the price in Moscow will immediately jump to 275,000 - 350,000 rubles). To replace existing implants you will have to pay about 60,000 rubles.

For mammoplasty, the price depends not only on the tariffs of a particular surgeon, but also on the selected implant. The cost of silicone prostheses ranges from 30 to 60 thousand rubles. Anatomical (drop-shaped) ones are more expensive than spherical ones because they look more natural. Much depends on the manufacturer and the texture of the implant (rough ones, for example, “take root” faster).

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The choice of what to save on is always up to the client. You can find a simpler clinic and enlarge your breasts for a modest 50,000 rubles. Or you can spend money on an experienced and popular professional and pay 400 thousand. The difference in prices for mammoplasty is due to the “stardom” and experience of the capital’s surgeons, the appetites of prestigious clinics, an elite hospital and a notoriously generous clientele. In any other city, the operation will cost much less, but the specialist you will get is not so eminent. However, sometimes an increase in the price of mammoplasty in Moscow is quite natural if the operation is complicated by difficult access or you have chosen the most expensive implant.

IN base cost usually include:

• tests
• materials
• surgeon's work

You have to pay additionally the actual prostheses, as well as anesthesia and hospitalization. The recovery period also costs a lot of money, and you certainly shouldn’t skimp on it. There are, however, clinics that offer an all-inclusive service, when all consumables are already included in the specified amount. The average price guideline from which to base your search for a surgeon is 140 thousand rubles for the whole thing.

Recovery after mammoplasty

Optimal rehabilitation or recovery after mammoplasty takes a couple of months. After about 60 days, all discomfort associated with the operation and its consequences will go away, and swelling will subside.

But you shouldn’t rush: you will feel a foreign “chill” inside for a long time, and the path to a regular lace bra without wires is not close. You will have to wear compression garments for a long time after mammoplasty (you can buy them at any medical store, in the section of postoperative dressings and bandages).

Productive recovery after mammoplasty will require patience. Do not remove compression garments, pick healing scabs from scars, or use any creams without consulting your doctor.

To avoid complications after mammoplasty, you should blindly trust your surgeon and follow all his recommendations. For example, you can wash your breasts only after a week (and then without a washcloth). For the next 30 days, any physical activity, sudden lifting of arms, swimming and rowing movements are prohibited. You can’t drive in the first two weeks; the same time limits apply for taking a warm bath and having sex. It is better not to visit the bathhouse for a month, and - for many the hardest point - you should not sleep on your stomach for the same amount of time.

Scars, stitches, scars after mammoplasty – an inevitable, but temporary “evil”. Don't be alarmed: after six months, with proper care, they almost disappear. The initial result largely depends on the quality of the threads and stitching technique, which takes into account the structure and elasticity of your skin.

Do you want your recovery after mammoplasty to go smoothly? Shift some of the responsibilities to loved ones, remove all stress from yourself, get plenty of rest, walk and eat right.

Complications after mammoplasty (suppuration, swelling, migration of the implant) are prevented with the help of timely prevention - wearing compression garments, avoiding exercise, taking antibiotics, sleeping on your side, carefully observing your own breasts, sensations and changes.

Main complications after mammoplasty

As after any operation, complications are also possible here. Here are the main ones:

• suppuration, infection
• scars
• prosthesis migration
• seroma
• double bubble after mammoplasty (the so-called “double fold”)
• capsular contracture
• numbness of nipples, loss of sensitivity
• ripples on the skin
• bleeding
• implant rupture or crack

An unpleasant side effect (quite rare, but still existing) is a double fold (bubble). It may not occur immediately, but rather late, three to four months after the operation. Double bubble after mammoplasty does not always arise through the fault of the surgeon: sometimes it is caused by the individual anatomical features of the gland. In fact, an additional circle in the form of a fold or bubble is formed by the implant, which never connected with natural tissues and slid down. Such unsuccessful mammoplasty needs quick and careful correction.

Contracture after surgery– an extremely common complication of mammoplasty, it occurs in 10% of all patients. This is a capsule-shaped tissue formation around a fresh implant, a kind of protective response of the body to the invasion of a silicone guest. Contracture itself is not dangerous and is not considered a serious complication unless it is large and does not deform the prosthesis, causing it to rupture.

Seroma after mammoplasty is an accumulation of intercellular fluid in one of the breasts. It becomes noticeable soon after surgery and can be corrected surgically or medicinally. Most often, the serous fluid is pumped out with a syringe, monitoring the result on an ultrasound.

In case of strong and asymmetrical displacement of one implant, when the defect is clearly noticeable and does not look aesthetically pleasing, it is required revision mammoplasty. And to avoid “seasonal migration”, you need to purchase high-quality compression garments and not remove them without the surgeon’s permission.

Increased temperature after mammoplasty absolutely normal in the first days (while you are in the hospital). This is how the body encounters a foreign body and reacts to swelling. However, if a sudden fever finds you at home, this may indicate that an inflammatory process has begun - rush to the doctor.

How to choose a surgeon for mammoplasty? Reviews and recommendations

Doctors themselves constantly repeat how modern, safe and relatively accessible mammoplasty has become today; reviews after the operation, however, are also negative. Before you gather your courage and sign up for a consultation, you should carefully study all the possible pitfalls and consequences of optional surgical intervention.

Having finally decided that you need mammoplasty, you should read reviews about doctors and clinics in advance. There are plenty of forums on the Internet where people share their own stories, honest assessments, before-and-after photos, and advice.

By typing in a search engine, for example, “ mammoplasty, Moscow, Babayan Gaik Pavlovich", in one click you will find out all the opinions about the results of the work of the eminent doctor.

If you want to find out why repeated breast augmentation operations are performed (the first one was unsuccessful), how the mistakes of a plastic surgeon are corrected and what they depend on, watch the video.

Thanks to reviews, you can create a personal rating of plastic surgeons in Moscow for mammoplasty. And you will choose a specific specialist from several of the best during a personal consultation (based on internal comfort, degree of trust and pricing policy).

The most frequently asked questions and answers – from the patient and the plastic surgeon

Q: Does breast surgery cause cancer?
A: Modern silicone implants are not oncogenic.

Q: Will new artificial breasts interfere with breastfeeding?
A: No, prostheses are installed under the muscle or under the mammary gland and do not affect lactation in any way. However, after involution, the shape of the breast may change slightly.

Q: How often are implants replaced?
A: Modern dentures come with a lifetime warranty. The reason for the replacement may be the patient’s personal wishes (for example, if her weight has changed or she wants a larger size) or medical indications.

Q: At first, only sleeping on your back is allowed. When can you sleep on your side after mammoplasty?
A: After two weeks, sleeping on your side is no longer prohibited, and after a month you can even treat yourself to lying on your stomach.

Q: Why are sizers (implant simulators) needed?
A: They allow you to literally try on the results of the upcoming surgery and choose the correct shape and size of the prosthesis to ensure you are satisfied. 3D modeling on a computer also performs the same function, but only external implant simulators (sizers) give a woman an idea of ​​the weight and texture of her future breasts.

Q: Is it possible to make artificial breasts look and feel real?
A: Yes, but it all depends on the professionalism of the surgeon. An experienced doctor will select the ideal anatomical implants and perform the operation so that the new breast will be indistinguishable from natural breasts in appearance. Although you shouldn’t expect magic: from some angles, a trained eye will still recognize silicone.

Q: Are diving and airplane flights permanently banned after mammoplasty?
A: Not forever. Pressure changes should be avoided only for the first 14 days to avoid discomfort.

Q: I would like to put on a regular bra as soon as possible... How long to wear compression garments after mammoplasty?
A: From one to two months, your doctor will decide more precisely. A compression bandage fixes the implants, prevents them from moving, prevents sutures from coming apart, reduces pain and relieves swelling; its importance cannot be underestimated!

As you can see, breast surgery has its own nuances, indications and contraindications. It is better to learn about them before visiting a medical institution and be prepared for various moments.

Now you know how to choose a surgeon (reviews), why there is such a wide range of prices (different professionalism, star rating of the surgeon and the cost of the implant), when a doctor can refuse an operation or postpone it a little, why it will be necessary to wear compression garments and how long you can’t sleep on the side and stomach and other interesting things for those who want unearthly beauty for their bust.

Girls, I wish you common sense when choosing the size of the implant and a successful operation!

What do you think about plastic surgery today? - share in the comments.

M In Russia we call this phenomenon of the operated mammary glands a double fold; Western surgeons call this offensive situation that occurs after prosthetic mammary glands a “double bubble” or “double bubble”. The terms are different, but the situation is the same... We will use both of these terms in the article, using the abbreviation “D-B”.

The main reason for the appearance of a double fold is restrictive, that is, a shortened, reduced or underdeveloped lower pole of the mammary glands, when the main part of the glandular tissue is concentrated on top of the mammary gland (in its upper pole). Most often these are tubular, cone-shaped breasts and well-formed mammary glands, but with elevated inframammary folds (Fig. 1).

Rice. 1. 1a - tubular mammary glands; 1b - cone-shaped mammary glands; 1c - combination of cone-shaped (left) and tubular (right) deformation of the mammary glands in the same patient; 1d - correctly formed mammary gland with a naturally elevated inframammary fold.

In order to correct this deficiency during mammoplasty, it is necessary to supplement the missing lower pole of the gland with an implant. In this case, the surgeon is forced to artificially form the inframammary fold much lower than the natural one.

But first, a little anatomy (Fig. 2).

The mammary gland is located on the chest wall and has the following landmarks relative to the ribs. The origin (upper pole) is located at the level of the II-III rib. The nipple and areola are located at the level of the V-VI ribs. The inframammary fold is at the level of the VII-VIII ribs. The tissues involved in the formation of this organ are the following (from the surface inwards):

2) Subcutaneous fat;

3) Superficial fascia with a network of Cooper's ligaments, which is woven into the gland;

4) Mammary gland;

5) Fascia of the pectoral muscles;

6) Pectoral muscles;

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All structures are involved in the formation of the inframammary fold. Basically the Cooper's ligamentous apparatus, in which all the glandular tissue is suspended like in a hammock. It is these ligaments, coming almost from the skin and intertwining with the fascia of the pectoral muscles, perforating the glandular tissue, that form the inframammary fold.

Naturally, such a complex structure is difficult to separate. “D-B” occurs when the natural inframammary fold cannot be destroyed and there are two of them: artificially formed under the implant and natural. That is, there is a “conflict” between the implant and tissues. This is the reason for the formation of the so-called early double folds, which become visible immediately after surgery or after the swelling has subsided. Late double folds may occur within a few months after surgery or several years later.

Naturally, the reasons for late “D-B” are different, as are the timing of their occurrence. But more on that later.

Let us consider in more detail the anatomical structures of early “D-B”, methods for eliminating them and the nuances of surgical techniques that prevent their occurrence.

So, the “risk group” is tubular, cone-shaped and normally formed mammary glands with elevated (above the VI-VII ribs) inframammary folds.

Tubular (or tubular) are called mammary glands with an excessively narrow base and excessively large areolas in diameter, such that the dimensions in diameter of these two landmarks are almost equal (Fig. 3a).

Rice. 3. 3b - reasons for the formation of a double fold during tubular breast prosthetics

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Rice. 3v Tubular breast prosthetics were performed using an ultra-high-profile anatomical implant with a truncated base and a reduction in the areola.

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Naturally, the inframammary fold is greatly exaggerated. The lower pole of the gland is practically absent, the glandular tissue is concentrated in the upper pole and has a tube structure. When eliminating this deformation, it is necessary to strictly select the shape of the implant and be sure to adapt the gland tissue:

The ideal way to eliminate tubular breasts, in our opinion, is to use ultra-high-profile anatomical implants with a truncated base and opening of the distal (part of the glandular tissue under the areola) section of the tubular gland in the form of an “umbrella”. In addition, at the same time, the areola hernia is eliminated using the “purse-string” method. The glandular tissue concentrated in the upper pole finds its place in the upper part of the truncated implant and easily fits into its slope, without subsequently forming a protrusion (Fig. 3c).

We consider a similar approach to be the most justified in cases of eliminating cone-shaped deformation of the mammary glands. The only difference is that with a cone there is no need to eliminate the areolar hernia and reduce the diameter of the areola.

Cone-shaped is called a form in which the width of its base is 3-4 orders of magnitude greater than the distal (areolar) part of the gland, while the glandular tissue has the shape of a pyramid (Fig. 4);

Rice. 4 Cone-shaped breast prosthetics were performed using an ultra-high-profile anatomical implant with a truncated base.

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Rice. 5. Correctly formed mammary gland with a naturally elevated inframammary fold. The augmentation was carried out using an ultra-high-profile anatomical implant with a truncated base.

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We consider the same approach justified if, with a normally formed breast, there is a reduced lower pole with a naturally high inframammary fold, as mentioned earlier. In this case, most often only a careful selection of the implant and clear overcoming (surgical separation) of the natural fold is necessary.

In this situation, it is necessary to take into account the memory of the shape of the skin of the natural inframammary fold. If it retains its shape even after deep detachment, its tension is overcome by means of through perforation caused by a sharp needle.

To avoid a double fold, a combined installation of the implant is necessary, that is, the formation of a two-plane bed for it. The upper part of the implant stands under the trimmed pectoralis major muscle. (Fig. 3b, 3c). At the same time, when it is in a contracted state, there is correct pressure on the implant from top to bottom, as a result of which it is always in a straightened state and has a constant shape, which allows the formation of a normal lower pole of the gland, overcoming natural restriction.

If the implant is installed completely under the muscle, including the lower pole, then due to the work of the muscles from below, the implant is squeezed upward and the same “D-B” effect is obtained. (Fig. 6)

Rice. 6. Increased deformity in the form of a double fold with tension in the muscles of the chest wall. Occurs only when an implant is placed fully into the muscle bed.

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The approaches described above make it possible to eliminate “D-B” already on the operated mammary glands. In these cases, the surgeon decides to leave the previously placed implant, if it is selected correctly, and adapt the soft tissues of the gland on it or change both (Fig. 6a, 6b, 6c).

Rice. 6a. Double fold after tubular breast prosthetics. Corrected using an ultra-high-profile anatomical implant with a truncated base, flattening the lower segment of the gland and eliminating the areolar hernia.

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Rice. 6b. Double fold after cone breast replacement (left). Corrected using an ultra-high-profile anatomical implant with a truncated base and flattening of the lower segment of the gland.

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Rice. 6th century Double fold after prosthetics with a round low-profile implant of normally formed mammary glands with a naturally high inframammary fold. Corrected using an ultra-high-profile anatomical implant with a truncated base and plastic surgery of the inframammary fold.

This is not a public offer! There are contraindications. Before use, consultation with a specialist is required.

I would like to note that this is a rather difficult task - eliminating a double fold. It is much easier to prevent this situation! As a rule, when eliminating an existing “D-B”, it is necessary to carry out not one operation, but several minor corrections after the main operation.

The causes of late double folds are as follows:

1. Mammary fibrosis;

2. Sliding of the gland from the implant - “waterfall effect”.

3. Lowering the implant below the formed fold. (Fig. 6c)

Late:

The most common situation is the occurrence of “D-B” due to mammary fibrosis. With it, the capsule is compressed: it compresses the implant, and the soft tissues of the gland are pulled upward, as they are fused to the anterior wall of the capsule, while the implant itself is displaced downward, displaced by these tightened tissues of the gland. In this situation, it is usually sufficient to perform a capsulotomy on the existing implant, or replace it if its condition requires it (Fig. 7).

Rice. 7. Mammary fibrosis on the right; an open capsulotomy was performed.

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With the waterfall effect - “flowing down” of the gland relative to the implant - the problem is solved in the same way as with early “D-B”, i.e., a reposition (redistribution of the lower pole) of the mammary gland is performed with the opening of its lower border and areolar (purse-string) pexia. If the implant continues to correspond to the given configurations, then its replacement is not necessary, otherwise it is replaced with the most suitable one (Fig. 9).

Rice. 9. “Waterfall effect” combined with a double fold. Corrected by areolar mastopexy with re-prosthetics with ultra-high-profile anatomical implants.

This is not a public offer! There are contraindications. Before use, consultation with a specialist is required.

IN In conclusion, I would like to note that the problem of the occurrence of double folds always remains relevant, regardless of the qualifications of the surgeon and of more and more new forms of implants that manufacturers offer. It is not for nothing that over the past 10 years, every congress dedicated to aesthetic surgery of problematic mammary glands begins and ends with reports on preventing the occurrence of “D-B” and on methods for eliminating already formed double folds. And we would like to wish all patients and doctors that this cup will pass them by, and if they do encounter this problem, then intuition and experience would help both of them overcome it!

This is not a public offer! There are contraindications. Before use, consultation with a specialist is required.

Reading time: 7 min

Does a woman need mammoplasty, are there any drastic changes before and after it, are there any serious complications?

These and other questions are most relevant for patients who, due to indicators or their own desire, are preparing for surgery to change the shape of the breast.

This type of surgery is not considered very difficult except in special cases, but being informed about possible problems in advance is a smart decision.

What is mammoplasty and when is it advisable to perform it?

This is an operation during which the surgeon corrects the shape of the breast. In another way, surgical intervention is also called endoprosthetics. The following factors are considered indications for manipulation:

• breast size is too small;
• large breast volume;
• loss of gland shape due to lactation;
• change in volume after weight loss;
• congenital pathologies, underdevelopment of the breast (micromastia and);
• amputation of one or two glands due to cancer;
• strongly expressed asymmetry;

Some women, having no medical prerequisites for surgical intervention, no significant deviations or changes in shape, are dissatisfied with the appearance of their own bust.

In these cases, surgery is possible at the request of the client, but the doctor must do everything to convince the patient that there is no need for such stress on the body as surgery.

There are also contraindications for performing manipulations on the mammary glands:

1. During treatment of cancer or with progressive growth of tumors.
2. For pathologies characterized by metabolic disorders and poor tissue regeneration. For example, diabetes, osteoporosis, anemia.
3. For severe forms of liver and kidney diseases.
4. For serious dysfunctions of blood vessels and heart.
5. The operation is not performed on pregnant women and women during lactation.
6. For some infectious diseases (hepatitis, HPV) and immunodeficiency conditions.

The procedure is not carried out until the breasts are fully formed, that is, until the age of 18.

Lactation and mammoplasty

As for the period of lactation and childbirth, it is possible to carry out the procedure no later than a year before pregnancy.

This is exactly the time required for complete recovery, and during this period preventive measures are taken to prevent complications after mammoplasty.

During the first consultation, the leading surgeon is obliged to warn the patient that the intervention will affect the implementation of lactation.

The operation is carried out three months after the baby has finished breastfeeding.

But if there were implants, under their weight and in the process of changing the shapes and ducts of the glands, the glands may sag. A corrective procedure is then recommended.

Depending on the task, the doctor determines the type of manipulation.

As a rule, the surgeon chooses a tactic according to the characteristics of the defect and the wishes of the patient herself.

Type of operation	Nuances
Magnifying	Correction of the breast in the direction of increasing volume and size during endoprosthesis replacement using artificial prostheses or the patient’s own tissues.
Reducing	Indicated when the bust volume is too large, which causes damage to the skeleton, spine, joints and blood vessels.
Reconstructing	Performed after chest trauma, partial or complete resection for medical reasons.
Corrective (nipples and areolas)	Changing shape (reducing or enlarging), location and shade.
Corrective (asymmetry)	Designed to achieve similarity of glands with obvious acquired or congenital differences in size.
Pull-up	Mastopexy is recommended for women who experience sagging breasts after lactation, weight changes and age-related factors.

Based on the choice of tactics, the surgeon determines the procedure and the option of access to the site of insertion of the prosthesis.

In addition, there is also a method of axillary injection, but not every implant is suitable here. With the transumbilical approach, an incision is made in the navel area, from where the prosthesis is installed.

The most gentle method is implantation under the gland, since there is a sufficient amount of tissue for the placement of the endoprosthesis, which ensures the shortest rehabilitation period.

Other techniques - under the fascia and muscle structures depend on the specifics.

The combined technique includes several types, with the implant installed in the canal between the muscle and the lower part of the breast.

Rehabilitation period

The recovery time after mammoplasty surgery depends on several factors:

• prosthesis size;
• the method of its location;
• gland tissue density;
• choice of surgical technique.

The postoperative period may vary depending on the characteristics and condition of the body, but it is usually divided into several stages:

1. Hospital stay from 3 to 7 days, when pain after mammoplasty is still bothersome.
2. For the next 14 days, strictly limit physical activity and wear special compression garments to prevent the seams from coming apart.
3. Within 2 months, you need to exclude the slightest injuries, you can gradually begin to play sports, but without the participation of the upper body. Alcohol is prohibited and intimate relationships are limited.
4. You can visit the pool and sunbathe after 3 months.

You will have to sleep on your back, but you can turn over on your stomach in two weeks. The sutures are removed on the 14th day. On the first day after surgery, the pain will be quite severe, so the patient is supported with medications.

Loss of sensitivity may occur, and the breasts will subsequently itch in the area of ​​the sutures; many patients noted that scars that have barely healed are very itchy.

Such phenomena do not pose a danger if they last exactly the time during which the incision sites heal.

If your breasts hurt for a very long time and severely after mammoplasty, the swelling does not go away, numbness and fistulas appear, the tissue becomes hard to the touch - this is a serious reason to immediately consult a doctor.

Complications

Problems after the intervention can be very different: from slow healing of sutures to displacement of the implant, increased temperature and the formation of fistulas.

The list of possible complications includes several types of complications, which are divided into categories.

Surgical complications

These are problems associated with the postoperative period that usually arise during the first 24 hours.

Infectious lesion

After a few days, or less often weeks, the patient begins to complain that swelling after mammoplasty is spreading.

The pain intensifies, the hematomas increase, redness of the skin is observed, and purulent exudate oozes from the sutures.

The woman's body temperature rises and a fever develops. If the gaps are detected at the initial stage, the infectious process can be quickly extinguished with the help of antibiotics.

Otherwise, you will have to remove the implant, clean the cavities, and carry out the correction again after healing.

In especially severe situations and with advanced infection, the doctor places a drainage after mammoplasty to drain the exudate.

The condition is dangerous because the penetration of bacteria into the wound can result in toxic shock, loss of consciousness, and this increases the risk of death.

Hematoma

If a vessel is damaged during the intervention, blood will ooze from its walls. A similar situation occurs when an infiltrate or fistula forms, from which serous fluid is released - this is.

In the area of ​​intervention, the hematoma increases and low-grade fever appears. Small lumps can resolve on their own as a result of drug therapy.

For more serious lesions, drainage of the wound, suturing of the vessel and cleansing of the cavity are required.

Removing the implant is not always advisable, but is done if there is excessive bleeding or fluid discharge.

Scarring disorder

Normally, without signs of complications, the seams are barely noticeable, and over time they become more and more difficult to detect. If the tissues are prone to hypertrophic fusion or the formation of keloids, the incision site becomes rough, the suture may shift, and in some cases even separate.

It is better to warn the surgeon in advance about the characteristics of the body. The doctor will plan proper postoperative care, and may prescribe laser resurfacing so that the scars after mammoplasty do not begin to enlarge and unsightly scars appear.

Breast swelling after mammoplasty is the same natural process as bruises and hematomas. This is due to changes in the condition of the tissues during surgery.

Swelling usually goes away within 30 days, but can persist for up to 2 months. It finally disappears after 3 months, when the breasts take on natural shapes.

This process is helped by controlling fluid intake. An exception is abdominal swelling after mammoplasty. If the incision is made in the navel area, recovery is longer and more difficult.

Changing sensitivity

This complication may be associated with damage to tissues and nerve endings. Accompanied by pain and numbness.

With prolonged loss of sensitivity, a woman loses interest in sex, becomes irritable, and becomes depressed.

In this case, in addition to the intervention of a surgeon, consultations with a psychotherapist and sex therapist will be needed.

Also, complications after the procedure may be of a specific nature, associated with tissue damage, circulatory disorders and other problems.

Capsular type contracture

A condition caused by compression by the capsule, which is accompanied by deformation of the breast.

There may be several reasons for this phenomenon, ranging from factors that arose during the operation to the body’s reaction to the introduction of a foreign body. The risk of such a complication increases with inframammary access, that is, with an incision under the breast.

It is more often observed when using silicone implants and endoprostheses, less often when using saline implants and those with a textured surface.

KK has 4 degrees, with the fourth asymmetry appears after mammoplasty, when the glands descend, the nipples look down.

Depending on the severity of the deformity, capsulectomy, re-endoprosthesis replacement and removal of prostheses are performed.

Implant rupture

In this case, the integrity of the shell of the embedded object is violated. Most often, cracks and micropores form over time, but they can also appear during surgery.

Sometimes the cause is poor-quality prosthetic materials or injury to the glands. As a rule, the process is asymptomatic, only the elasticity and shape of the bust changes.

But in some cases, there may be a burning sensation in the breast after mammoplasty. The solution to the problem is to replace the implant.

Doctors note a number of other possible complications:

1. Breast asymmetry after mammoplasty due to changes in the location of the prostheses. They can shift, with the nipples being at different levels. The solution is repeated intervention.
2. Symmastia is a type of breast when they look fused. Special surgery required.
3. Allergy to prosthesis. Rejection of an object by the body, in which the skin turns red and swells. The temperature may rise after mammoplasty. The solution is removal of the object, conservative treatment.
4. Calcification is characterized by pockets of compaction. There are no pronounced symptoms, but discomfort is present. If the spread is minor, the problem can be eliminated with drug therapy.
5. occurs due to the fact that in the area of ​​the scar there is compression of the arteries, which means a disruption of the blood supply. It entails quite serious consequences, the formation of fistulas and the release of exudate.
6. With prolonged use of an endoprosthesis, the tissue becomes thinner, the bust sags and loses its shape. Rippling develops - the skin acquires a corrugated surface. The reason may also be incorrect selection of the implant size. The solution is a repeat procedure with replacement of a more suitable prosthesis.

A common problem is the double bubble after mammoplasty. , which, like a mesh, supports the breast, is not completely destroyed during the operation, and an additional ligamentous apparatus is formed on top of it during the healing process.

Most often this happens when. You can get rid of the defect using a simple procedure involving excision of excess tissue.

Prevention of complications

Measures to prevent negative consequences after mammoplasty do not always depend on the patient. But 50% of the time a woman can prevent complications herself. She must strictly follow all the surgeon’s recommendations:

• avoid injury;
• do not allow physical activity during the period specified by the doctor;
• wear compression garments;
• take care of your skin;
• handle seams correctly:
• Avoid exposure to the sun, solarium and swimming pool for 2 months;
• observe the rules of hygiene;
• stop drinking alcohol and smoking.

The healing process is quite fast, and after three months the woman can admire the result.