Breast augmentation through the areola. Installation of a breast implant: methods of breast enlargement, how to place it, approaches List of necessary examinations

Breast augmentation through the areola is one of three options for mammoplasty that surgeons can offer you today.

The name says it all: this procedure involves access through a small semicircular incision at the border of the areola. A “pocket” will be formed through it, into which the implant is placed.

The halo route is the oldest and most popular method of access, although it would seem that the axillary one should have bypassed it long ago, because with it the scar remains in a place where no one can see it. Here, an incision is made along the edge of the pigmented area of ​​the nipple, and although in most cases it can be hidden with tattooing or it will naturally discolor on its own, it will still not go anywhere and upon very careful examination it will still be somewhat noticeable. And if the surgeon makes a mistake and goes beyond the boundaries, the postoperative scar will stand out very much.

The disadvantages of this approach also include the risk of loss of sensitivity in the nipple, although in most cases sensitivity returns over time. With the risk of lactation disruption, everything is much more complicated - for a young girl who decides to enlarge in the prime of her life, lose the opportunity breastfeeding– a serious risk.

But if the method is so traumatic, are there really advantages that will make you turn a blind eye to it? There definitely is. No one will use a method that is obviously losing in every sense.

And so, if we talk about the advantages, then first of all this is the invisibility of the scar. If the operation is performed correctly, and if the patient’s body is not prone to excessive scarring, then the mark will be invisible until a very careful examination of the incision area, while the axillary and submammary approaches involve larger incisions that are easier to detect.

Well, the variability of implant installation - under the gland or under the muscle - this method gives you the right to choose.

These are not all the advantages and disadvantages - only the most striking ones. About the rest, as well as about indications for surgery and rehabilitation after it.

Periareolar breast augmentation

And so, continuing the procession on the topic of what advantages and disadvantages breast enlargement entails in the periareolar (another variant of the name of this procedure) method, we will systematize them into laconic lists.


Advantages:

  • no bleeding;
  • invisible scar;
  • minimal incision;
  • variability of the location of the endoprosthesis.

This method also allows you to include “additional options” in the operation, such as:

  • lift;
  • elimination of asymmetry;
  • breast areola correction.

Flaws:

  • risk of mammary gland dissection;
  • risk of loss of nipple sensitivity;
  • a poorly executed incision will result in a pronounced scar;
  • installing an implant under the muscle will create additional discomfort after surgery;
  • increased risk of capsular contracture.

Another advantage that comes from increasing mammary glands the areola is seamless. The time for sutures has passed; they are almost no longer found in advanced patients plastic clinics- replaced them best analogue- high quality glue.

But how can an implant with a volume of at least 100 ml be inserted through such a miniature incision? By simply moving the tissue apart, a channel is created through which the surgeon will insert it, then secure it with a subcutaneous suture, and the skin, according to the tradition of sutureless plastic surgery, will be glued together with special glue. Additionally, adhesive strips can be installed.

Postoperative period

Breast augmentation using axillary, submammary or transareolar methods entail approximately the same rehabilitation scenario:


The first couple of weeks will require regular follow-up with the surgeon who performed the operation. Inspections are necessary to identify possible Negative consequences from surgery: gray, hematoma, suppuration, shift, displacement or rotation of the implant.

Breast plastic surgery through the areola nipple is notable for the fact that after it, already on days 5-6, you can lead an almost pre-operative lifestyle, with the exception of stress - with other ways of enlargement, this period increases by 3-5 days.

After the operation, noticeable pain will accompany you for about a week - some take painkillers during this period, others pain threshold allows you to transfer this to a “sober” nervous system.

It will take approximately six months for the implant to take root and for the breast to begin to take on its final shape. This process will last almost as long, and only 10-12 months from the date of surgery will you see the true result of the surgeon’s work and compliance with all his recommendations for the postoperative period.

Breast augmentation surgery video


- the most popular Plastic surgery in Moscow. Dr. Philippe Mistakopoulou helps patients choose the desired breast size, taking into account body proportions, maintaining balance and harmony. After breast augmentation, the breasts acquire a natural teardrop shape. The operation helps not only to enlarge the breasts, but also to lift them, and also, if there were any.

Breast augmentation through areola

Installation anatomical implants volume 350cc under the pectoralis major muscle, without incisions of the breast tissue. Cosmetic seam along the edge of the areola.

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Breast augmentation through the areola is one of the most gentle and atraumatic techniques. Philip Nikolaevich installs a breast implant through the periareolar approach, making a 3.5-4 cm incision along the lower edge of the areola. The structure of the areola is close to mucous tissue, which is restored faster than the skin. Thanks to this, the scar along the edge becomes invisible within 1-1.5 months after the operation, and no scars remain on the chest. Advantages of the operation:

  • Breast augmentation through the areola takes only about an hour;
  • no scars remain on the skin of the breast;
  • the sensitivity of the nipple and areola does not change;
  • the ability to breastfeed is preserved, since the breast tissue is not affected during the operation;
  • After the operation, the patient can quickly return to her usual lifestyle.

Plastic surgery through the areola is low-traumatic, and the body recovers quickly.

Who is indicated for mammoplasty through the areola?

  • dissatisfaction with small breast volume;
  • the desire to restore the volume and elasticity of the mammary glands after pregnancy or weight loss;
  • asymmetry of the shape and size of the mammary glands;
  • tubular mammary glands;
  • large areola diameter;
  • slight sagging of the breasts (ptosis of the 1st-2nd degree);
  • wish .

Mammoplasty through the areola is suitable for young nulliparous girls who plan to breastfeed their child in the future, and for women after childbirth who want to regain their beautiful shape and do not exclude further lactation. Breast augmentation through the nipple does not affect the glandular tissue at all and does not interfere with feeding functions.

Preparing for surgery

Before the operation, you need to have a face-to-face consultation with the surgeon. He will assess the condition of the breast and individual health characteristics, and select the ideal implants and surgical technique. For example, if you have a small areola, placing a large implant through the periareolar approach will be difficult. In this case, Philip Nikolaevich can offer. If the sagging of the glands is severe (ptosis from the 3rd degree), the doctor will recommend a lift ().

The doctor will also tell you about contraindications and possible risks after the operation, how it will go, and how quickly you can return to your normal lifestyle.

How are implants selected?

The choice of implants depends on the wishes and individual characteristics. The most obvious methods of selection are the use of the so-called “sizer” and 3D modeling. A sizer is an overlay implant that allows you to estimate the future volume of the breast. The surgeon has various sizes of sizers at his disposal. By placing them in a special bra, a woman can choose the size she likes. 3D modeling helps you choose the shape of the implant. During the consultation, the surgeon takes photographs and then models the breasts on a computer. different types implants. This way you can see your future breasts before surgery.

Dimensions are also measured during the consultation. chest. The width, height and projection of the implant must correspond to them. The doctor takes into account the thickness of the large pectoral muscle and glands, the presence of ptosis and asymmetry of shape, evaluates the symmetry of the areolar complex and other indicators. As a result, an implant of a certain size, width, height and projection is selected. For a more natural result, Philip Nikolaevich recommends choosing teardrop-shaped ones, because they perfectly follow the shape of a natural female breast.

The advantage of teardrop-shaped implants is that the breasts look as natural as possible in both vertical and horizontal positions. The breast takes the shape of a drop, and the upper, less filled edge of the implant does not protrude into the upper part of the gland, even if the implant big size. Therefore, teardrop-shaped implants are especially suitable for women with small breasts.

According to Dr. Mistakopoulou, it is best to avoid unnaturally shaped breasts. But if you want to have fuller, rounder breasts, your doctor may recommend installing round implants. If your own glandular tissue the patient has enough round implant can be installed under the mammary gland.

Examination before surgery

Before the operation, the patient should not have colds or other diseases. It is necessary to undergo examination:

  • do an ultrasound of the mammary glands and blood vessels of the lower extremities;
  • take blood and urine tests;
  • undergo an ECG;
  • consult an anesthesiologist.
  • Print list of examinations

You should take a bath the night before. Allowed light dinner. The operation is carried out strictly on an empty stomach; eating and drinking on the day of mammoplasty is PROHIBITED!

How does enlargement occur through the areola?

Mammoplasty through the areola is performed under general anesthesia and lasts about an hour. First of all, the surgeon makes a 3.5-4 cm incision to install the implant, along the pigmented edge of the areola, which differs from the skin in structure. Thanks to this, the scar is completely invisible in the postoperative period. Then Philip Nikolaevich creates a subcutaneous tunnel under the base of the mammary gland or under the pectoralis major muscle, without affecting the breast tissue. In this place there will be a so-called “pocket” for placing the implant. The implant is inserted into the pocket. After surgery, dissolvable sutures are placed in the skin and the patient is placed in a compression bra.

Postoperative period

You will be discharged from the hospital on the 2nd day after the operation. After 3-4 days, depending on how you feel, you will be able to return to work. In the first week you need to come to the surgeon for examination 1-2 times, then 1 time every 2 weeks during the first month, and finally 1 time in the next 3-4 weeks. You will need to wear a special compression cuff for 2-3 weeks after surgery. For the first 10 days, it is advisable to sleep on your back.

You can take a shower no earlier than 6-7 days after plastic surgery - just before that, your external sutures will be removed. The scars will appear pinkish for the first 3-4 months and then disappear. The aesthetic result appears 3-4 weeks after surgery. The final result depends not only on the skill of the surgeon, but also on the health of the patient and how carefully she follows the doctor’s instructions.

Beautiful female breast is a source of pride for every representative of the fair sex, regardless of her type of activity, age and social status in society. Besides, magnificent bust attracts the admiring glances of men, which cannot but please women’s pride.

That is why girls all over the world, whom nature has deprived large sizes mammary glands, trying to find a way to correct and enlarge them. Some people prefer to achieve elasticity and beautiful bust shapes with the help of sports training, others turn to plastic surgeons.

Surgical methods of breast enlargement

Breast augmentation surgery gives women the opportunity to improve their body and give it the desired shape. Modern plastic surgery has sufficient quantity techniques that allow you to change the size and shape of the bust. Among the most effective and popular methods of breast enlargement today are:

  • Lipofilling. Introduction to mammary glands own fat taken from the buttocks or sides of the abdomen. With the help of such an operation, it is possible to slightly correct the size of the bust, correct their cosmetic defect and reduce fat deposits in unwanted, “donor” places.
  • Mastopexy. Breast lift, which can be performed with or without an implant. The method helps restore natural proportions, improve the shape and enhance the aesthetics of the mammary glands.
  • Correction using endoprostheses. Silicone implants (or those made from hydrogel) are inserted into the patient’s mammary glands. saline solution etc.) It is this technique, as the most popular type of breast surgery, that will be discussed in our article.

How breast implants are inserted: pros and cons of methods

The most common types of mammoplasty are methods using endoprostheses. They allow you to get breasts of the desired size and shape, depending on the type of implant chosen. Today there are several installation methods, the difference between which is the location of the incision and the method of introducing the foreign element. Depending on the placement, breast implants can be installed entirely or partially under the muscle, as well as between the mammary gland and the muscle fascia.

Let's try to figure out which method is the safest and allows you to get ideally shaped breasts. Which access to choose, and what is the difference between them?

Incision under the breast - submammary approach

This is one of the very first types of breast plastic surgery using implants. Using access under the chest, plastic surgeons and today endoprostheses are successfully installed, but already created using new technologies. During surgical intervention an incision is made along the line of the natural fold located under the mammary gland, a place for the implant is formed and it is placed in the already created pocket.

IN in this case It is possible to install an implant under a muscle or under a gland. The first option is the most preferable, since it allows you to achieve more natural look bust.

Among the main advantages of submammary access are:

  • logic and perfection of technology;
  • easy rehabilitation period;
  • possibility of installing large implants;
  • preservation of breast tissue function.

The disadvantages of this method of breast augmentation include:

  • high risk the appearance of a wide postoperative scar in the lower part of the mammary gland, which is associated with displacement of the fold as a result of the installation of a large implant;
  • technical limitations of the method in combination with other types of plastic surgery;
  • the formation of a keloid scar that cannot be corrected.

Access through the areola - periareolar breast augmentation

This is the second most popular method of breast enlargement. Breast augmentation through the areola makes it possible to insert an implant through a small incision along the edge of the nipple. This method is the most acceptable from an aesthetic point of view.

Periareolar mammoplasty has a number of advantages:

  • an excellent opportunity to hide the fact of the operation thanks to an inconspicuous scar along the edge of the areola;
  • The technique is perfectly combined with other types of breast plastic surgery, in particular breast lifting, asymmetry correction, areola reduction, and the like.

Breast augmentation options that are implemented using access through the nipple have several significant disadvantages:

  • with a tendency to hypertrophied scarring, the mark from the incision can be very noticeable, as it is located in the very center of the chest;
  • if a breast implant is installed completely or partially under the muscle, then in the postoperative period the patient will feel significant discomfort;
  • there is a high risk of loss of nipple sensitivity;
  • Often, women after periareolar mammoplasty develop pericapsular contractures, which lead to deformation of the mammary glands.

Endoscopic breast augmentation through the armpits - transaxillary approach

This operation involves installing implants using a special endoscopic equipment. This surgical intervention involves the introduction of an endoprosthesis through an incision in armpit using medical optical instruments. In this case, mammoplasty is performed under the muscle, as the most effective and safe method of breast enlargement.

Breast augmentation through the armpit is the least traumatic method. It has several advantages:

  • the duration of the recovery period is reduced to two weeks;
  • the scar resolves completely within 4-5 months;
  • there is the possibility of reliable fixation of the prosthesis, which eliminates the risk of its displacement in the postoperative period;
  • During the operation, breast tissue is not damaged, which is especially important for women planning to breastfeed;
  • surgical correction lasts no more than 40 minutes.

Among the disadvantages of endoscopic breast augmentation, the following should be noted:

  • axillary access does not solve the problem of the formation of fibrous contractures;
  • Seamless mammoplasty has a fairly high cost.

Where are breast implants placed?

The use of different approaches for breast augmentation allows you to choose the location of endoprostheses. Depending on the location of the implant, surgeons distinguish:

Subglandular location (under the gland)

Placing the implant under the gland is suitable for active, muscular patients and allows for the most natural appearance of the breasts. appearance. This option of mammoplasty has many advantages:

  • after enlargement, the natural contours of the gland are preserved;
  • short recovery period due to low tissue traumatism;
  • the ability to eliminate soft tissue ptosis during surgery;
  • reducing the risk of bleeding in the postoperative period;
  • There is virtually no pain during scar healing;
  • When performing physical activity, deformation of the implant is eliminated.

Unfortunately, this method has its drawbacks, including: the likelihood of possible tissue infection during surgery, rejection of the prosthesis, and the formation of capsular contractures.

Subfascial location (under the fascia)

This placement of the endoprosthesis is performed infrequently. Breast implants are installed under the tissue of the gland, between the fascia and the muscle that it covers. The effectiveness of this method remains controversial. Despite this, some plastic surgeons consider this method to be the most acceptable for reliable implant fixation.

Subpectoral location (partially under the muscle)

The implants are installed under the pectoralis major muscle after cutting its lower part. The endoprosthesis turns out to be half covered with muscle tissue, and half with the mammary gland. Placing an implant into the pectoral muscles is widely used in clinics plastic surgery and is most in demand in Central America and the USA.

Axillary location (entirely under the muscle)

When installing a breast implant under the muscle, the lower part muscle fibers does not dissect, unlike the subpectoral type of location. This operation has many disadvantages, including a long postoperative period, limited hand movements throughout the entire rehabilitation, and a high risk of implant deformation.

Breast augmentation can be done by making a semicircular incision under the areola (the dark, pigmented area around the nipple). This method is called areolar or periareolar breast augmentation. The incision made here usually quickly darkens and is therefore harmoniously masked by the edge of the areola - the border between dark and light skin. But if you look directly at the chest, the scar still remains noticeable. With the perialeolar approach, the implant can be placed both above and below the mammary gland.

If the position of the implant under the muscle is chosen, then using this small semicircular incision under the areola, bypassing the mammary gland from below, the surgeon will form a pocket for the implant through the lower border of the pectoral (pectoral) muscle. After that, the implant will be inserted through the same incision. Areolar implant placement is the second most popular method of breast augmentation today.

Advantages

One of the most important and obvious advantages is the absence of scars in the fold under the breast (as with submammary access), which “give away” the fact of the operation. A small incision at the bottom of the areola (as well as an incision in the armpit) is not usually associated with breast implantation (according to at least, among non-professionals).

Another advantage of this approach is the ability to combine some additional breast adjustments with breast augmentation:

  • Breast lift (for mild ptosis)
  • Correction of breast asymmetry or position of the areolar complex
  • Reducing the areola if it is large in diameter

periareolar breast enlargement - hypertrophied scar

Flaws

  • If you are prone to irregular scarring, the scar will be clearly visible, as it is located right in the center of the chest
  • When placing the implant partially or completely under the pectoral muscle, connective tissues and the muscles must be separated, which leads to more discomfort in the postoperative period.
  • Risk of loss of nipple sensitivity. But in general, with the periareolar approach, this risk is slightly higher than with breast augmentation through other incisions (under the breast or in the armpit).
  • Increased risk of capsular contracture. This is most likely due to the fact that the areola and breast tissue contain bacteria that can be transferred to the implant during insertion through the areola.

Recovery period

The recovery period is generally the same for breast augmentation by any method. The discomfort is not caused by the location of the incision, but by the tension of the tissue after insertion of the implant and surgical manipulations, such as tissue detachment to form a pocket. In most cases, the operation does not require the placement of drainage tubes.

The patient must wear a special compression garments, which not only helps the implant quickly take its position, but also helps reduce swelling and more comfortable passage postoperative period for the patient. The patient can return home the next day after surgery. On this day, you can already take a cool shower, use shampoo and a soft washcloth.

On average, after 5-7 days, most patients return to their usual routine, only limiting significant physical activity. Full physical activity can be resumed 6-8 weeks after surgery.

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