Micromastia is a pathology, the sign of which is a small breast size due to underdevelopment or loss of volume.
The content of the article:
Structure and development of the mammary gland
Aesthetic parameters of breast perception
Principles of plastic correction of small breasts
Characteristics of breast implants
Plastic correction of small breasts
Features of the course of the postoperative period
Micromastia
Breast underdevelopment can provoke many reasons. As a rule, it occurs in infantile girls and in masculine women who have signs of both sexes and suffer from hirsutism. According to statistics, micromastia is observed in 28-35% of women.
Micromastia can be unilateral — with underdevelopment of one of the mammary glands, bilateral — with a small size of both mammary glands.
Usually micromastia gives a woman only psychological discomfort, since during lactation the breast can perform its function completely. Although there are also severe cases when treatment is mandatory.
Only after 16-18 years, after the completion of breast formation, it is possible to diagnose micromastia. The reasons for its development are quite diverse, but among the main ones are the following:
heredity;
intoxication, which can occur as a result of acute or chronic diseases, surgical interventions, malignant neoplasms of the endocrine organs;
hormonal disorders;
drastic weight loss — the breast consists of a large amount of fatty tissue, so with its lack, micromastia can also develop;
age — over the years, women have an involution of glandular tissue. Because of this, the breast may shrink.
To correct the pathology, it is necessary to determine the reasons for which micromastia has developed. Hormone treatment is used in the presence of endocrine disorders. If the reason is different, then the treatment is carried out surgically. Gels are not used to enlarge an underdeveloped breast, but implants and prostheses are used. The prosthesis installed in the breast does not affect the course of pregnancy and lactation.
Structure and development of the mammary gland
The mammary glands complement the reproductive organs and are modified sweat glands. They are covered with thin skin, especially tender in the area of the areola. There are sweat and sebaceous glands on the areola of the nipple. Nipples of different women can have different shapes, harden when excited. In each mammary gland there are 15-20 lobules that produce milk. They are surrounded by a large amount of fatty tissue. From the lobules to the nipple go the milky ducts, which open at its top. During pregnancy, the endocrine glands produce hormones, under the influence of which the breast swells and increases in size, after which it produces milk necessary for feeding the baby.
Breast size can change over the course of a lifetime. This is especially noticeable during periods when the level of estrogen in the blood increases. For example, during pregnancy, lactation, and puberty.
Breast development in the fetus begins at the 5th month of development, and by the time it is born, it already has a nipple-areolar complex and primitive excretory ducts. In the first 2-3 years of life, the nipple develops, after which it increases.
In medicine, the process of breast formation is divided into 6 stages.
Puberty period. At the age of 10-15 years, the girl’s breasts swell and become denser, the areola of the nipples darkens, there is an overgrowth of fatty tissue in the breast, which is why it increases in size. When palpating the breast, you can feel hardening — glandular tissue.
Early reproductive period. At the age of 15-25 years, individual anatomical and physiological characteristics appear in the breast. There is an active development of the glandular structure and ducts.
The period of maturity. At the age of 25-40 years, the breast is ready to fully perform its functions.
The period of involution. In 40-55 years, the glandular tissue of the breast becomes smaller, it is replaced by adipose tissue and connective tissue.
The period of extinction. At 55-80 years of age, the involution continues, the breast loses its shape.
The period of old age. After 80 years, the breast sags, and its volume decreases. At this time, the risk of developing neoplasms increases.
Aesthetic parameters of breast perception
Ideally, the breast should be in the shape of a cone or hemisphere. Its base should be on the chest wall, and the protruding part should be the nipple. When drawing an imaginary line through the nipples, the axis of the breast should be formed, on both sides of which it is uniformly convex, has the same weight. The ideal breast has a small inter-thoracic gap, the lateral part of the gland is close to the edge of the torso or protrudes beyond it (thanks to this, the waist seems thinner), a natural shape with a filled lower part. In this case, the diameter of the nipple should be 0.8 cm, and the areoles — 3.5-4.5 cm.
Principles of plastic correction of small breasts
Mammoplasty is one of the most popular procedures in plastic surgery. Every year around the world, about 1 million girls increase their breasts. Thanks to mammoplasty, it is possible not only to change the shape and give an aesthetic appearance to the breast, but also to correct such a defect as micromastia. Mammoplasty treatment is also performed with sagging breasts, asymmetry, hypertrophy or after removal of the mammary glands.
Most plastic surgeries on the breast are associated with its enlargement. Most of the women who have decided on this operation have a normal breast structure and there are no endocrine diseases, but their breasts do not correspond to modern ideals, which is why women may have severe emotional experiences.
Another group of those who want to increase their breasts are women with initially normal breast size, which decreased after breastfeeding a child.
Endoprosthetics is possible only after the end of breast growth — that is, after 18-20 years. Before the operation, the patient must undergo a full examination, after which the surgeon will make the necessary measurements and recommend implants of the most suitable shape and size.
At the moment there is a huge selection of implants of different shapes and sizes. During the operation, the doctor can only enlarge the breasts or, if the patient wishes, also perform a lift.
The result after the operation is affected by the psychological state of the woman, the initial appearance of the breast, a possible allergy or surgical interventions previously performed on the breast, a tendency to bleeding or scarring. All these points are discussed with the doctor before the intervention.
Characteristics of breast implants
All implants have a shell: smooth or textured. Its function is to hold the filler. In addition, it plays an important role in engraftment. It should be strong to withstand all loads, and at the same time soft and thin, so as not to injure the surrounding tissues. Most modern prostheses have a textured surface. It comes into contact with a large number of surrounding tissues, thanks to which the implant takes root faster and better, and the risk of complications is significantly reduced.
Implants can be round or teardrop-shaped. Teardrop—shaped are anatomical prostheses. They look natural and are suitable for most women. Most often, doctors prefer prostheses of this form. But round implants are not bad either. In some situations, the surgeon may recommend using them. During the operation, they can be given the desired shape.
The profile of the prosthesis is the ratio of the height and width of the base. The surgeon can choose implants with different profiles. It depends on what result the patient wants to get.
Today, implants are filled with a special gel. It is viscous, so even if the implant is damaged, it will not leak out. This gel has several types of fluidity: soft, elastic and dense. There are also prostheses that are filled with saline solution. There are also combined prostheses with 2 cameras. At the same time, one of them is filled with gel, and the other with saline solution. Thanks to prostheses with saline solution, the breast size can be changed up or down by increasing or decreasing the volume of fluid in the implant. Two-chamber prostheses are most often used in reconstructive mammoplasty.
Expander implants are also used in reconstructive mammoplasty. During the operation, the doctor places them in the chest and fills them with saline solution. Thus, a specialist forms a place for the installation of a silicone implant within a few weeks or months.
Plastic correction of small breasts
The procedure for breast enlargement takes place under general anesthesia and lasts from 30 minutes to 2 hours. Access to the breast is chosen by the doctor based on the individual characteristics of the patient’s body.
There are 3 types of access in total:
1. incision under the breast (submammary). Such an incision, as a rule, has a length of 3.5-5 cm. This is usually enough to place the prosthesis both under the glandular tissue and under the large chest muscle. This technique is often used by surgeons, as the doctor can see and control the course of the procedure. The disadvantages of this method include high invasiveness and, as a result, a long rehabilitation period. After applying this method of surgery, a rather large scar may remain;
1. incision around the nipple-areolar complex (periareolar). After using this method, there are practically no traces of surgical intervention. However, this method is not recommended for women who want to give birth and breastfeed. This is due to the fact that a large amount of damage occurs during the operation. For this reason, women may have milk stagnation in the future, which can lead to mastitis. In addition, after the operation, there is often a loss of nipple sensitivity. This method is not suitable for a significant increase in breast volume;
1. incision in the axillary area (axillary). The scar after this operation is almost invisible. Also, the advantages of the operation include the ability of the doctor to control the entire process, so that damage to blood vessels and lymph nodes can be avoided. This possibility exists thanks to the endoscope. This operation is not performed if the patient wants to get a breast size larger than 4. This method requires the experience and professionalism of the surgeon.
Breast augmentation in 2 stages is performed if the patient does not have the right amount of tissue to install a prosthesis of the required size. For 1.5 months, a woman wears expanders that stretch the skin. After that, the breast is enlarged by one of the three methods above.
The placement of the implant is also chosen by the doctor. It depends on what the initial state of the breast is. During the operation, the surgeon can place the prosthesis under the glandular tissue, under the large chest muscle or in combination.
Features of the course of the postoperative period
Rehabilitation after breast augmentation lasts, as a rule, for a short time, the pain is not clearly expressed and is easily relieved with the help of painkillers. For 2-3 days after the procedure, the woman should be in the clinic. In some cases, the doctor may prescribe antibiotics. The stitches are removed for 7-10 days.
For the first month and a half after the procedure, the patient should use compression underwear, avoid performing heavy physical work. For the first time after the operation, it will be difficult to raise your hands. Therefore, it is desirable that household actions, during which you need to make such movements, are performed by household members.
In addition, after surgery, it is recommended to refrain from sexual contact. This is due to the fact that during arousal, blood circulation in the chest increases, which can cause the appearance of hematomas.
The results achieved during mammoplasty are preserved throughout life — there is no need to replace prostheses. The only condition for maintaining the initial result is maintaining a stable weight: during weight gain, the skin is stretched, which can lead to sagging breasts and implants (if they are located under the mammary gland). If the prosthesis is located under the pectoral muscle, then the change in body weight will not affect the appearance of the breast in any way.
