When performing mammoplasty, incisions are made in areas where their visibility after suturing will be minimal: either along the lower edge of the areola, or in the inframammary fold, or in the armpit. About six months after plastic surgery to change the shape and size of the mammary glands, the scars become almost invisible visually and cannot be detected by touch. However, due to reduced skin elasticity, inflammation or non-compliance with recommendations during the rehabilitation period, they may stretch and have an insufficiently aesthetic appearance. It is very rare, but the formation of a keloid (excessive, rough) scar is possible. In these cases, surgery is performed to correct scars after mammoplasty.
Indications for scar correction after mammoplasty
- scar hypertrophy - scars are clearly visible and can be identified by touch, have a bright pink color, protrude above the surface of the skin, and can be painful when pressed;
- formation of a keloid scar - scars protrude above the surface of the skin, often tighten it and tend to grow. The tendency to form keloid scars is an individual (genetic) feature of the body, which cannot always be identified before surgery.
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Breast lift without scars: report from the operating room. Olya's story
How to lift sagging breasts? Surgeon Vardan Arshakyan shows a technique that allows you to do this with a minimum number of incisions and almost no rehabilitation. Report from the operating room and the story of patient Olga.
Vardan Arshakyan – plastic surgeon, candidate of medical sciences, oncologist-mammologist. He was one of the first in Russia to start working with the BodyTite device. The Israeli BodyTite device was originally developed for minimally invasive liposuction, and has proven itself excellent in this capacity. But it turned out that this is not all he is capable of. (The website of the company that represents it is www.invasix.ru and on Instagram - @inmodemd)
According to Dr. Arshakyan, this is the best technique for lifting small breasts and correcting asymmetry.
The doctor undertook to demonstrate how it works and chose two volunteers from among our readers.
The first contender was Olya, a beauty journalist. (To forestall possible questions: we did not lobby Olya, the doctor made the decision on his own, but it’s nice to know that our colleagues trust us and participate in our projects.)
In the application Olya wrote:
“I used to have beautiful breasts of almost size three. She stood like Madonna in her early years. The coolest compliment of my life: “If you put a pencil under your chest, it will immediately fall.” Unfortunately, after two births, the entire arsenal of the artist would fit there. I wear a bra even at home, otherwise it’s sad to look in the mirror.”
On the day of the operation, Olya was a little worried. “Before that, I lived like in a castle: no surgical interventions, no fractures, no chronic diseases. Apart from chickenpox, there is nothing to talk about with me :) But Vardan Aramaisovich is an incredibly attentive doctor. He explained in detail how the operation is performed. I drew how the muscles and glands are located. At the very first consultation I realized that I could trust him.”
Vardan Aramaisovich: “Previously, in order to reduce the area of skin, it certainly had to be excised. Now it is possible to do this using radiofrequency exposure.
The BodyTite device solves two problems: it breaks down the subcutaneous fat layer and reduces the skin flap. Therefore, the technique is used in liposculpture of the body (abdomen, hips, back, arms), for lifting the lower third of the face and combating a double chin, as well as for correcting ptosis of the mammary glands.
Thanks to this technique, I can avoid vertical scars and gland detachment, the so-called periareolar mastopexy, and make do with a minimum number of incisions. In the future, the patient will not have problems with lactation, and after the operation she will not need to wear compression garments to “shrink” the skin and undergo procedures aimed at improving turgor.
This is the least traumatic technique. But you need to understand: because of this, its capabilities are limited. The Body Tite device is capable of correcting 1-2 degree ptosis, provided that the breast volume is within the normomastia range (2.5-3 sizes). Olya is an ideal candidate for such a procedure.”
Photo before surgery:
Usually patients are sent home on the same day the operation is performed, but to make Olya feel calmer, she will be left in the hospital for a day. Tomorrow she can lead a normal life. Vardan Aramaisovich says: “The only limitation: until we remove the stitches, you will need to shower carefully. So as not to wet your breasts.”
This doesn’t scare Olya: “I have a lot of dry shampoo :)”
The doctor begins marking.
“This is one of the most important parts of the operation. It is at this stage that asymmetry is corrected. The marking is done while standing: when the patient is lying down, it is problematic to understand which mammary gland is higher and which areola is lower.
It is considered physiologically correct when the nipple is located at the level of the middle of the shoulder. Plus or minus two centimeters. We must lift the breast so that the nipple is at this level.”
Vardan Aramaisovich takes measurements with the precision of a meticulous couturier.
“You can do the markings by eye, but I’m used to trusting the numbers. The eye does not notice the slight asymmetry.”
Olya has minor asymmetry. The upper edges of the areola are located at an equal distance from the jugular notch of the sternum, but one nipple is located lower. “I will correct this by increasing the heating of the upper pole.”
Olya: “After the first lactation, one breast sank more. Therefore, I fed the second child differently. The difference has evened out a little.”
“During feeding, not only the skin, but also the areola stretches. I suggested to Olya that she adjust her size so that her breasts would look more harmonious. This is a simple manipulation that does not affect the ductal system.”
Vardan Aramaisovich applies stencils to the nipple to select the appropriate diameter. Olya seems to have forgotten about her excitement and jokes: “Which one suits me, M or L? And, Doctor, it looks like you loved geometry at school.” - “I adored it.” I took an advanced math class, and it still helps me in my work.”
Radiofrequency correction of mammary gland ptosis: report from the operating room
The operation does not last long, one and a half to two hours, so Olya is given local anesthesia and so-called sedation - put into a state similar to dozing. The doctor believes that such anesthesia is tolerated more easily by the body than standard endotracheal anesthesia.
The operation is carried out in three stages.
The first is the treatment of the subcutaneous fat layer with the BodyTite device.
Vardan Aramaisovich makes an incision with a scalpel along the border of the areola.
The surgeon will now operate the BodyTite device. It has different attachments for different parts of the body. When correcting the shape of the breast, this is used:
It consists of two electrodes. One (thin) electrode is inserted into the subcutaneous fat layer through an incision along the border of the areola and delivers radiofrequency energy. The second remains outside, on the surface of the skin, and receives the signal.
Vardan Arshakyan: “In the first post, when we were looking for volunteers, there were many questions about the safety of the technique. I will answer them here.
So why is this technology completely safe? First, the RF beam has a controlled and predictable direction. It occurs strictly between two electrodes and does not affect adjacent (so-called underlying) tissues. This is the difference between the BodyTite bipolar technique and, for example, the monopolar Thermage procedure. The mechanism of physical influence in both cases is the same - radio wave. However, Thermage has one electrode, so the doctor can only control the dissipation of Rf energy very loosely.
Secondly, the operation affects exclusively the subcutaneous fat layer of the mammary gland. We do not interfere with the glandular component, the ductal system and the nipple-areolar complex.”
As a result of heating, part of the adipose tissue is destroyed, and the mechanism for the formation of new collagen fibers is launched.
Vardan Aramaisovich: “I prefer to warm up the tissues gradually and not aggressively. I keep the temperature at 38°. I warm up the areas that need to be tightened more (to correct asymmetry) more actively.”
The surgeon moves the nozzle. The external electrode slides over the surface of the skin, and this allows you to control where the effect is currently occurring.
The control system resembles the parking sensors system in a car. The device makes beeping sounds. As the temperature rises, the beeping becomes more frequent. In addition, the surgeon is assisted by an assistant: she reads out loud the temperature of the subcutaneous fat and epidermis, which is read by sensors.
Already on the operating table you can see how the skin contracts. Stretch marks disappear before our eyes. But the process of collagenesis will continue for another six months: month after month, turgor will improve.
Those standing next to the operating table can hear the subcutaneous fat “breaking”. Popcorn makes a similar sound.
The second stage of the operation: reduction of the area of the areola.
It is performed using the usual surgical method. The doctor outlines the boundaries of the new areola with a scalpel and sutures the boundaries.
Pink spots appear on the surface of the chest (if you look closely at the photo above, you can see them). Vardan Aramaisovich is pleased: “Hyperemia. This means that we have warmed up the fabrics well. The result will be great."
Third stage: tightening the surface layer of the skin with Fractora
BodyTite is a multifunctional device. In addition to surgical purposes, it can operate in Fractora fractional radiofrequency mode. That is, to compact, tighten and even out the skin texture. In the case of ptosis correction, Fractora is included in the price and comes as a bonus. If necessary, of course.
According to the doctor, there is such a need: the skin is thin and flabby. It will be useful to stimulate the epidermis.
The applicator has a large number of needle electrodes that heat the dermis using radiofrequency energy.
This completes the operation. The stitches are secured with plasters, and Olya is taken to the ward.
An hour later she sends a text message: “Anesthesia is a plague! I fell asleep in two seconds. Now I’m editing the video, I feel great. I’m waiting for the second volunteer girl to be brought to the ward, there will be something to discuss!)”
First sensations and results
The next day, the doctor changes the bandage and sends Olya home.
Olya: “Immediately after the operation, my roommate Sveta (that’s the name of the second volunteer of the project - Ed.) and I had similar sensations. It was as if I had fallen off a bicycle, only I tore up not my knee, but my chest :) In general, I can’t boast of a high pain threshold. Even elos hair removal was ummm... sensitive for me. And here, although it is unpleasant, it is tolerable.
A couple of hours later, a magical woman came and put on a drip with painkillers. It was absolutely wonderful :)"
Vardan Aramaisovich: “Before the operation, I warn patients that the breasts will rise by an average of 3-4 centimeters. Perhaps stronger. It is impossible to say the exact number in advance: the skin reaction is individual. The next day is still very early to evaluate the result, but I can already see that Olya’s skin has turned out well.
The swelling will increase and reach its peak by the fifth day after surgery. Then it will gradually go away. On the 14th day we will remove the stitches. Before this, Olya should not wet her chest and sleep on her side. The skin should be treated with Bepanten cream. It is not necessary to wear compression garments - a sports or tight-fitting top is enough.
Red dots are normal after the Fractora procedure. In a few days they will disappear.
Olya’s feelings after a week:
“The most difficult thing was getting home after the operation. I called a taxi, and every bump, bump, and rail felt pain in my chest. At home it felt much better: there was just a nagging, aching sensation here and there. The next two days were weekends, so I watched a movie and didn’t go out.
On Monday, I cheerfully went to get the bandage changed, and Sveta actually went to work. I probably wouldn’t really want to go to the office, but there were no unpleasant sensations that would seriously interfere with this. This is not childbirth, after which you recover for a week :)
My friends who had breast implantation said that they practically just lay there for a month. I expected something similar to await me, but everything turned out to be much simpler. I live almost the same as before the operation. I take the children in my arms (the doctor asked me to be more careful with weights, but I have already violated these recommendations a hundred times). Among the inconveniences, there is a slight stiffness and it is uncomfortable to sleep on your back. I put a pillow on it and try to lie down on my side.
The first five days there was such great swelling - and volume!) Now it has gone down, but the result is still obvious. And it's even better than my expectations.
Frankly speaking, I didn’t fully imagine what I would get in the end. With implants it’s easy to predict: there will be balls like this. And here’s a lift. While maintaining the natural shape of the breast. “Well, ok, let’s check,” I thought.
In addition to lifting my breasts, stretch marks and sagging have gone away. The skin is incredible! Previously, before this procedure, I somehow caught myself when buying clothes, choosing the one that covered the neckline. Although before giving birth I loved cutouts and sexy dresses. But there was nothing to be proud of... Now the skin is so tightened and smoothed out - fantastic! In general, I am surprised, captivated and want to quickly choose new beautiful underwear.”
First results: removal of stitches
Two weeks later, Olya came to have her stitches removed. The procedure takes literally 5-7 minutes, but is not very pleasant. It was felt that Olya was worried, so Vardan Aramaisovich distracted her with a conversation: “I heard that you had a social event today, the opening of a Sephora store?”
“Oh, yes,” Olya replies, “the queue at the entrance is almost from the metro. A lot of people, champagne, everything as usual.”
“Champagne in the morning? “I guess I chose the wrong job,” the doctor jokes, and meanwhile the stitches have already been removed.
Vardan Aramaisovich: “I am pleased with the result. Before the operation, the left mammary gland had the second degree of ptosis. Right - first. Now he is completely gone. The nipple is located above the inframammary fold.
By the way, a short educational program for those who do not fully understand the difference between types of ptosis:
- 1st degree – the nipple is at the level of the lateral projection of the inframammary fold.
- 2nd degree – located below the fold and “looks” forward.
- 3rd degree – below the fold and directed downwards.”
Olya seems to have only one emotion: “Yuppiiii! I'm happy!"
Finally, let’s compare the “before” and “after”:
Important: the patient has one shoulder higher than the other, so in the frontal collage it seems that the “after” photo is located slightly lower. Actually no: notice that the navel is at the same level.
Stay tuned, the next article will tell the story of our reader Svetlana. And a little later we will show the final result of both heroines.
Other works of Vardan Arshakyan can be viewed on his website.
Institute of Plastic Surgery and Cosmetology: Olkhovskaya, 27, tel.: +7 (495) 775 01 02
The price of radiofrequency correction of breast shape is 200,000 rubles. or 25,000 rub. for 1 quadrant. The quadrant is the “quarter” of the mammary gland. This unit of measurement is used when the surgeon corrects not ptosis, but asymmetry, and works only with certain areas of the breast.
Methods for correcting scars after mammoplasty
Surgical correction is performed no earlier than six months after breast augmentation, reduction or breast lift surgery, after the “ripening” of the scar is completed. When a keloid scar forms, special therapy is first performed to prepare the scar for plastic surgery.
The correction itself consists of excision of the deformed scar and underlying tissues, if necessary, replacing damaged areas of skin with healthy ones. The main task is to make the consequences of the operation as less noticeable as possible, eliminate stretching and transform the postoperative sutures into a neat light strip.
The duration of the operation to correct scars after mammoplasty is 30-60 minutes. Performed under general anesthesia or local anesthesia. Hospital stay depends on the volume and complexity of the operation.
Goals and objectives of mastopexy
Mastopexy (lift) does not make the breasts larger or smaller, but it does “raise” the mammary glands. The operation does not affect breastfeeding - in the future it is quite possible, because the surgeon does not injure the tissue of the milk ducts. Mastopexy is performed in two ways, the choice of a specific one is made on a strictly individual basis:
- the first stage – the sagging is still slight, so you can do a lift along the outer line of the areola;
- the second and third stages - the doctor performs the operation in a vertical manner, when the scars run along the areola line and down to the submammary fold.
Sometimes the surgeon decides, even in the second stage of ptosis, not to make a vertical incision, but offers the patient a small breast augmentation. If the mammary gland is too large by nature, then its sagging begins at a young age; for this it is absolutely not necessary to feed the child. In such cases, an anchor lift , special meshes are additionally used - a very large load is placed on the skin, so the results obtained after plastic surgery should be preserved in every possible way.
Cost of scar correction surgery
The cost of correction depends on the extent of the operation. You can find out the cost of the operation in the “Prices” section or by calling the main phone number of our Plastic Surgery Center “SM-Plastic” +7 (495) 777-48-05 . You can make an appointment with a plastic surgeon using the feedback form.
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At what age is it best to have a breast reduction?
Today, experts do not identify a specific, most acceptable age for breast reduction. As a rule, most surgeons agree that before performing this operation, the breasts need to be fully formed, despite the fact that they can be extremely voluminous even in a 14-year-old teenager, and cause a lot of both physical and psychological problems. As a rule, the optimal age for surgery is from 18 years old, when a person can already relatively sensibly weigh all the risks, the pros and cons of the operation.
How long will the recovery period last?
It usually takes 1 month to fully recover and resume most daily activities. Before this, it is undesirable to put any kind of stress on the chest and upper body as a whole. Most patients return to work after 2-3 weeks, especially if the work is sedentary and does not involve stress; during this period, swelling and bruising have time to subside. Often women worry not so much about post-operative troubles in the form of bruises, swelling, uncomfortable compression garments, but rather from the unusualness of the situation and the inability to accept their “new” breasts - the feeling of lightness can also have an unpleasant side. However, although everyone recovers individually, in order to feel their breasts as “mine” again, it usually takes about 2-3 months.
