Edited by Dr Masino Scutari
" first part
THE SURGEON'S ASSESSMENTS
During the first meeting with the woman, the specialist evaluates the following factors:
1
The reasons that led the person to want to change his appearance. It is important to be aware that a slight breast relaxation is completely natural and, if normal, it is not unsightly.
2
The age of the woman. We must, in fact, keep in mind that, before undergoing any surgery, the breast must have completed its development.
3
The size of the breast. If the breasts are bulky, the surgeon, in addition to "lifting", must also reduce the amount of breast tissue (gland and fat) during the same operation. In practice, reduction mammoplasty is added to the normal breast lift.
4
The shape of the breast. In this regard, it must be said that a beautiful breast must correspond to precise characteristics, therefore it should be conical in shape (see drawing 2); her nipples should "look" slightly outwards and not forward, the two breasts should not be too close together, they should have the same volume and the same height.
5
Breast measurements. The ideal breast (regardless of shape and size) should have a distance of approximately 6 centimeters between the nipple areola and the inframammary groove. There should be approximately 10 centimeters between the nipple apex and the upper base of the breast.
THE NEW ": THE NATURAL BRA
Normally, if your breasts don't "hold" you are wearing a bra. Nothing more obvious, but in this case we are talking about an absolute novelty in the "field of aesthetics": an internal subcutaneous bra. This is not the traditional graft of synthetic material (prosthesis), but a completely natural breast support, made up of the same tissue as the woman who undergoes surgery.
THE ADVANTAGES OF THE NEW METHOD
The advantages of the new "natural prosthesis" are: permanent duration and inalterability over time; the minimum size of scars; the fact that its presence is not felt to the touch.
The method was devised by the Paduan surgeon Masino Scutari. In practice, a small incision is made around the areola of the nipple, a small portion of the muscle band that surrounds the pectoral muscles is removed, it is placed in a "cup" shape under the breast and the right and left margins are anchored to the muscle. bib.
The new autotransplant does not cause rejection as the patient's own tissue is perfectly tolerated by the organism. Unlike artificial prostheses (similar techniques involve the use of silicone sheaths or nets made of materials that are foreign to the organism) the muscle groups do not they develop the so-called "fibrous capsule" which over time can give the breasts an unnatural shape and a hard texture to the touch.
The impossibility of the formation of the fibrous capsule is possible thanks to the fact that the two tissues that come into direct contact, that is the mammary gland and the fascia of the pectoral muscle, gradually integrate, until they form a single body.
THE PATIENT REQUIREMENTS
It is also necessary to consider the type of pectoral muscle of the woman.
The muscle band must in fact be wide and thick enough, so as to be able to guarantee effective support. These parameters are checked by the surgeon during the first medical examination.
THE INTERVENTION STEP BY STEP
1) The surgeon draws on the skin the outline of the incisions he will make. A smaller circle is drawn along the edge of the nipple areola, and a larger circle at a variable distance from the first. The first incision serves to delimit the areola of the nipple, the second serves as an access route to the subcutaneous tissue to perform surgery, and delimits the portion of excess skin to be removed (ie the one between the two concentric circles).
2) Depending on the woman's needs, a "local anesthesia accompanied by sedation or a" general anesthesia is practiced.
3) Starting from the periareolar incision, the subcutaneous tissue of the breast is detached at the top (up to the collarbone), down (up to the inframammary sulcus) and laterally (up to the armpit).
4) The fascia of the "pectoralis major" muscle is then freed from the upper half of the mammary gland to the collarbone. A "lamina" of connective tissue is then extracted (strong and elastic that acts as a support) which covers the surface of the muscle. The rectangle of muscular fascia taken has the base equal to the semicircumference of the breast and the height equal to the distance between the nipple and the inframammary sulcus. To get an idea of this natural support, you can imagine a "balconette" bra.
5) At this point we then move on to position the support band under the breast and fix its external margins, with special points, to the "pectoralis major" muscle. We then move on to external structures.
AFTER THE OPERATION
In the days immediately after the operation, antibiotic drugs are taken. After 2 weeks the containment bandages are removed (these are special analgesic patches). For the following 3 months, it is also advisable to wear a support bra.
In the event that the scars remain slightly wrinkled around the areola of the nipple, after a few months, it is possible to proceed, after a few months, with a small surgery to correct the scar under local anesthesia.
