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Pectoral augmentation
(Pectoralis major)
The pectoralis major, the big breastmuscle, can be congenitally
underdeveloped or totally missing, on one or on both sides. This is called
Poland's Syndrome. Certain diseases can inhibit the muscular development
or cause a muscular degeneration, like polio or paralyses. The muscle
can of course degenerate by physical inactivity as well. The pectoral
bulks dominate the contour of the chest and gives an athletic look of
the chest.
The extreme awareness
of the body nowadays, seen as the popping up of fitness-studios, makes
people more concerned about the shape and volume of their muscles. In
spite of hard training the desired shape might not be achieved and all
these factors might give a desire for surgical pectoral augmentation.
All these conditions
can be improved by replacement or augmentation of the muscle by implants.
Principle:
A solid but soft implant made of silicone is inserted through the axilla.
The shape and size of the implant can vary. Either can the belly be augmented
with a spool-formed implant or the whole muscle be augmented with an anatomic
shaped implant.
Methods: A
4 - 5 cm long incision is made high up in the axilla. If the muscle is
missing, a pocket is developed under the skin. Otherwise a pocket is dissected
under the muscle, just as big as the implant is. If the pocket is made
bigger, the implant can dislocate. The pocket and the skin are closed.
A compressive and fixating bandage is applied for one week.
Anaesthesia:
In Poland´s syndrome, the procedure can be made in local anaesthesia
combined with heavy sedation. In pure submuscular augmentation, general
anaesthesia is preferred.
Operating time:
1 - 2 hours.
What happens afterwards?
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During
the first 24 hours there will be some heavy, tensile pain, which will
gradually disappear during the first week. Painkillers will be needed. |
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Antibiotics
and anti-inflammatory will be prescribed for 7 days. |
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Initially
the breasts will be swollen. The swelling disappears gradually during
the first month. |
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The
stitches are removed about the 10th day. |
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One
should sleep on the back. |
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Avoid
moving the arms over the horizontal plane or restrict moving the arms
to prevent for dislocating the implants. |
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Avoid
car driving during the first week. The same reason as above. |
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Restrict
from physical activities for 4 weeks. |
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The
time off is 1 - 2 weeks depending on activities. |
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Connective tissue surrounds the implants and keeps them in place if
the implants are "immobilized" the first 3 - 4 weeks. |
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Transient
numbness or hypersensitivity over the muscle is not unusual during
the first 1 - 2 months. |
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COMPLICATIONS
Referred unwanted biologic events can occur with a certain low frequency
and must be regarded as calculated risks. Other risks not mentioned
can also occur. For patients this must be considered before a decision
for plastic surgery is set.
Bleeding:
All operations can cause postoperative bleeding. These risks increase
by the intake of analgesics and Vitamin E. These should be avoided
2 weeks prior to the planned operation.
Infection:
All operations can cause infections. An implant has to be removed
temporarily and can be reinserted after a few months in case of
infection.
Capsular
contracture: Every foreign body causes a formation of surrounding
connective tissue, a capsule. If this capsule contracts, the implant
can be deformed.
Dislocation:
The implant can be dislocated or change position. This is often
due to direct injury to the muscle.
Scarring:
All scars are red for a couple of months and they fade away during
the fist year. Direct sun or solarium against the scars should be
avoided to prevent them for permanently become red or pigmented.
The scars are normally very discreet.
Smoking:
Smoking does compromise blood circulation and healing. Smoking should
be abandoned prior to a planned operation
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