The Actuality & Development Of Mammoplasty

The breast is the female's important symbol of secondary sex characteristic and postural beauty. But in the realistic life, the woman may be bankrupt in the aesthetic feeling of physique because of the mammary hypogenesis, mammary hypertrophy or the mammary damage after the operation of galactophore tumour,these may result in a series of the responses of psychology and sociality.In general the mammary anaplasty can reforge perfect breast and eliminate the regret of physique and mentality in allusion to the primary affection and the body disfigurement. The mammary anaplasty can be classified as the augmentation mammoplasty, the reduction mammaplasty, the breast reconstruction and the therapy of the nipple and areola disease etc.The mammary postural beauty of mature woman includes two aspects: quality character and quantity character. The mammary configuration is embodied in fundus diameter, height, prolapse degree, volume and the location of nipple. The breast figure can be divided into different shapes, such as half ball, taper, disk or prolapse. The normal female breast stand between the second and the sixth rib. The perfect breasts are characterized as chubbiness, symmetry, pliancy and erection. The volume of the breast is about 250~350 milliliter.The breast augmentation mammoplasty is one of the established aesthetic operations. With the social and economic development, the female aesthetic consciousness is increasing. The breast augmentation can shape a pair of chubby erection mamma and figure the ideal female curve in virtue of surgical artifice. Its main indicatio includes the primary mammary hypogenesis, the mammary organizepathological changes before adolescence or the secondary mammary hypogenesis affection. The system of augmentation mammoplasty includes the prosthetic augmentation mammoplasty, the augmentation mammoplasty by injecting or autotransplant. The material of the augmentation mammoplasty with artificial breast implants involves silicone prosthesis, saline-inflated mammary prosthesis, polyurethane-covered implants and textured surfaces implant etc. The triglycerides, Hyaluronic Acid and Polyethlene glycol are in tentative phases. The material of the augmentation mammoplasty by injecting involves polyacrylamide hydrogel and free autologous granular fat. Five kinds of incisions are usually adopted: the inframammary incision, the periareolar incision, the axillary incision, the axillary front line incision, and umbilical incision. The implants are placed submuscularly or subglandularly. The capsule contracture after breast reconstruction with ailicon implant is the main complication. The occurrence of fiberous capsule contracture is relevant to the type of prosthesis, the location of prosthesis, excessive bleeding, infection or the volume of lacuna etc. The contracture with serious capsule should be cut. The other familiar complications include the implant breach or basset, hematoma and ache etc.The strict performance of aseptic technique and skilled atioumatic operation, the complete stop of bleeding and the use of high quality artificial breast implants are the crucial points to reduce and avoid the complications of augmentation mammoplasty. The complications of augmentation mammoplasty by injecting include single or multiple nodules, asymmetry, hematoma, inflammation, and germfree inflammation etc.With the development of the microtechnique, the endoscopic techniques are applied in plastic and cosmetic surgery in order to peel off, stanch, sever in deep-seated structure. The main disadvantages of initial aesthetic breast augmentation are the lack of visualization of the implant pocket, necessitating blind, blunt dissection of the pectoral muscle origins. In order to address these shortcomings, the use of minimally invasive endoscopic techniques have been explored in 1990s. From then on the technology of endoscopic breast augmentation mastoplasty has been already used more and more. The advantages of endoscopic breast augmentation include minimal ravage, orthoptic operation, accurate manipulation, assured hemostasia, and easilyresume ect. It is described as a new method for the treatment of gynecomastia in order to reduce the scar of incision. The use of endoscopic techniques can avoid forming a new incision in the operation of capsule contracture and can be used to diagnose the leakage of silicone prosthesis. In recent years, as a new augmentation mamaplasty method, the external soft-tissue expansion system has already stired up the people's interest.The reduction mammaplasty is applicable for the mammary hypertrophy and ptosis breast. It can shape the breast through resecting a part of skin and mammary organization, reducing the form and structure, reforming breast situation, and refiting nipple and areola. According to the pathologic character, the macromastia can be classified as two kinds: the simple and the complex macromastia. It is necessary to do biopsy during operation for distinguishing the both. Different factors should be considered in the reduction mammaplasty. It is accord with reducing the volume, rectifying and resuming mammary normal shape, protecting mammary physiological function, hoding the normal sensation of nipple-aerolar complex, concealing skin incision, leaving behind less complications, designing simply etc. Mr.Goinard rectified the mammary hypertrophy through resecting mammary organization under the skin in 1903. More than 10 methods of the reduction mammaplasty have been reported from that time. The traditional technique includes: Strombeck reduction mammaplasty , Mckissock reduction mammaplasty , Biesenberger reduction mammaplasty, Lower pedicle reduction mammaplasty, Inferior pedicle reduction mammaplasty without vertical scar, Reduction mammaplasty with a circumareolar incision etc. Along with the development of the plastic surgery, many surgeons have modified the traditional technique to avoid its limitation and have developed a few new methods with some advantages in many aspects. The reduction mammaplasty should be selected according to the patient's situation. The degree of mammary hypertrophy and the experience of clinical practice should be also refered to in the clinic.The breast reconstruction is applied to improve the patient's psychological condition and the quality of life after cancer radical operation. The other indicatio of the breast reconstruction includes the mammary hypogenesis or the mammaryasymmetry caused by benign disease resection. The breast reconstruction can padded the scarcity, gain the breast hunch., and perfect the mammary harmony and symmetry. The content of the reconstruction involves six aspects: repairing the chest wall defects, reconstructing the breast, restoreing the axilla front wall and emptiness below clavicle, reserveing nipple-aerolar complex, and rectify the asymmetry of the double breast. The surgical reconstruction is classified as dilater (prosthesis) transplant and autologous tissue transplant. The latter includes different tissue types such as transverse rectus abdominis musclocutaneous flap, deep inferior epigastric perforator flap, latissimus dorsi myocutaneous flap, and gluteal myocutaneous flap etc. The surgical strategies in the treatment of operable breast cancer have changed basically within the last decade. Immediate breast reconstruction with autologous tissue has been applied gradually. Skin conserving operation for breast cancer has been accepted in recent years, so the breast reconstruction needs less skin. The higher requirements are embodied in reducing the operative scar, overcoming the shortcoming of traditional method and presenting good cosmetic outcome. The endoscopic techniques are applied in the collection and diversion of autologous tissue flap with advantages of gathering adequate tissue mass in limited skin incision and exposuring the pedicle easily. Alough the breast reconstruction was adopted late in China, its development is very quick. In recent years, there is a sharp increase in the quantity of operations. The myocutaneous flap, especially the latissimus dorsi myocutaneous has been applied widely for the immediate breast reconstruction. Immediate breast reconstruction with latissimus dorsi myocutaneous flap may be the fashion in our country.Although the mammoplasty is perfected in many ways, there are many possible complications due to the methods of mammary anaplasty and materials of augmentation mammoplasty. The following detailed and integrated datum about the possible complications and long-term effects after the mammary anaplasty are in short of reports also.In conclusion, with the development of the society, the conversion of mentality conception, the renovation of the medical equipment and technology, and the emergence of new stuff, the foreground of the mammary anaplasty should be bright and encouraging. The breast shape after operation of the mammary anaplasty will be perfect and verisimilar.