What Is a Breast Prosthesis?

Breast implants can be grouped into two broad categories. One type is allogeneous tissue, such as silicone prostheses and dilators; the other type is autologous tissue, such as various myocutaneous flaps (as shown in Figure 3).

1. Breast implants 1. Introduction

The breast is composed of connective tissue, milk-producing mammary glands, breast ducts, and adipose tissue. The connective tissue, breast glands, and breast ducts form the stent of the breast, and fat constitutes the body of the breast. Behind the breast tissue is the pectoralis major muscle. With the development of plastic surgery, the pursuit of plump and fit breasts has become the goal of more and more women. In addition, breast cancer is the malignant tumor with the highest incidence in women. Breast loss caused by breast cancer resection causes huge psychological trauma to patients and seriously affects quality of life. Therefore, the need for various methods to increase and increase the volume of the breast is increasing. At present, the methods of breast augmentation mainly include three categories: non-surgical method, injection method and surgical method. Generally speaking, non-surgical methods are often used for personal breast augmentation, non-surgical methods or injections are commonly used in beauty salons, and surgical methods are often used to achieve breast augmentation in hospitals.

Figure 1. Comparison of body size before and after breast augmentation

2. Breast implants 2. Breast augmentation methods:

1 Breast implant (1) Non-surgical method.

Non-surgical methods include three types:

1) Take hormone drugs, adjust hormone levels in the body, promote breast development, and improve secondary sexual characteristics. However, this method has large side effects and can easily induce breast cancer.

2) Wipe and rub external medicines and absorb them through the skin to achieve breast enhancement. However, this method has a short drug action time and the long-term effect of breast augmentation is not certain. However, long-term use or abuse may cause irregular menstruation, darker areola color, breast skin atrophy or thinning, etc. It may also increase the risk of breast cancer in the breast, vagina, cervix, uterus, and ovaries, and liver Kidney function is also impaired.

3) The physical effect of the machine is used, but instead of the real breast, the breast muscles are raised by this method, and the appearance is not beautiful. Now this method has been eliminated.

2 Breast implant (2) injection method.

The injection method uses a syringe to inject breast augmentation material into the breast. In the past, the breast augmentation materials injected were mostly liquid paraffin and liquid silicone, but the effect was not good after use, and there were many complications. fat. In recent years, with the development of liposuction slimming techniques, there have been more and more reports of injecting the sucked fat tissue into the breast for breast augmentation, which can achieve the effect of using waste and achieving both ends. Many people think that this method of breast augmentation is "green breast augmentation". Because it uses autologous fat, no rejection reaction will occur, which will reduce fat and increase breast milk, killing two birds with one stone. But this method is not very mature and needs to be explored and improved continuously.

3 Breast implants (3) surgery.

Surgical method, breast implant augmentation, is to increase the breast by surgically placing the prosthesis into the breast or the space behind the pectoralis major muscle. Breast implants are composed of a silicone elastomer shell. The shell is usually filled with a silicone gel or a soft adhesive silicone gel that retains shape memory. Since the 1970s, silicone gel prostheses have been widely used in cosmetic breast augmentation. It is a material commonly used by plastic surgeons at home and abroad. Due to its large molecular weight and jelly-like shape, it feels closer to normal human tissues. However, silicone and silicone gel breast implants affect the penetration of X-rays. Therefore, after using breast augmentation, X-ray examination of the breasts and breasts will be affected.

In addition, the implant can also be filled with physiological saline that is not harmful to the human body. However, due to the small molecular weight of salt water, it feels hard when filling is overfilled. When filling is not satisfied, the prosthesis is prone to rupture due to wrinkles in the outer membrane. Because physiological saline is filled under open conditions, it is extremely susceptible to contamination and may cause the formation of mold groups in the saline. Once the prosthesis is broken, it will cause harm to the human body.

Figure 2. Schematic diagram of breast implant site

(A: Breast implant implanted after the breast; B: Breast implant implanted after the pectoralis major muscle)

3. Breast implants 3. Types of breast implants

Figure 3. Major types of breast implants

1 Breast implants (1) silicone implants

Silicone prostheses were popular in the 1980s and consist of a silicone elastomer shell. This shell is usually filled with a silicone gel or a soft adhesive silicone gel that retains shape memory. Silicone prostheses are currently limited to patients with small breasts, good local soft tissue coverage, and unwillingness to use autologous tissue from other parts of the body. The method is to place the silicone prosthesis into the deep side of the pectoralis major muscle. If this space on the deep side of the pectoralis major muscle cannot accommodate the prosthesis, it needs to be expanded with a dilator. In recent years, most breast prostheses have used saline solution as a filling material. Silicone gel and saline solution are currently the most studied and widely used fillers.

Figure 4. Schematic of silicone implant placement

2 Breast implant (2) autologous myocutaneous flap

Over the past 10 years, advances in breast reconstruction technology have enabled women to choose to use autologous tissue to reconstruct breasts. The so-called autologous myocutaneous flap transplantation is to cut a certain volume of skin, subcutaneous fat and muscle tissue from a patient's lower abdomen, back, or buttocks and transplant it to a specific site for plastic surgery. Because the above three parts often have excess tissue, they are the most common source of autologous tissue in breast reconstruction, and the donor area will obtain a more beautiful appearance after removing some tissues. The most commonly used is the rectus abdominis myocutaneous flap. The advantages of the rectus abdominis myocutaneous flap are the large amount of transferred tissue and good blood flow. At the same time, it has the effect of shaping the abdominal wall. It is especially suitable for obese patients with abdominal swelling.

The following describes the surgical procedure with horizontal rectus abdominis flap transplantation as an example: The breasts of normal women are composed of lactating mammary duct tissue and fat, and breast cancer is one of the common cancers in women. The pathogenesis is mainly familial inheritance and menopause. Mastectomy is often used in patients with breast cancer. Sometimes people with a family inheritance of breast cancer perform bilateral mastectomy to prevent future tumors. Breast reconstruction is often used for mastectomy or preventive mastectomy caused by small tumors. Abdominal flap transplantation Cuts a certain volume of tissue from the patient's lower abdomen, including skin, subcutaneous fat, muscle tissue and blood vessels (as shown in Figure 5A), and transplants it to the breast for shaping (see Figure 5B). The last is the reconstruction of the nipple. One method is to transplant the contralateral nipple part to the reconstructed breast. The other method is to add a small piece of skin to the reconstructed breast. After the reconstructed wound heals, intradermal tattoos are used. Technology helps to get nipples and areolas with more realistic colors. Although this breast reconstruction is not perfect, it can also enable women to obtain a naturally realistic and durable breast (as shown in Figure 5C).

Figure 5. Schematic diagram of horizontal rectus abdominis flap transplantation

(A: a certain volume of tissue is cut from the lower abdomen; B: transplanted to the breast for plastic surgery C: the operation is completed)

4. Breast implants 4. Risks of breast augmentation

The current methods of breast augmentation include autologous tissue transplantation, breast implant placement and breast augmentation by injection. Either of these three methods is traumatic and invasive to the body, so it cannot be painless. Advertisements do not have surgery, no pain, and most rapid breast augmentation is by injection. In recent years, a new injection breast augmentation filling material appeared on the market-polyacrylamide hydrogel. This material imported from abroad is called Injelle Fowler and domestically produced Ogilvy. This material caused controversy among experts and scholars, and called for discontinuation (The State Food and Drug Administration has published on April 30, 2006, "Stop production, sales and use of polyacrylamide hydrogels (for injection) Notice "). Appealers are advised to go to a regular hospital for consultation before deciding whether to undergo surgery, so as not to be misled or even cause serious consequences. Finally, remind young girls that if you are not married or pregnant, breast augmentation surgery now may affect breastfeeding in the future. It is recommended to have children after marriage and consider breast augmentation after breastfeeding.

Breast prosthesis extended reading:

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