Repeat Operations on the Mammary Glands Following Various Types of Aesthetic Mammoplasty

The dissertation is dedicated to studying the experience of repeat operations on the mammary glands performed following various types of aesthetic mammoplasty. The causes of unsatisfactory results of primary surgical interventions are investigated, tactics and indications for repeat corrective operations after implant augmentation, various types of mastopexy, and reduction mammoplasty are developed. Early and late results of repeat interventions are analyzed, which makes it possible to form a systematized approach to selecting the correction method depending on the type of primary aesthetic mammoplasty.

Relevance of the problem. Repeat corrective operations following primary surgical interventions performed for aesthetic purposes can be identified as a separate direction of plastic surgeon practice. The inevitability of repeat interventions is determined by both objective factors, such as scars that represent the price paid for aesthetic perfection of form, and subjective criteria, such as the evaluation of the aesthetic outcome of the performed operation by the surgeon and the patient.

The problem of repeat corrective operations is especially relevant for aesthetic breast surgery. Predictable causes of repeat interventions after aesthetic mammoplasty, in addition to the general factors listed above, include the specific lability of the mammary gland in terms of its shape and size throughout a woman's life, associated with physiological changes in tissues and the ptotic position. The necessity of using implants for augmentation mammoplasty determines the dependence of the aesthetic surgical outcome on the individual organism response of the woman to a foreign body. In addition, there exists a number of causes leading to unsatisfactory results of aesthetic mammoplasty that can be attributed to unpredictable factors (use of flawed techniques, insufficient surgeon qualification, etc.) and should be analyzed separately.

The relevance of the problem of repeat corrective operations on the breast following aesthetic interventions is beyond doubt among leading plastic surgeons. Thus, according to Hindcrer U. (2001), for certain types of aesthetic plastic operations on the breast, the need for repeat correction can reach 50% of cases. In order to reduce the number of repeat operations, an increasing number of plastic surgeons analyze their experience of aesthetic interventions on the breast, identifying causes and patterns leading to additional corrective interventions (Wang L., Qiao Q., Luan J., 2000; Vagal C.N., Peck F. et al., 2001).

In our practice, we also frequently encounter the necessity of repeat corrective operations following various types of aesthetic surgical interventions on the breast performed both in our department and in other medical institutions. The analysis of the experience of repeat corrective operations following various types of aesthetic mammoplasty formed the basis of this study.

Goal of the study:

Studying the experience of repeat operations on the mammary glands following various types of aesthetic mammoplasty, aimed at improving the aesthetic result of the primary surgical intervention and eliminating postoperative complications. Plan:

1. To conduct an analysis and summarize the available own experience of corrective operations on the mammary glands following aesthetic mammoplasty,

2. To identify the causes of unsatisfactory aesthetic results and develop a systematization of corrective operations on the mammary glands following aesthetic mammoplasty,

3. To determine indications for selecting various types of corrective operations on the mammary glands following aesthetic mammoplasty,

4. To develop the basic principles of surgical correction of aesthetic deficiencies and consequences of surgical complications following aesthetic mammoplasty,

5. To provide an evaluation of early and late results of corrective operations in the correction of aesthetic deficiencies and consequences of surgical complications following aesthetic mammoplasty,

Scientific novelty:

For the first time, based on clinical observations concentrated in a single medical institution:

• a clinical evaluation of repeat operations on the mammary glands following various types of aesthetic mammoplasty;

- for the first time, an analysis of complications in the performance of operations on the mammary glands depending on the type of mammoplasty was conducted;

- for the first time, an analysis of early and late results of repeat operations following aesthetic mammoplasty was conducted.

Practical significance:

- the technique of performing repeat operations on the mammary glands following aesthetic mammoplasty has been improved with consideration of indications for corrective operations; vulnerable periods in the development of possible complications have been identified;

- based on the analysis of early and late postoperative results, the advantages of various methods of aesthetic mammoplasty have been demonstrated; a comprehensive approach to selecting indications for repeat operations depending on the type of aesthetic mammoplasty has been developed.

Realized results of the work:

The results of the research and practical developments have been implemented in the activities of the Department of Reconstructive Microsurgery of the State Institution Russian Scientific Center of Surgery named after Academician B.V. Petrovsky RAMN,

Validation.

Dissertation materials were reported:

- at the I All-Russian Scientific Conference "Actual Questions of Aesthetic and Reconstructive Surgery of the Breast" (Kyiv, February 5-6, 2004).

Publications:

On the topic of the dissertation, 5 scientific works have been published in the materials of scientific conferences, symposia, congresses,

Volume and structure of the work:

The dissertation is presented on 140 pages of typed text and consists of an introduction, 4 chapters, conclusion, conclusions, practical recommendations, and a bibliography containing 54 domestic and 136 foreign sources. The work is illustrated with 46 figures and contains 18 tables.