Mastoplastica additiva

Mastoplastica additiva introduzione

L’intervento di mastoplastica additiva è il più richiesto tra gli interventi di chirurgia estetica in generale ma anche tra le varie procedure di mastoplastica dirette al rimodellamento e all’ estetica della regione mammaria.
La mastoplastica additiva risponde da sempre al desiderio di ogni donna di sentirsi donna, mamma ma soprattutto donna sensuale col suo giusto appeal meglio inteso come sex-appeal.
Si tratta di un intervento richiesta da un numero di donne molto superiore a quello corrispondente alle esigenze obbiettive di un aumento del seno.
La mastoplastica additiva è richiesta sia da donne con un seno piccolo o inesistente che da donne con un seno prosperoso, ma….non abbastanza.
Viene richiesta anche da donne con un seno cadente che con l’aiuto di una protesi mammaria può riacquistare “visibilità”.
La procedura chirurgica di mastoplastica additiva può essere eseguita in vari modi, con utilizzo di protesi mammarie che è la soluzione più praticabile e più richiesta o con autotrapianto di grasso.

Mastoplastica additiva e protesi mammarie

L’aumento del seno con l’utilizzo delle protesi mammarie ha raggiunto livelli di affidabilità e obbiettivi di risultato elevatissimi.
La mastoplastica additiva degli anni 60 con le prime protesi in silicone a superficie liscia e molto sottile, riempite di silicone molto fluido, sono state sostituite dalle moderne protesi in silicone a superficie testurizzata e a gel altamente coesivo.
Questa evoluzione tecnologica ha risposto adeguatamente alle problematiche che le mastoplastiche additive avevano creato nei decenni passati.
In passato la mastoplastica additiva con utilizzo di protesi in silicone a superficie liscia, sottile , riempite di gel di silicone molto fluido, comportavano un’elevata incidenza di contrattura capsulare, dovuta al trasudamento del silicone fluido ( bliding ) attraverso la superficie sottile del rivestimento protesico. Questo comportava per l’elevata reattività ( stato infiammatorio ) dei tessuti circostanti l’impianto protesico, con la conseguente contrazione reattiva della capsula periprotesica ( tessuto reattivo che si forma normalmente intorno alla protesi considerata dall’organismo un corpo estraneo ) e indurimento della mammella che con l’accentuarsi del problema subiva anche trasformazioni di forma e causava dolore.
La mastoplastica additiva negli anni passati è stata messa molto in discussione fino al punto da essere messa al bando ( 1992 ) dalle massime autorità americane ( FDA ). Lo sviluppo tecnologico degli impianti protesici ha subito negli anni successivi un notevole impulso, data la grande richiesta da parte del mercato di procedure di mastoplastica additiva e così si è giunti alle moderne protesi in silicone a gel altamente coesivo e a superficie testurizzata.

La qualità della superficie e le caratteristiche del gel altamente coesivo ha abbattuto letteralmente l’ incidenza della contrattura capsulare, rendendo l’intervento di mastoplastica additiva ancora più richiesto.
L’introduzione nel mercato delle protesi a gel altamente coesivo, che le rende semisolide con una memoria di forma, ha consentito alla mastoplastica additiva di ottenere risultati più rispondenti alle pretese delle donne più esigenti che richiedono un seno a “goccia”.
Questo tipo di protesi adottate dalla moderna mastoplastica additiva, vengono definite, per la loro forma, “ a goccia” oppure anatomiche oppure biodimensionali.
Con l’utilizzo di questo tipo di protesi mammarie, la mastoplastica additiva oggi rende possibile sollevare anche un seno caduto ( entro certi limiti naturalmente ) ma anche quando con le protesi di vecchia generazione bisognava, in certi seni ptosici ( caduti ) per forza associare all’impianto protesi anche un lifting del seno ( mastopessi ).
La mastoplastica additiva moderna consente quindi di evitare le cicatrici di una mastopessi, che prevede per definizione cicatrici molto estese.
Nel seno cadente infatti, se viene alloggiata una protesi di tipo anatomico a gel altamente coesivo, l’areola e il capezzolo vengono a “poggiare” sulla parte più prominente del polo inferiore della protesi, trovandovi un valido sostegno. E’ così che anche una semplice mastoplastica additiva può risolvere il caso di una ptosi limitata del seno.

Mastoplastica additiva e protesi riempite con soluzione fisiologica

Sono utilizzate principalmente negli Stati Uniti da quando le protesi in silicone erano state messe al bando. Non hanno trovato moto gradimento in Europa, perché tendono a sgonfiarsi e causano con maggior frequenza ed evidenza il fenomeno del Wrinkling ( pieghettarture ) dovuto al sottoriempimento del liquido di cui sono riempite.

Mastoplastica additiva vie di accesso

Le vie chirurgiche ( le incisioni per intenderci ) d’accesso possibili per confezionare le tasche ( lo spazio ) ove alloggiare le protesi mammarie possono trovarsi a livello del solco sottomammario ( la via più frequentemente utilizzata ), sul margine inferiore dell’areola oppure nel cavo ascellare.
La via del solco sottomammario è la più sicura, la più estetica e consente di utilizzare protesi anche molto voluminose ( a livello del margine areolare inferiore o a livello del cavo ascellare, potrebbe costituire un problema per l’inserimento di protesi di grandi dimensioni).

Mastoplastica additiva tecniche

Tecnica sottoghiandolare. In questo tipo di mastoplastica additiva la protesi mammaria viene alloggiata in una tasca realizzato su un piano retroghioandolare. L’indicazione a questo tipo di tecnica è abbastanza limitato. Questo tipo di tecnica di mastoplastica additiva è consigliato o semplicemente ammesso quando c’è tanto tessuto ghiadolo _ adiposo a disposizione come copertura della protesi ( non quindi nei soggetti magri, con mammelle magre e svuotate ). Diversamente, se le protesi mammarie non hanno sufficiente tessuto di copertura, rischierebbero di essere visibili nei loro contorni ( con l’impressione di mammelle rifatte ) o di essere comunque percepibili al tatto.
Altro tipo di indicazione alla mastoplastica additiva con impianto di protesi sottoghiandolare è data dai casi di mammelle ptosiche. In tal caso l’impianto sotto muscolare potrebbe ( ma non è detto che accada ) causare il fenomeno antiestetico del cosiddetto double bubol ( doppia bolla o doppio profilo ) data la posizione più elevata della protesi, trattenuta dal muscolo gran pettorale e la posizione ptosica ( cadente ) del polo inferiore della mammella che cade.
La tendenza in quasi tutti i casi è di alloggiare la protesi mammaria sotto il piano muscolare,.

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