Breast reconstruction after childbirth

During pregnancy, the mammary glands change shape: skin stretching, asymmetry and ptosis (sagging) are often observed - in this regard, breast restoration after childbirth and breastfeeding becomes a pressing issue for many women. Massage, creams, exercises, special diets, cosmetic procedures - various methods are offered to restore the bust to an attractive appearance, but they do not always achieve the desired result. If a woman is categorically not satisfied with the shape and size of her breasts after childbirth, then mammoplasty is used to correct certain deficiencies. In this article we will tell you what problems can be solved with plastic surgery.

Why did my breasts change so much after giving birth?

The female breast consists of lobules of glandular tissue, fatty tissue, ligaments and skin. It is these anatomical elements that determine its appearance. During pregnancy, the lobules of the mammary glands fill with milk and increase in size, so the breasts become larger. At the same time, the load on the ligaments increases, and the skin stretches - the breasts sag. The nipples may change size, and the skin becomes thinner: a network of veins and blood vessels can be seen through it. Special care contributes to successful breast recovery after breastfeeding. But it is almost impossible to return the mammary glands to their previous “girlish” shape after childbirth.

So, external changes in the mammary glands during pregnancy and lactation depend on:

original anatomy and breast size;
heredity;
breast care during this period;
hormonal background.

The most common problem that mothers face is breast sagging as a result of breastfeeding. Many women try to restore their breasts to a firm and attractive appearance through exercise, cosmetics and procedures. And if these methods do not help, they turn to plastic surgeons. Mammoplasty is possible 6-12 months after completion of lactation and feeding the child. Stretched and lost elasticity of the mammary glands should not overshadow the joy of motherhood, but, on the contrary, become a reason for new changes and a pleasant gift. Why not make your postpartum breasts even better than they ever were before? Mammoplasty is an operation to correct the shape and size of the mammary glands. With its help, women who have become mothers can solve several aesthetic problems.

When and why do you need to strain the thoracic ducts?

Lactostasis
In medicine, a phenomenon accompanied by stagnation of breast milk is called lactostasis. During the postpartum period, this is a very common pathological phenomenon that causes inconvenience to the woman and child.

Lactostasis has a pronounced clinical picture. The first symptoms of milk stagnation in the mammary glands:

When expressing, uneven flow of milk is noted. For example, from some ducts milk flows unhindered, while from others it is released only drop by drop or does not drip at all.
Hardened glandular tissue. The breasts usually swell and feel like stone. On palpation, lump-like lumps may be felt.

If the skin in the chest area is red, you should consult a doctor.
Painful sensations and a feeling of discomfort. Even minor touches to the breasts can cause severe attacks of pain in a woman.
Feeling bursting from the inside.

If you do not immediately contact a medical facility, the clinical picture will become more vivid:

inability to touch the breast due to severe pain;
increased body temperature;
redness of the skin in the chest area.

Most often, congestion occurs in the first month after the birth of a child. The danger of the pathological condition is accompanied by the development of lactostasis into mastopathy - an inflammatory process that affects soft tissues. Treatment will require taking antibacterial drugs, and in some cases surgery is inevitable.

Breast pump
To prevent stagnation of milk in the breast, you need to become familiar with the main provoking factors.

Neglecting pumping. Until the lactation period improves, you will need to first pump before feeding the newborn.
Irregularity of putting the baby to the breast.
A child with a weak sucking reflex. Most babies are born weakened, as a result of which their oral cavity is not developed and they are unable to completely empty the mammary glands.
Replacing colostrum with milk. As a rule, this process occurs no earlier than 2-5 days after birth. It is accompanied by a sharp and strong flow of milk, but it is worth understanding that its quantity does not always correspond to the baby’s needs.

The most common problem that provokes the development of many pathological conditions is improper attachment of a newborn to the breast. Most often, this is faced by young women who have become mothers for the first time and are still inexperienced in these matters.

Sagging breasts: what to do? Breast lift after childbirth.

Sagging breasts are called “ptosis.” Causes of breast drooping include:

age;
hormonal changes that lead to a decrease in gland volume and fibrofatty involution;
the influence of the Earth's gravitational forces;
skin stretching and thinning;
sprain of the ligaments that support and secure the mammary glands.

Mastopexy (breast lift) is performed separately or in addition to endoprosthetics and correction of the nipple-areolar complex. The operation does not affect a woman's ability to breastfeed in the future.

There are 3 types of mastopexy:

Periareolar - the doctor makes an incision around the areola. The method allows you to raise the nipple-areolar complex by more than 2 cm. It is also used if excision of the skin is required.
Vertical - the plastic surgeon makes two incisions: the first runs along the contour of the areola, and the second - vertically to the line of the inframammary (submammary) fold. The method allows you to lift the breasts even higher and carry out more extensive resection of excess skin.
Anchor (or “T-shaped”) - the first incision runs along the line of the lower semicircle of the areola, the second one descends from its center to the middle of the inframammary fold, along the contour of which the third incision is made. The operation is suitable for patients with severe ptosis and allows additional asymmetry to be removed.

Depending on the degree of ptosis and the anatomical features of the patient’s mammary glands, the plastic surgeon will select the optimal surgical option at the initial consultation.

As a result of mastopexy, the breasts become toned and firm, and their beautiful shape is restored. If the patient wishes to increase her bust size, this operation can be combined with endoprosthetics.

Vertical breast lift with 385 ml implants. Result after 4 months. The work of the head of the plastic surgery department of the clinic named after. N.I. Pirogov Oleg Leonidovich Nesteruk.

Small breasts after childbirth: what to do? Breast endoprosthetics.

It is believed that breast size naturally increases during pregnancy, but these expectations are not always met. When lactation, that is, milk production in the glands, ends, the breasts noticeably decrease in volume. At the same time, the birth of a child leads to a restructuring of the entire organism. After pregnancy and breastfeeding, fibrofatty involution of the mammary glands occurs, which reaches a peak during menopause. This means that under the influence of hormonal changes the amount of glandular tissue decreases and its deficiency is compensated by fatty tissue.

Breast replacement with specially selected implants allows not only to enlarge small breasts, but also to give them a beautiful and expressive shape, and to correct asymmetry and ptosis. To solve these problems, the plastic surgeon will select implants of a suitable volume and profile, based on the anatomical features of the breast and the wishes of the patient. They are installed under the muscle, fascia or under the mammary gland. The method of installing implants is no less important:

perialar (through the areola);
submammary (under the breast);
axillary (through an incision in the armpit).

If a woman expects to have another child in the future, doctors prefer submammary access due to the minimal risk of damage to the milk ducts.

Breast augmentation with implants 310 milliliters, submammary access, 3 months later.

How long does it take to recover after childbirth?

Restoring the body after childbirth is a long and complex process. The body has been constantly changing for nine months and will take time to return to its previous state. Gradually, the hormonal levels will return to normal, and with it the normal functioning of all organs and systems will be restored, the hair will become stronger, the purity and smoothness of the skin will return, and brittle nails will disappear.

Different sources contain different periods of recovery after childbirth, but most often the authors indicate a period of six to eight weeks - the time it takes for the uterus to return to its previous state. Recovery after the second and third births may occur more slowly: it largely depends on the characteristics of the pregnancy and the method of delivery. After a natural birth, recovery is faster than after a cesarean section.

Large breasts after childbirth: what to do? Reduction mammoplasty.

Reduction mammoplasty is the most effective method for solving such a problem as gigantomastia. Due to the high load on the spine, the formation of diaper rash, skin stretching and ptosis, breast reduction surgery is performed not only for aesthetic reasons, but also for medical reasons. In the USA and some European countries, reduction mammoplasty is included in the compulsory health insurance program. The essence of the operation is the resection of excess fatty tissue, glandular tissue and skin. As a result, the patient may partially or completely lose the ability to breastfeed, since during this operation the intersection of the milk ducts is inevitable. The method of reduction mammoplasty is selected individually: it depends on the initial volume of the mammary glands and the preferred result. The plastic surgeon strives not to disrupt the innervation of the nipple, and during the process of reduction mammoplasty he can adjust the size of the areola - make it commensurate with the reduced breast.

Reduction mammoplasty performed by Oleg Leonidovich Nesteruk.

How to express milk correctly?

There is a myth that to express milk strictly after each feeding, so that there is no stagnation of milk and it comes in better. This statement is partly true, but only in some special cases. To find out in what cases pumping may be required, let’s remember how lactation develops.

What is lactation

As is known, in the first two to three days after birth, the mother’s mammary gland produces colostrum - a very special type of milk, fundamentally different in composition from mature milk and containing a high concentration of proteins, microelements and fat-soluble vitamins with a relative poverty of carbohydrates and fats. Colostrum is released in a very small volume, usually not exceeding 20-30 ml per feeding by the third day after birth. This volume corresponds to the needs of a child aged 2-3 days. These days, the mother does not yet have a feeling of fullness in her breasts, her breasts are soft. The baby, if he is properly attached to the breast and sucks effectively, completely empties the gland. However, the process of colostrum production does not stop for a minute, and if you press on the nipple a few minutes after feeding has ended, a few drops of colostrum will be released from it.

On the third day after birth, the next phase of lactation : the mammary glands stop secreting colostrum, which is replaced by transitional milk. It is less rich in proteins, but contains more carbohydrates and fats, thus approaching the composition of mature milk. The beginning of the secretion of transitional milk coincides in time with the so-called tide. This moment is felt as a feeling of fullness, sometimes as a tingling sensation in the mammary glands. From this moment on, the glands work at full capacity, providing the baby’s growing nutritional needs day by day.

Let us remind you once again that a young mother needs to limit fluid intake to 800 ml when milk arrives, so as not to provoke its production in excessive quantities, which is a predisposing factor for the development of lactostasis (milk stagnation).

What determines the amount of milk?

As already mentioned, milk is produced in the mammary gland constantly, accumulating in the required volume for the next feeding. If a child begins to suckle, feeling hungry, sucks actively and correctly, then by the time he is full, the breast is almost completely empty. In this case, there is no need to express milk . There is a close feedback between feeding and the central (coming from the brain) regulation of lactation, which is manifested in the fact that the more milk the baby sucks from the breast, the more milk is produced for the next feeding.

If the baby sucks inactively or ineffectively, incorrectly, without emptying the gland, then the brain receives signals that more milk is being produced than the baby needs, and less milk will be released at the next feeding. Thus, the best prevention of both hypogalactia (reduced milk supply) and lactostasis is correct and regular attachment of the baby to the breast and effective sucking.

Of particular importance at the stage of lactation is the free mode of breastfeeding and feeding on demand. This feeding regimen, on the one hand, stimulates the production of more milk when there is still not enough milk, on the other hand, it allows the child to completely empty the gland, preventing stagnation in it.

lactation formation lasts about 2-3 weeks and ends by the end of the first month of the child’s life. At this point, the gland produces fully mature milk. The feeding rhythm is usually established. The child requires the breast in his own individual mode, but for each baby, if this mode is set up correctly, the frequency of feedings is more or less rhythmic. On average, a child aged 1-2 months needs to be fed every 3 hours (±30 minutes), including at night. Accordingly, the mother’s mammary gland and the centers that regulate its work adapt to this feeding rhythm. If the baby needs more milk, he suckles more actively or requires the next feeding earlier, which serves as a signal for more milk production.

When to express milk

At the stage of colostrum production, if for some reason the child does not attach to the breast, it is necessary to express the colostrum so that the brain receives signals about the emptying of the mammary gland and stimulates its constant work. Also, at this stage, it is necessary to develop the milk ducts, so that by the time the baby is able to suckle, the gland is ready to “give” milk.

lactation formation, the need to express milk arises when the intensity of milk production by the gland exceeds the child’s nutritional needs, when he does not empty the breast completely (normally, after feeding, the mammary gland is soft, without areas of engorgement). Areas of lactostasis are defined as engorgement of the mammary gland, painful to the touch. With such phenomena, it is necessary to express milk , because after stagnation of milk, inflammation of the mammary gland develops - mastitis.

How to use a breast pump

to express milk . The operating principle of all breast pumps is based on creating a vacuum in its cavities, as a result of which milk flows from the milk passages into the reservoirs. But it should still be said that no matter how perfect breast pumps are, at the stage of lactation it is better to develop the breasts with your hands. The use of breast pumps is justified in cases where there is a lot of milk and the breast is already well pumped, when there are no problems with the nipple. This is also convenient because the entire structure is sealed, and if you sterilized it before use, then as a result of pumping you get sterile milk, which can be stored in the same “container” in which it came during the pumping process (in a bottle or a special bag) .

The need to express milk arises in cases where the mother is forced to leave home and needs to create a supply of milk,

Ideally, when a baby is fed on demand, he can and should draw from the breast as much milk as the breast produces. If the gland's milk production exceeds the child's needs at this age, the brain receives signals that excess milk is being produced, and the gland begins to produce less milk.

When the formation of lactation is complete, the need to express milk arises in cases where the mother is forced to leave home and she needs to create a supply of milk to feed the baby in her absence.

How to express properly

milk
First of all, it should be said that the process of expressing milk should in no case be traumatic for the breast. All efforts should be moderate. The effectiveness of pumping depends on the correctness of the actions, and not on the force applied by the hands. It is not uncommon to see the breasts of a woman who has recently given birth, all covered with bruises as a result of improper pumping.

Before you start expressing milk , you need to warm up your breasts by gently massaging them with your palms in front, behind and on both sides from top to bottom. Then you should grab the gland with both hands so that the thumbs of both hands are located on the upper surface of the chest (above the nipple), and all other fingers are on the lower surface (under the nipple). During the period of milk flow, the nipple often swells, and this interferes not only with pumping, but also with feeding. To reduce swelling, you need to carefully and carefully express the contents of the milk ducts located in the nipple for several minutes at the beginning of feeding or pumping. Direct the movements of the fingers - thumb and index - of both hands from top to bottom and from the surface of the nipple - into its thickness. At first, the movements should be very superficial, but gradually, as the outflow of milk improves, the degree of pressure should be increased. If you do everything correctly, you will feel how the nipple becomes more and more soft and pliable, and the milk is expressed first in rare drops, and then in thin streams. The appearance of streams of milk coincides with a decrease in nipple swelling.

After this, you can start expressing milk (or feeding). It should be remembered that the milk ducts pass in that part of the gland that is located on the border of the areola (peripapillary pigmentation), above the nipple. It is to this zone that the forward movements of the fingers need to be directed. The movements should be the same as when expressing milk from the milk ducts of the nipple, only now not two fingers of both hands, but all five should be involved in the work. The gland should rest, as it were, in the palms, located between the thumbs and all other fingers, while the main force (but moderate!) should come from the thumbs, and all the rest should support the gland, lightly pressing from top to bottom and from back to front. Thus, milk is expressed until the streams of milk begin to dry up. Next, you should slightly change the direction of the movements of the fingers in order to influence other lobes of the gland. To do this, you need to change the position of your fingers, placing them so that one hand is below and the other is on top. Moreover, if the left breast is being expressed, then the thumbs of both hands are located on the inside of the chest, the other four - on the outside. If the right breast is expressed, then the thumbs of both hands are on the outside of it, and the other four are on the inside. Finger movements should be made in the direction from the periphery to the nipple with light pressure deep into the gland. You need to stop expressing after the milk stops flowing in streams.

You may be interested in the articles “Pumping: when is it necessary?” and “How to choose a breast pump” on the website mamaexpert.ru

I don't like how my nipples and areolas turned out after giving birth. What to do?

Plastic surgeons at our clinic can also perform correction of the nipple-areolar complex in combination with a lift, endoprosthetics, reduction mammoplasty, or separately. As a result of this operation, it is possible to reduce the size of the areola by excision of excess pigmented tissue, and also to correct an inverted or elongated nipple.

Recovery after correction of the shape and size of the areolas occurs quickly - the patient can return to normal life on the day of surgery. The operation is performed upon completion of breastfeeding.

What to do if there is too little milk

To enhance lactation, the mother milks her breasts or adheres to the rules: she feeds the baby often, during the day and at night, for 20 minutes. Sometimes the baby gets tired of sucking, and to prevent him from falling asleep, it is recommended to massage his palms, legs, and clap his back. The more he sucks, the more milk will be added. But it is not advisable to take special tablets.

Ways to increase lactation:

maintain a drinking regime - drink 6-7 glasses of liquid per day;
set aside time for daytime sleep to create conditions for the production of prolactin;
before feeding, warm the breasts with dry heat and massage;
Massage your back below the shoulder blades 2 times a day;
feed the baby in silence;
give in turn to both breasts.

If your own methods do not help, it is recommended to ask a breastfeeding consultant for help.

Actions for lactostasis

Breast reconstruction after childbirth and breastfeeding at the clinic named after. N.I. Pirogov (St. Petersburg)

The plastic surgery department of the Pirogov Clinic in St. Petersburg has been operating since 1999 and is recognized as the leading one in the city. We are proud of our doctors, whose many years of experience and professionalism have been awarded. Our specialists are fluent in modern plastic surgery techniques, perform complex reconstructive surgeries and reduce the risks associated with surgery to a minimum. In addition, we offer our patients:

regular discounts and promotions for all types of mammoplasty;
a comfortable hospital for 1-2 people, the stay in which can be extended if desired;
operating rooms and intensive care units equipped with modern equipment from reliable foreign manufacturers;
personal support of patients from Russian cities at all stages of the operation;
interest-free installment plan for all operations in the plastic surgery department.

The price of operations aimed at breast reconstruction after childbirth and breastfeeding consists of several parts. If you do not find the information you need on the website, call +7 (812) 320-70-00 - contact center specialists will answer your questions, provide advice and help you make an appointment with a plastic surgeon.

Massage against stagnation

A serious nuisance for a mother who is breastfeeding - if the milk stagnates, sometimes the temperature rises, accompanied by chills. With proper organization of feeding, stagnation (lactostasis) rarely occurs. If this happens, it is worth knowing how to develop breast milk after childbirth and learn how to massage for stagnation. Before this, a heated diaper is applied to the chest or 5-7 minutes. lying in the bath. When washing in the bathroom, it is allowed to use a stream of water for massaging.

Doing a 5-minute massage, move gently and smoothly, lightly pressing on the gland, from the areolas towards the armpits and collarbones.

Vibration.
The thumb and index finger are placed in the pits where the ribs connect to the sternum. Massage, making circular movements, first the upper areas, then descend.
Rub these places with the knuckles of clenched fists.

It is useful to stretch the collar area and shoulders, warm the subclavian areas and armpits by rubbing, advises supermamsru.

When the baby sucks, continue to massage and stroke the places where the milk has stagnated. The remaining milk is expressed, and congestion continues to be treated with a cool 10-minute compress.