Amayi ambiri amafuna kukhala ndi mawere akuluakulu, pokhulupirira kuti mawere awo akhala aang'ono kwambiri kapena akhala ochepa kwambiri chifukwa cha mimba kapena kuwonda. Mulimonsemo, njira yomwe imagwiritsidwa ntchito kwambiri ndi prosthesis kapena implant m'mawere. Malinga ndi mabuku a sayansi, amayi osachepera 1% omwe akufuna kukhala ndi mawere akuluakulu ali okonzeka kuchitidwa opaleshoni¹. Izi zinati, ku United States, chiŵerengero cha amayi ndi atsikana amene amasankha zoikamo m’thupi pofuna kudzikongoletsa chinawonjezeka kuŵirikiza kaŵiri pakati pa 1997 ndi 2000.².

Njira yopangira ma implants m'mawere

Ndi njira yokhazikika komanso yodalirika yoperekera chikhutiro kwa mkazi amene amaona kukula kwa mawere ake kukhala kosakwanira. Opaleshoni imaphatikizapo kulowetsa fupa la prosthesis, nthawi zambiri pogwiritsa ntchito mawere a bere.

Kuyambira 2001, madokotala amagwiritsa ntchito gel osakaniza silikoni, ndipo silikoni gel opangira pachifuwa chayambanso chidwi. Ma prostheses ena, omwe ali ndi seramu yokhudzana ndi thupi, ndiye kuti njira ya saline, sagwiritsidwa ntchito kwambiri chifukwa kukhudza kwa bere nthawi zina sikumakhala kosangalatsa komanso kutulutsa kwamtunduwu pafupipafupi.

Lipofilling kapena mafuta autografting njira

Njira yopangira opaleshoniyi³ Nthawi zambiri amagwiritsidwa ntchito pomanganso bere pambuyo pa opaleshoni yochotsa bere, kawirikawiri pakuwonjezera zodzikongoletsera. Kumapangidwa ndi kutenga mafuta m'thupi la mkazi (m'mimba, ntchafu, matumba), kuti alowetsenso m'mawere. Njirayi ikuwoneka ngati yabwino, koma imakhala ndi zovuta zingapo: gawo la mafuta ojambulidwa limatengedwa ndi thupi. Ndipo kuchuluka kwa mayamwidwe amafuta ndikovuta kuneneratu, zomwe zimatsogolera ku mabere asymmetries kapena kuchuluka kwa mabere osakwanira. Izi nthawi zambiri zimafuna retouch. Kumbali ina, mafuta omwe amagwiritsidwa ntchito poyamwitsa nthawi zina amatha kuyambitsa zotupa m'mawere. Ndiyeno, njirayi ndi yosagwiritsidwa ntchito kapena yosakwanira kwa amayi omwe alibe mafuta okwanira achilengedwe. Ma implants a silicone a m'badwo watsopano amagwiritsidwa ntchito nthawi zambiri.

Mbiri yachidule ya implants

Zoyika zamafuta kwambiri za silicone zodzaza ndi mabere zidapangidwa muzaka za 60 pomwe panalibe malamulo owongolera msika wa zida zamankhwala. Ku United States, bungwe la boma la Food and Drug Administration (FDA) lakhala ndi ulamuliro wotere kuyambira 1976, koma zida zina (ma valve amtima, ma implants a cochlear, prostheses, ndi zina zotero) zakhala zikuwonedwa ngati zofunika kwambiri, kuika mabere kudakalipo, panthawiyo, zinali zachilendo.

Mu 1990, pafupifupi akazi miliyoni a ku America anali ndi implants zoterozo, ndipo FDA inalibe, monga momwe lamulo limanenera, likufuna opanga kutsimikizira kuti ali oyenerera ndi otetezeka. Komabe, atolankhani amafotokoza nkhani ndi malingaliro ochulukirachulukira malinga ndi zomwe mavuto akulu azaumoyo angakhudzidwe ndi zida izi. Zowonadi, monga gel osakaniza a silikoni omwe ankagwiritsidwa ntchito panthawiyo, nthawi zonse ankayenda pang'onopang'ono kupyola khoma la implantation, kutha kuchititsa kupanga ma antibodies omwe, ankawopedwa, angakhale pa chiyambi cha matenda "auto-. chitetezo cha mthupi ”(polyarthritis, scleroderma, fibromyalgia, etc.).

Mu 1991, FDA idakhazikitsa lamuloli ndikufunsa opanga kuti apereke maphunziro oyenera. Izi, komabe, ziyenera kukhudzana ndi anthu ambiri ndi zida zofanana, ndikufalikira kwa nthawi yayitali; popeza palibe chimodzi mwa mikhalidwe imeneyi chomwe chikanakwaniritsidwa panthawiyo, chinkaganiziridwa kuchotsa implants palimodzi pamsika, nthawi yochita kafukufuku wokwanira. Koma gulu lamphamvu lolandirira anthu linatsutsa zimenezo, mochirikizidwa makamaka ndi amayi okhala ndi khansa ya m’mawere. Ngakhale opanga awo sanapambanebe kuwonetsa chitetezo chawo, ma implants a mawere a silicone adakhalabe pamsika ngati "zofunikira pazaumoyo wa anthu", zomwe zimangopezeka kwa makasitomala ena pofufuza zachipatala. .

Pakati pa 1995 ndi 2001, kunali kuyimitsidwa, gel osakaniza silikoni anali oletsedwa m'mayiko ambiri padziko lapansi kuti afufuze bwino zotsatira za implants okhala ndi gel osakaniza. Panthawi yonseyi, ma prostheses okha okhala ndi seramu kapena saline solution adayikidwa.

Mu 2001, mawonekedwe a gel ophatikizana, owoneka bwino a silikoni adathandizira kukonzanso zoyika m'mawere za silikoni. Ma gels awa ali ndi mwayi woti asakhale ovuta kwambiri pakathyoka.

Njira yothandizira opaleshoni

Asanalowerere, kukaonana ndi dokotala wa opaleshoni kumatheketsa kuvumbula vutolo ndi kulongosola kukula kwa implantation. Zimasankhidwa molingana ndi chikhumbo cha mkazi, zomwe akufuna, ndipo zimagwera m'magulu osiyanasiyana: kusintha kuyenera kudziwidwa (zingakhale zamanyazi kukhala ndi opareshoni chifukwa cha zotsatira zosayembekezereka), koma sizikhala. wolumala ndi mabere ambiri. M'pofunikanso kuti anatomy a mkazi uyu akhoza kuthandizira prosthesis ndi kuti mawonekedwe osankhidwa angapereke zotsatira zachibadwa. Choncho malangizo a dokotalayo n’ngofunika chifukwa amalongosola zimene zingatheke malinga ndi mmene thupi la mkazi aliyense lilili. Kenako, amawonetsa zithunzi za mawere kuti adziwe zomwe akufuna.

Pamene kuyika kwa implant m'mawere kumachitika pansi pa anesthesia wamba, pamafunika kupita kukaonana ndi opaleshoni.

Pa opaleshoni, yomwe imatha pafupifupi ola limodzi, mayi wochitidwa opaleshoniyo amapatsidwa mankhwala opha tizilombo toyambitsa matenda monga kulowetsedwa kuti achepetse chiopsezo cha matenda⁴. Njira yabwino kwambiri yoyikamo implants imapangidwa mozungulira areola, m'munsi mwake ndipo imakhudza gawo limodzi mwa magawo atatu mpaka theka la areola iyi. Dokotalayo amapereka chipinda chokulirapo kuposa choyikapo kuti chiyikepo. Zowonadi, izi zimapangitsa kuti prosthesis isunthike pang'ono m'chipindachi, ndikukhala ndi chikhalidwe chachilengedwe pakusintha kwamalo (kugona kumbuyo mwachitsanzo). Dokotala wa opaleshoni amaika prosthesis kutsogolo kapena kumbuyo kwa minofu ya pectoral: kutsogolo nthawi zambiri, ndi kumbuyo kwa minofu iyi ngati mkazi ali ndi bere lochepa kwambiri kapena alibe.

Ndipo pambuyo opaleshoni m`mawere implantation?

Mayi amene wangolandira kumene ma implants m’mawere nthawi zambiri amagonekedwa m’chipatala usiku wotsatira opareshoniyo. Amamva kuuma pamene akudzuka pachifuwa chake, mofanana ndi pambuyo pa gawo labwino la masewera olimbitsa thupi. Poyamba, akamasuntha, amamva ululu. Kenako ayenera kudzilola masiku 4 kapena 5 akupuma mokwanira komanso masiku 7 mpaka 10 akuchira. Nthawi zina, bra ikhoza kuperekedwa ndi dokotala.

Maonekedwe a chilonda nthawi zambiri amakhala ofiira pang'ono kwa mwezi ndi theka kwa miyezi iwiri, ndiye pang'onopang'ono amakhala ang'onoang'ono, pafupifupi mzere woyera wosaoneka. Chotsatira chomaliza chimapezeka m'miyezi 3 mpaka 6, nthawi yoti machiritso achitike komanso kuti minofu ndi implants zitenge malo ake. Pambuyo pa opaleshoni, kukhudzidwa kwa nsonga zamabele kumakhudzidwa mosiyanasiyana kwambiri: kumatha kukhalabe bwino pambuyo pa opaleshoniyo, kapena kufikika ndikubwereranso pakatha milungu ingapo mpaka miyezi ingapo, ngakhale nthawi zambiri, imatha kukhala yayitali.

Kuyamwitsa kumakhalabe kotheka, kuchitapo kanthu sikukhudza zopangitsa za mammary. Kuyeza khansa ya m'mawere kunali kovutirapo pang'ono ndi ma implants chifukwa adapangitsa chithunzi cha radiological kukhala chosavuta kuwerenga, kotero nthawi zina khansa zimakhala zosavuta kuzizindikira komanso panali nkhawa zakuchedwa kwa matenda. Masiku ano, kupita patsogolo kwa radiology kumapangitsa kukhala kosavuta kuposa kale kuwerenga mammograms pambuyo pa implant. Kukhudza, mutha kumva kuti pali prosthesis, koma kukhudza kumakhalabe kwachilengedwe ndi ma gels ogwirizana omwe amagwiritsidwa ntchito pano.

Kafukufuku wokhudzana ndi chitetezo cha ma implants

Palibe kugwirizana pakati pa kuyika kwa prosthesis ndi khansa ya m'mawere. Ichi ndi chifukwa chake dokotala wa opaleshoni amaika mtundu womwewo wa prosthesis pamene akumanganso bere lomwe lapezeka ndi khansa. Kuika bere kumbali imodzi sikuwonjezera chiopsezo cha khansa mu bere lina.

Zotsatira za kuyika mabere⁶

• Kuchepetsa zikhoza kuchitika: pambuyo ndondomeko, zingafune reoperation. Koma izi sizimakhudza zotsatira zomaliza.
• Mawonekedwe a mphesa zakhala zachilendo. Izi ndi momwe thupi limachitira ndi implant yomwe imapanga malo olimba, ngati chipolopolo chozungulira prosthesis. Zikuchulukirachulukira, chifukwa cha kuwongolera kwatsopano kwa ma prostheses ndi njira zopangira opaleshoni. Panopa, madokotala ochita opaleshoni kusamala kuchita hemostasis (kupewa m'dera magazi pa opareshoni) ndi kusiya magazi pang'ono ngati n'kotheka kuzungulira prostheses, ndi kapangidwe ka envelopu, amene kwambiri amachepetsa chiopsezo cha hull. .
• Kuchepetsa chidwi. Pakati pa 3 ndi 15% ya amayi amamva kuchepetsedwa kotheratu mu nsonga ndi m'mawere pambuyo poika impulanti.

  Ndizofala pambuyo pa opaleshoni, ndipo zambiri zimachira pakapita milungu ingapo kapena miyezi ingapo. Komabe, amayi ena amasungabe kusintha kwa kumva kapena kupweteka.⁷.

• Shift : Ma implants amayikidwa kutsogolo kapena kumbuyo kwa minofu yayikulu ya pectoralis. Maonekedwe a retro-pectoral nthawi zina amatha kupangitsa kuti prosthesis isasunthike panthawi yomwe minofu iyi ikuphwanyidwa. Izi zitha kukhala zochititsa manyazi ndipo nthawi zina muyenera kulowererapo ngati ndizochititsa manyazi.
• Kukalamba kwa prosthesis. Kukalamba kumeneku kungayambitse kutsika kwa seramu prosthesis kapena kupasuka kwa ma silicone prostheses. Izi zikuyenera kuyang'aniridwa, makamaka chapakati pa giredi XNUMX mpaka XNUMX. Dokotala wa opaleshoni angasankhe kusintha fupalo kapena kuyang'anitsitsa nthawi zonse kuti aone ngati akuwonongeka. Kuchotsa prosthesis ndi seramu yokhudzana ndi thupi (madzi amchere osabala) ndikopanda vuto pazaumoyo, ngakhale kungayambitse kusasangalatsa kokongola. Kuphulika kwa silicone prosthesis kumafuna kusintha kwa prosthesis. Monga ma gels amakono amagwirizana kwambiri (silicone amakhalabe ogwirizana kwambiri ndipo sizingatheke kufalikira mu minofu), ndizosavuta kuchotsa komanso zotetezeka kwa amayi.
• Chenjezo: Ngati muli ndi prosthesis ndipo mukuwona chinthu chachilendo (kusamuka, kutayika, kusazolowereka, kusintha kukhudzana, ndi zina zotero), muyenera kuonana ndi dokotala wanu kuti akuyeseni.