Abesifazane abaningi bafisa ukuba namabele amakhulu, bekholelwa ukuthi amabele abo abelokhu emancane kakhulu noma abe mancane kakhulu ngenxa yokukhulelwa noma ukuncipha kwesisindo. Kunoma yikuphi, indlela evame ukusetshenziswa kakhulu yi-prosthesis noma i-breast implant. Ngokusho kwezincwadi zesayensi, ngaphansi kwe-1% yabesifazane abangathanda ukuba namabele amakhulu balungele ukuhlinzwa¹. Sesikushilo lokho, e-United States, inani labesifazane namantombazane abakhetha izifakelo ngenxa yezizathu zezimonyo liphindeke ngaphezu kokuphindwe kabili phakathi kuka-1997 no-2000.².

Indlela yokufaka amabele

Kuyinqubo evame kakhulu futhi enokwethenjelwa ukunikeza ukwaneliseka kowesifazane ocabangela ubukhulu besifuba sakhe njengenganele. Ukuhlinzwa kuhilela ukufaka i-prosthesis, ngokuvamile ngokusika i-areola yebele.

Kusukela ngo-2001, odokotela abahlinzayo basebenzise ijeli ye-silicone ehlangene, futhi izitho zokwenziwa zebele ze-silicone seziphinde zazuza isithakazelo esikhulayo. Amanye ama-prostheses, aqukethe i-serum ye-physiological, okungukuthi isixazululo saline, manje asetshenziswa kancane kakhulu ngoba ukuthintwa kwebele ngezinye izikhathi akujabulisi futhi ukuchithwa kwalolu hlobo lwe-prosthesis kaningi.

Indlela yokugcwalisa i-lipofilling noma i-fat autografting

Le nqubo yokuhlinzwa³ ivamise ukusetshenziselwa ukwakhiwa kabusha kwebele ngemva kokuhlinzwa kokususwa kwebele, akuvamile ukusetshenziselwa ukukhulisa ibele ngezimonyo. Kuhlanganisa ukuthatha amanoni emzimbeni wowesifazane (esiswini, emathangeni, ezikhwameni zehhashi), ukuze aphinde awabuyisele emabeleni. Indlela ibonakala iyinhle, kodwa iveza ubunzima obuningi: ingxenye yamafutha ajovwe ibe isimuncwa umzimba. Futhi izinga lokumuncwa kwamafutha linzima ukulibikezela, okuholela kuma-asymmetries webele noma umthamo webele onganele. Lokhu ngokuvamile kudinga ukuthinta kabusha. Ngakolunye uhlangothi, amafutha asetshenziswa ekumunceni kwawo ngezinye izikhathi angaholela kuma-cysts emabeleni. Futhi-ke, le ndlela ayisebenzi noma ayanele kwabesifazane abangenayo isamba esanele semvelo samafutha. Ngakho-ke izimila ze-silicone zesizukulwane esisha zivame ukusetshenziswa kakhulu.

Umlando omfushane wezimila

Izimila zebele ezigcwele ijeli ye-silicone enamafutha kakhulu zathuthukiswa ngeminyaka yama-60s lapho kwakungekho mthetho olawula imakethe yemishini yezokwelapha. E-United States, i-ejensi kahulumeni i-Food and Drug Administration (FDA) ibinegunya elinjalo kusukela ngo-1976, kodwa ezinye izinsimbi (ama-valve enhliziyo, izifakelo ze-cochlear, izitho zokwenziwa, njll.) ziye zaphathwa njengento eza kuqala, ukufakelwa kwamabele kuseyikho, ngaleso sikhathi, okwakungavamile.

Ngo-1990, abesifazane baseMelika abacishe babe yisigidi babenezifakelo ezinjalo, futhi i-FDA yayingakafuni, njengoba kudingwa umthetho, ukuthi abakhiqizi bafakazele ukusebenza kahle nokuphepha kwabo. Kodwa-ke, abezindaba babike ama-anecdotes nemibono eyengeziwe ngokuya ngokuthi yiziphi izinkinga ezingathi sína zempilo ezingase zihlotshaniswe nale mishini. Ngempela, njengejeli ye-silicone eyayisetshenziswa ngaleso sikhathi, yayihlala ifuduka kancane odongeni lokufakelwa, ikwazi ukubangela ukukhiqizwa kwamasosha omzimba, okwakusatshwa, ayengase abe umsuka wezifo “auto-. amasosha omzimba ”(i-polyarthritis, i-scleroderma, i-fibromyalgia, njll.).

Ngo-1991, i-FDA yasebenzisa umthetho futhi yacela abakhiqizi ukuthi banikeze izifundo ezifanele. Lokhu, nokho, kumele kuhlobane nenani labantu abaningi kanye nemishini efanayo, futhi kusatshalaliswe isikhathi eside; njengoba kungekho kulezi zimo ezingagcwaliseka ngaleso sikhathi, kwakucatshangwa ukuthi kuhoxiswe izimila ngokuphelele emakethe, isikhathi sokwenza ucwaningo olwanele. Kodwa ithimba elinamandla lamelana nakho, lisekelwa ikakhulukazi abesifazane abanomdlavuza wamabele. Nakuba abakhiqizi bazo bengakaphumeleli ekuboniseni ukuphepha kwabo, izimila zebele ze-silicone zahlala emakethe "njengezidingo zezempilo zomphakathi", zifinyeleleka kuphela kumakhasimende athile kumongo wocwaningo lwemitholampilo. .

Phakathi kuka-1995 no-2001, kwakukhona ukumiswa, ijeli ye-silicone eyayivinjelwe emazweni amaningi omhlaba ukuze ihlolisise imiphumela yezimila eziqukethe lolu hlobo lwejeli. Phakathi naso sonke isikhathi salokhu kumiswa, kwafakwa kuphela izitho zokufakelwa ezine-serum ye-physiological noma i-saline solution.

Ngo-2001, ukubonakala kwamajeli e-silicone ahlangene, aminyene avumela ukuvuselelwa kwezimila zebele ze-silicone. Lawa majeli anenzuzo yokuba nenkinga encane uma kwenzeka aphuka.

Inkambo yokungenelela kokuhlinzwa

Ngaphambi kokungenelela, ukubonisana nodokotela ohlinzayo kwenza kube nokwenzeka ukudalula inkinga nokuchaza ubukhulu bokufakelwa. Kukhethwa ngokwesifiso sowesifazane, ngalokho akufisayo, futhi kuwela ngaphakathi kwebanga: ushintsho kufanele lubonwe (kungaba yihlazo ukuhlinzwa ngomphumela ongalindelekile), kodwa akwenzeki. ukhubazwe umthamo omkhulu wamabele. Kuyadingeka futhi ukuthi i-anatomy yalona wesifazane ingakwazi ukusekela le prosthesis nokuthi ifomu elikhethiwe linganikeza umphumela wemvelo. Ngakho-ke iseluleko sikadokotela ohlinzayo sibalulekile ngoba uchaza lokho okungenzeka ngokokwakheka komzimba wowesifazane ngamunye. Bese ekhombisa izithombe zamabele ukuze abone ukuthi ufunani.

Njengoba ukubekwa kokufakelwa kwebele kwenzeka ngaphansi kwe-anesthesia ejwayelekile, kudinga ukuvakashela ngaphambi kodokotela obulala izinzwa.

Ngesikhathi sokuhlinzwa, okuthatha cishe ihora, owesifazane ohlinziwe unikezwa ama-antibiotics njengendlela yokunciphisa ingozi yokutheleleka⁴. Ukusika okujwayelekile kakhulu kokufaka isigxivizo kwenziwa eduze kwe-areola, engxenyeni yayo engezansi futhi kuthinta ingxenye eyodwa kwezintathu kuya kuhhafu yale areola. Udokotela ohlinzayo uhlinzeka ngendawo enkulu kune-implant ukuze ayibeke endaweni. Ngempela, lokhu kamuva kuvumela i-prosthesis ukuthi ihambe kancane kuleli gumbi, futhi ibe nokuziphatha okungokwemvelo ngesikhathi sokushintsha isimo (ilele ngemuva njengesibonelo). Udokotela ohlinzayo ubeka i-prosthesis ngaphambi noma ngemuva kwe-pectoral muscle: ngaphambili kaningi, nangemuva kwalesi sisipha se-pectoral uma owesifazane enebele elincane kakhulu noma engenalo.

Futhi ngemva kokuhlinzwa for ibele implant?

Owesifazane osanda kufakwa amabele uvamise ukulaliswa esibhedlela ngobusuku obulandela ukuhlinzwa. Uzizwa eqinile lapho ephaphama esifubeni sakhe, kufana nokuthi ngemva kweseshini enhle yokuzivocavoca. Ekuqaleni, lapho enyakaza, angase ezwe ubuhlungu. Kufanele-ke azivumele izinsuku ezi-4 noma ezi-5 zokuphumula okuqinile kanye nezinsuku eziyi-7 kuya kweziyi-10 zokululama sezizonke. Kwezinye izimo, i-bra ingase ibekwe udokotela ohlinzayo.

Ukubonakala kwesibazi ngokuvamile kubomvu kancane inyanga nesigamu kuya ezinyangeni ezimbili, bese kancane kancane kuba umugqa omhlophe omncane, cishe ongabonakali. Umphumela wokugcina utholakala ezinyangeni ezi-3 kuya kweziyisi-6, isikhathi sokuphulukiswa okwenzekayo nokuthi izicubu nokufakelwa kuthathe indawo yakho. Ngemva kokuhlinzwa, ukuzwela kwezingono kuthinteka ngendlela eguquguqukayo kakhulu: ingahlala iqinile ngemva kokuhlinzwa, noma ifinyelelwe futhi ngokuvamile ibuyele emasontweni ambalwa kuya ezinyangeni ezimbalwa, ngisho noma ezimweni ezingavamile, ingaba yinde.

Ukuncelisa ibele kuhlala kungenzeka, ukungenelela akuphazamisi izindlala ze-mammary. Ukuhlolelwa umdlavuza webele kwaba nzima kakhulu ngokufakelwa ngenxa yokuthi kwenza isithombe se-radiological sifundeke kalula, ngakho-ke ngezinye izikhathi umdlavuza kungabi lula ukubonwa futhi kube nokukhathazeka mayelana nokubambezeleka kokuxilonga. Namuhla, ukuthuthuka kwe-radiology kwenza kube lula kakhulu kunangaphambili ukufunda ama-mammograms ngemva kokufakelwa. Ngokuthinta, ungazwa ukuthi kune-prosthesis, kodwa ukuthinta kuhlala kungokwemvelo kakhulu nama-gel ahlangene asetshenziswayo okwamanje.

Ucwaningo ngokuphepha kwezifakelo

Akukho ukuxhumana phakathi kokubekwa kwe-prosthesis nomdlavuza webele. Yingakho udokotela ohlinzayo ebeka uhlobo olufanayo lokufakelwa lapho akha kabusha ibele okutholakale ukuthi linomdlavuza. Ukufakelwa kwebele ngakolunye uhlangothi akuwandisi amathuba okuba nomdlavuza kwelinye ibele.

Imiphumela emibi yokufakelwa kwebele⁶

• Ukukhulisa kungenzeka: ngemva kwenqubo, kungase kudinge ukuphinda kusetshenziswe. Kodwa lokhu akunawo umthelela kumphumela wokugcina.
• Ukubukeka kwamaqhude isibe yisimo esingavamile. Lokhu ukusabela komzimba ekufakweni okwakha indawo eqinile, njengegobolondo elizungeze i-prosthesis. Kuya ngokuya kungavamile, ngenxa yokuthuthukiswa kwezitho zokwenziwa ezintsha nezindlela zokuhlinza. Njengamanje, odokotela abahlinzayo bayaqaphela ukwenza i-hemostasis (ukuvimbela indawo ekuphumeni kwegazi ngesikhathi sokuhlinzwa) futhi bashiye igazi elincane ngangokunokwenzeka ezungeze izitho zokwenziwa, kanye nokuthungwa kwemvilophu, okunciphisa kakhulu le ngozi ye-hull. .
• Ukuzwela okwehlisiwe. Phakathi kuka-3 no-15% wabesifazane bathola ukuzwa okwehliswe unomphela engonweni nasebeleni ngemva kokufakwa kokufakelwa.

  Kuvamile ngemva kokuhlinzwa, futhi iningi lakho liyalulama emasontweni ambalwa okuqala noma izinyanga. Kodwa-ke, abanye besifazane bagcina ushintsho ekuzweleni noma ngisho nobuhlungu.⁷.

• Shift : Izimila zibekwe ngaphambili noma ngemuva komsipha omkhulu we-pectoralis. Ukuma kwe-retro-pectoral kwesinye isikhathi kungadala ukugudluka kwe-prosthesis ngesikhathi sokufinyela kwalo msipha. Lokhu kungase kubangele amahloni futhi ngezinye izikhathi kufanele ungenelele uma kuyihlazo ngobuhle.
• Ukuguga kwe-prosthesis. Lokhu kuguga kungabangela ukuwohloka kwe-serum prosthesis noma ukuphuka kwezitho zokwenziwa ze-silicone. Ngakho-ke kufanele igadwe, ikakhulukazi ngasebangeni lesishiyagalombili kuya kweleshumi. Udokotela ohlinzayo angase anqume ukushintsha i-prosthesis noma ukuyiqapha njalo ukuze abone izimpawu zomonakalo. Ukukhipha isithako sokwenziwa nge-serum ye-physiological (amanzi anosawoti oyinyumba) akunangozi ngokombono wezempilo, ngisho noma kubangela ukungakhululeki kobuhle. Ukuqhekeka kwe-silicone prosthesis kudinga ukuguqulwa kwe-prosthesis. Njengoba ama-gel amanje ehlangene kakhulu (i-silicone ihlala iboshwe kahle futhi ayinakwenzeka ukusabalala ibe yizicubu), kulula ukuyikhipha futhi iphephile kwabesifazane.
• Isexwayiso: Uma une-prosthesis futhi ubona okuthile okungajwayelekile (ukususwa endaweni, ukwehla kwamandla emali, okungavamile, ukushintsha ukuxhumana, njll.), kufanele uxhumane nodokotela wakho ohlinzayo ukuze ahlolwe.