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Medical expert of the article
Plastic surgery in recent years has become especially popular among both women and men. Indeed, thanks to them, it is possible to improve the appearance, correct the figure, get rid of many defects and flaws. However, such operations are carried out not only on the face. In particular, cruroplasty is gaining ground - a specific operation that allows you to simulate the shape, correct the external and internal contours of the legs, make the legs more even. This type of plastic surgery is performed by implant placement with simultaneous lipofilling.
The result obtained in the process of cruroplasty is preserved for life. The rehabilitation period is simple, there are practically no negative consequences.
Indications for the procedure
Many people dream of beautiful legs. However, there are many cases when desires and reality are far from each other, and it is not always possible to fix the problem with the help of physical exercises that train certain muscles in the legs.
Modern plastic surgery helps to cope even with rather complicated situations associated with correcting the shape of the legs. Thus, the dream of many patients can really become a reality.
Indications for cruroplasty often become:
- too thin shins;
- insufficient development of the musculature of the leg, which is the result of exposure to genetic or intrauterine factors;
- atrophic processes in muscle tissue caused by primary diseases or injuries;
- curvature of the leg muscles due to age-related or other disorders;
- excessive curvature of the lower extremities due to congenital or acquired factors;
- unequal thickness of the legs;
- irregular contour of the legs.
In most cases, patients turn to a specialist for cruroplasty for aesthetic reasons. For example, the need for plastic surgery occurs after a sharp weight loss, after neurological problems, accompanied by atrophy of individual muscle fibers, as well as after injuries of the lower extremities.
The patient should be approached to the procedure of cruroplasty carefully, he should be calm - both mentally and physically. A week before the operation, it is recommended to do light gymnastics, take long walks in the fresh air, and jog. Any surgical intervention is stressful for the body, therefore, before the procedure of cruroplasty, the patient should rest as best as possible, not forgetting about good nutrition. If there is excess weight, then the operation should begin preparation even earlier in order to correct body weight.
Smoking is considered a negative factor for the healing of postoperative sutures. Nicotine constricts blood vessels, impairs blood circulation, and increases the risk of complications. To avoid negative consequences, smokers are advised to refrain from nicotine, at least a couple of weeks before surgery, cruroplasty, as well as during the entire recovery period.
As for alcohol, it does not directly affect the quality of healing, but it negatively affects blood coagulation processes. Therefore, moderation in the use of alcohol should be observed both before and after kroroplastika.
In the course of a medical consultation, before carrying out cruroplasty, you need to inform the doctor about the medications you are taking. It is advisable to stop taking medications, including oral contraceptives, 1-2 weeks before the operation. If this is not possible, then it is necessary to consult a doctor.
On the eve of the intervention, the patient should take a shower (preferably with a bactericidal soap), without the subsequent application of creams, lotions or oils. It is necessary to leave all jewelry and valuable accessories at home, put on light and comfortable clothes. Shoes should be flat.
Since cruroplasty most often involves the use of epidural anesthesia and intravenous anesthesia, it is important that the stomach is completely empty at the time of surgery. If it contains liquid or food masses, they can enter the respiratory tract, which is dangerous for the patient during anesthesia. To avoid complications, you should easily have dinner in the evening, and the next morning, on the eve of the intervention, do not consume either food or water.
Many experts advise to exclude salted foods a week before the operation of cruroplasty. This is due to the fact that salt can provoke swelling of the lower extremities, which is extremely undesirable in the postoperative stage.
If everything is done correctly, then you can not only prevent the development of complications after cruroplasty, but also accelerate the further restoration of tissues and the whole body.
Technique of the chroplasty
Implants for cruroplasty are different - both in size and in density. As a filler, saline or gel silicone is usually used. The implant surface can also be different - from smooth to textured. The prosthesis itself should imitate the muscle shape as much as possible, be hypoallergenic and safe.
Most often with cruroplasty, these types of implants are used:
- symmetrical (prostheses with a limiting average thickness);
- asymmetric (prostheses repeating the configuration of the calf muscle).
The decision about which prosthesis will be used during cruroplasty is made by the doctor.
How is the intervention going?
The patient is placed on the operating table (position - lying on his stomach). The surgeon treats the area of the intended operation with an antiseptic, makes the necessary marks and performs a popliteal incision up to about 3.5 cm.
Next, the doctor with special scissors separates the soft tissue from the connective tissue membrane of the calf muscles, forming a place for the introduction of the endoprosthesis. Such a place should correspond to the size of the implant, since it completely simulates the natural configuration of the muscle.
The silicone prosthesis is placed below the muscle fascia, or axillary (subfascial or submarine technique is used accordingly). After that, the doctor sutures the fascia, imposes several sutures on the subcutaneous fat and performs the final skin suture. The wound is treated, an aseptic retentive dressing is applied.
The entire period of cruroplasty surgery takes an average of one and a half hours.
Contraindications to the procedure
Since cruroplasty is a full-fledged surgical intervention, it requires a serious attitude and a balanced approach, both on the part of the patient and the surgeon. The doctor collects all the information about the patient’s health status in advance, analyzes the available indications and contraindications for the operation. Laboratory tests are mandatory, a complete medical examination is performed.
Kuroroplasty, as well as any other plastic surgery, cannot be prescribed if there are such contraindications:
- acute course or exacerbation of chronic infectious and inflammatory diseases, pathologies of the cardiovascular system;
- severe renal or hepatic insufficiency;
- pregnancy and lactation;
- obesity (including endocrine etiology);
- malignant tumor processes;
- blood diseases, a tendency to thrombosis, bleeding disorders, varicose veins;
- psychical deviations.
Kroroplasty is not performed with decompensated hypertension, since in such patients the risk of developing bleeding from damaged vessels is greatly increased.
Another important contraindication is keloidosis. This is a systemic connective tissue pathology, in which growths are formed on the site of the postoperative scar. A true keloid scar is constantly increasing, regardless of the original size and depth of skin damage.
If the doctor found that cruroplasty cannot be performed for one reason or another, then additional examinations can be carried out. In some cases, contraindications are relative, and the issue of the operation is decided on an individual basis.
Consequences after the procedure
As with any other operation, cruroplasty has its own risks of developing negative consequences. Complications are rare, but still happen, and each patient should be informed about this.
- Hemorrhages, hematomas appear as a result of damage to blood vessels during the operation. Light hematomas gradually resolve on their own, and massive hemorrhages may require additional intervention with suturing or coagulation of the damaged vessel.
- A purulent inflammatory process can develop if the rules of aseptic and antiseptic are not followed during the intervention. In some cases, the infection can get into the wound by the hematogenous route - in particular, from the foci of infection already in the body. To prevent this, it is necessary to cure all infectious diseases before carrying out cruroplasty. 
- Violation of sensitivity, paresthesia can occur as a result of damage or compression of the nerve endings. Such abnormalities usually disappear on their own, as tissue regenerates.
- An endoprosthesis contouring occurs when the implant is incorrectly selected. Such an unpleasant consequence requires surgical correction, which is performed in two stages. First, the endoprosthesis is removed, and after a few months another, more suitable implant is placed.
- Swelling of the lower extremities is a thickening of the lower leg due to the accumulation of fluid in the tissues. This phenomenon usually goes away on its own about 2 weeks after cruroplasty.
- Deformation of the operated limb may occur due to mechanical trauma to the endoprosthesis. In such a situation, it is necessary to replace the implant with a new one.
- Scars are a relatively rare consequence after cruroplasty, which occurs in patients with an individual tendency to form keloid scars, or when the wound healing period is too long (for example, if this period was complicated by the development of infectious inflammation).
Swelling after cruroplasty
Edema can occur as a result of direct surgical damage to the tissues of the lower limb. In addition, vascular permeability increases, which leads to the exit of plasma from the smallest vessels. During the operation, both the blood and lymphatic vasculature are invariably damaged, which leads to the formation of swelling.
In general, edema after cruroplasty is considered normal. After a while, it passes on its own, but this process can be accelerated with medication.
Most often, to prevent and eliminate edema after cruroplasty, it is recommended to wear special compression underwear. Such underwear helps the venous vessels on the legs to function properly, namely, to raise and transport blood up.
In some cases, it is possible to solve the problem with edema with the help of lymphatic drainage massage, which should be performed by a specialist. If such a massage is done incorrectly, then you can not only not help, but also harm the patient.
To reduce puffiness after cruroplasty, heparin ointment is used, which is applied only to intact skin areas. For the same purpose, Lyoton gel is used, which improves blood circulation and has a slight anti-inflammatory effect. External preparations Troxevasin, Troxerutin, Heparoid Zentiva prevent excessive fluid accumulation. Of the medications for internal use, Detralex, Troxevasin, Eskuzan, etc. Are most suitable. According to the doctor's prescription, diuretics Lasix, Triampur, etc. Can be used.
A special diet with salt restriction accelerates the disappearance of edema. Food containing potassium should also be added to the diet - these are bananas, baked potatoes, raisins.
After cruroplasty, it is advisable to lift the legs more often in the supine position - for example, to lay a roller or pillow. Do not forget about wearing compression stockings or tights.
Complications after the procedure
Each patient should be familiarized with a list of possible complications after cruroplasty in advance. On the Internet, you can certainly find unpleasant reviews and photos that make many patients doubt the operation. However, the vast majority of complications arise when patients do not follow the doctor's recommendations. What should I pay attention to to prevent the development of postoperative problems?
Before deciding on plastic surgery, you must first collect all the information about the clinic and the doctor who will perform kroroplastika. It is important that the clinic is in demand, has modern equipment, high-quality supplies and drugs. Doctors should provide the patient with not only a high-quality operation, but also competent diagnostics, regular consultations (before and after cruroplasty), comfortable stay conditions, anesthesia and compression underwear, adequate postoperative care.
Nevertheless, it is necessary to take into account even the minimal risk of complications that are most often associated with:
- with the individual characteristics of the body and its unforeseen reactions;
- with non-compliance with postoperative rules and doctor's appointments.
Important: any concerns about the well-being or management of the postoperative period is an occasion to see a doctor.
Complications can be divided into two groups:
- Common complications provoked directly by the operation of cruroplasty:
- pain syndrome;
- increased body temperature;
- the formation of keloid scars;
- change in skin sensitivity.
- Specific complications associated with an endoprosthesis and anatomical features of the lower extremities:
- limb deformities;
- implant damage;
- prosthesis contouring;
- other rare complications (allergy to endoprosthesis material, tissue atrophy, calcium deposits in the implantation zone).
Since the vast majority of complications are due to improper care and maintenance of the rehabilitation period after cruroplasty, it is important to carefully follow all the doctor’s instructions and follow his recommendations.
Care after the procedure
Physiological edema after cruroplasty should disappear on its own within 2 weeks after surgery. If this did not happen, then we can assume the following reasons for this phenomenon:
- irregular or short-term use of compression garments;
- exposure to hot water or ultraviolet rays during the early postoperative period;
- early practice of physical activity.
An increase in temperature is possible in a small range (up to 38 ° C) in the first 2-3 days after cruroplasty. It is necessary to worry and consult a doctor in such cases:
- if the temperature "jumped" sharply;
- if the fever lasts more than a week;
- if the indicators returned to normal, then increased sharply.
With the development of the inflammatory process, the patient may develop such signs:
- redness of the skin in the area of the operation;
- sharp pain during palpation;
- the release of serous or purulent fluid from the postoperative scar.
With severe intoxication, the body can react quite violently: nausea, vomiting, dizziness, loss of appetite, etc. Are possible. In such situations, contacting a doctor should be immediate.
To prevent loss of skin sensitivity, the doctor may prescribe B-group vitamins, physiotherapy.
After cruroplasty, complete tissue repair occurs within about 2-3 months. Until this time, the patient may feel some inconvenience, swelling and slight pain.
The duration of disability varies depending on the occupation:
- for office workers, this period is approximately 2-4 weeks;
- for persons engaged in physical labor - 4 weeks more.
The operated limbs begin to hurt in the evening on the day of the intervention, when the action of the anesthetic drug ends. To reduce pain, pills are prescribed, at the discretion of the doctor. You can reduce pain by applying ice bags - for 20 minutes 4 times a day. Most often, the pain recedes within 2-3 days.
To prevent and reduce swelling after cruroplasty, you should:
- immediately after the operation, put on compression underwear and wear it during the entire rehabilitation period;
- during the first three days, keep your legs above the body (use a special roller or several pillows).
Legs are taught to exercise gradually. If necessary, apply a bag of ice. Until all the unpleasant symptoms disappear, it is recommended to wear soft shoes without heels. Over 2 months, physical activity should be limited, thermal effects should be avoided (hot shower, bath, bath, ultraviolet radiation).
Kroroplasty is generally considered a relatively simple and safe plastic surgery. The recovery period does not take much time, and the result begins to delight patients almost immediately.