How plastic surgery began in Ulyanovsk
Sergei Mikhailovich has extensive experience in plastic surgery, although the path to this specialty was not quick. In 1986, he graduated from the Kuibyshev Medical Institute and began working in surgical dentistry at the Regional Dental Clinic. After 4 years, he moved to the department of maxillofacial surgery of the Ulyanovsk Regional Clinical Hospital.
As our interlocutor notes, in those years reconstructive operations were carried out in Ulyanovsk: they eliminated congenital clefts of the lip and palate, scar deformities on the face, and so on. But aesthetic medicine was just in its infancy. In 1993, plastic surgeon Evgeny Arkharov came to Ulyanovsk from Stavropol, and about a year later cosmetic surgeries began to be performed at the regional hospital. Sergei Mikhailovich became interested and began to travel to study in Moscow, Yekaterinburg, and St. Petersburg. He has many certificates and, of course, a diploma. He is a member of the ROPREH society. Constantly continues to improve his skills. He became involved in plastic and reconstructive surgery as a specialist in 1998. He can perform many plastic surgeries, but does not deal only with gynecology.
Mammoplasty - breast augmentation or correction (from 150,000 rubles); Abdominoplasty - tummy tuck (from 90,000 rubles); Liposuction - removal of excess fat deposits in the abdomen and other parts of the body (from 15,000 rubles); Blepharoplasty - plastic surgery of the upper and lower eyelids, getting rid of wrinkles and bags under the eyes (from 50,000 rubles); Facelift (from 80,000 rubles); Otoplasty is a plastic surgery to correct the ears and get rid of protruding ears (from 30,000 rubles); Lipofilling is a complex technique for correcting age-related changes in the face and body contours, the essence of which is the transplantation (transplantation) of the patient’s own fat tissue from one zone to another (from 11,000 rubles). *Prices are average for the city
Interview from Andrey Bezdenezhnykh’s book “Simbirsk context. Private life. Book 3”, 2004. Source: website of the literary club “First Dew”
Andrey Bezdenezhnykh
Evgeniy Vladimirovich Arkharov
Reference: 40 years (as of 2004 – Portal note). Born in Ulyanovsk. Head of the plastic surgery department of the regional hospital. The best plastic surgeon in the area.
For your information: The first “registered” plastic surgery was performed in Ancient India - a flap of skin from a warrior’s forehead was used to recreate a nose that had been severed during a battle.
– Evgeny Vladimirovich, what is the status of your department?
– This is a budget department of the hospital. Exactly the same as surgery, ophthalmology or traumatology. But since people come to us not sick, but healthy, who want to slightly change their appearance for the better, then, naturally, this type of service is paid. People pay into the hospital cash desk. The department has existed since the end of 1994. It employs two surgeons, five nurses, a nurse and two masseuses. On average, about five hundred people come to the department for consultation each year. Of these, only one and a half hundred people reach the operating table. Some are denied due to medical reasons, others change their minds on their own.
– Why do people change their minds?
– A specific example: today there was a young girl at the reception. I wanted to increase the volume of my breasts - insert “prostheses”. But after consultation she refused. Why? It is better to perform this operation after you have already given birth and nursed the child, because there is a small risk of allergies in the fetus. No, the Ministry of Health allows implantation of prostheses before childbirth. And many women do just that. But my duty is to warn them about possible small troubles.
– Most of your patients are women?
– Women make up about 90%. A third of them are asked to make changes on the face, a third on the chest, and a third on the buttocks. Men apply rarely and mainly in serious cases. For example, when facial disfigurement occurs after an injury. There are guys who have been to “hot spots”. Just recently they operated on a young man who was wounded in the nose in Chechnya. The nose turned into a cake. I had to restore its shape.
– Do they bring children to you?
– Some time ago there was a period when a lot of “lop-eared” children of 10-12 years old were brought to us. Then it stopped, which, you see, even looked somewhat strange.
– So it turns out that 9-11 years before this, some lop-eared Casanova committed “atrocities” in Ulyanovsk, who “spoilt” hundreds of our women?!
– I don’t know... This, of course, is a frivolous thought, but the fact remains a fact.
– Which of the operations you perform is the most expensive?
– These are operations that require extensive intervention and a long rehabilitation period. For example, breast reconstruction in women. Rarely, there are cases when a woman is born without one breast (Poland syndrome). Or surgery to remove belly fat.
– What is the price level for plastic surgery?
– Our most expensive operation costs up to 8 thousand rubles. These are very low, “Ulyanovsk” prices... I’m even sure that nowhere in Russia there are prices lower than ours. In Moscow and St. Petersburg, prices are prohibitive. There, the cheapest operation costs $500, and the most expensive is $6-7 thousand. In Samara, prices are three to four times higher than ours.
– What does this have to do with?
– The main reason is that in most large cities, clinics providing such services are private. They set the prices they see fit. We are a budget organization. Our prices are set based on the actual cost of a particular operation.
– Why aren’t private clinics of this kind created in Ulyanovsk?
– Probably because prices must correspond to the economic realities of the region. If we switch to private services, then Ulyanovsk residents with their low incomes will not be able to afford these operations. In general, this is not a question for me, but for investors. I am a doctor, my job is to operate. Creating a clinic - constructing a building, equipping it, solving all organizational problems - is a matter of people with money.
– Is it generally profitable to invest money in medicine?
- I guess, yes. But Ulyanovsk businessmen are not ready for this. They do things that bring quick profits. Medicine begins to make a profit after five or more years. But in larger cities, rich people have already begun to work for the future and are engaged in long-term projects. They work not for themselves, but for their children and grandchildren.
– I wonder where the daughters and wives of rich and famous Ulyanovsk residents go – to you or to private clinics in other cities?
– Well, first of all, the daughters and wives of rich people rarely bring themselves to the point where they need surgery - this includes sports and good creams. And of those who decide to undergo surgery, 30-40 percent go to private clinics in other cities. The issue of prestige plays a role here. You walked through our department, you saw that the building here is old, and the beds are ordinary - hospital beds. Others turn to us because our operations are no worse.
– In the West, the profession of a plastic surgeon is prestigious and highly paid. In our country, as I understand it, it is not like that. How do you feel about your profession?
– I love my job, my work is interesting and varied. Even the simplest and most similar operations are still different, since identical persons do not exist. But this work is hard. Surgeries on the heart or abdominal cavity require speed, determination, and quick rescue of the person. We have difficulties of a different nature. Sometimes we stand for five hours and dig, millimeter by millimeter, into a hole the size of a ten-kopeck coin. A large incision is unacceptable with us - you cannot leave a scar, cut a vessel (in “major” surgery, cutting dozens of vessels is allowed) or damage a nerve, which can cause the entire face to become distorted. Our work is comparable to the work of a watchmaker. This is monotonous, tedious, painstaking work that requires great attention and diligence. It seems like you’re not unloading the cars, but you leave the operating room completely crushed. And since you don’t receive adequate financial satisfaction in return, then... sometimes I experience very conflicting feelings.
– How did you come to this profession?
– I graduated from medical school (by the way, my parents have nothing to do with medicine, my father is a design engineer, my mother is a translator), and received the specialty of an oral and maxillofacial surgeon. I started working according to my profile in Stavropol. When cooperatives began to be created after perestroika, my immediate boss opened a cooperative at our hospital that performed cosmetic surgeries. And I often had to help him. To be honest, I didn't like it at first. At my day job I was involved in large oncological operations. This is what seemed noble and right, and this is what I wanted to do next. But oncological tumors in maxillofacial surgery were quite rare, and the cooperative was experiencing a boom - with the advent of perestroika, people began en masse to straighten out their wrinkles... My supervisor kept telling me: “Study, fool! It will be useful in life!” And he taught me... Either he was staring at it, or circumstances just happened that way, but now it has become my main specialty.
– Do you feel like a creator when you perform an operation?
– When, for example, I remove a birthmark or a tumor on the face, then no. Here you need to be not a creator, but a pedant. But when, for example, I create a neat female nose from a large, fleshy “Armenian” nose, then of course - yes... But not during the operation, but when I already see the result.
“One local police officer I know told me that after he had worked for several years, he began to look at all people as potential criminals. Don’t you have something like this - look at a person and automatically note what and where he needs to “tweak”?
- There is no such. For one very simple reason - I have a personal doctrine: I believe that there are no ugly people at all. Every person is beautiful in their own way. And even in a person disfigured by some tragic events, you can find beauty. If he has a beautiful soul. The hero of Dumas’s novel “The Man in the Iron Mask” is an example of this. The huge scar on the protagonist’s face gave him masculinity in the eyes of women. Therefore, initially I do not consider myself to have the right to approach a person with some kind of stamp. To say on a tram: “You should flatten your ears, and you should touch up your nose” would be stupid. A person must mature himself and understand that he wants to change something in his appearance. If he has come to this conclusion, then you are welcome to contact us - we will study the problem and decide whether it requires intervention.
– Plastic surgery, in some way, is interference in the affairs of the Creator, in the affairs of God...
– This is absolutely not true. God creates the soul. God in man is his soul. The body is just a shell for the soul. A person is free to change this shell. Every year we change our trousers, jacket, hairstyle, finally. We're shaving! We are changing ourselves! Some people get tattoos on their bodies, others go on a diet and lose weight. So, is all this against God? The same goes for surgery. To change a soul - to influence a person, to oppress him, to humiliate him - this is against God...
– What is beauty: a vessel in which there is beauty, or a fire flickering in a vessel? Which beauty is more important: external or internal?
– I will answer unequivocally – a combination. Both. If you substantiate this, a whole conversation will turn out... Firstly, no one knows the exact answer to the question why the “jug” itself - external beauty - cannot have a single standard. Nobody knows what external beauty is... Even the great Leonardo da Vinci calculated the parameters of beauty. He calculated them all - the height of the forehead, the shape of the eyes - but still, the drawing created according to all the calculated parameters seemed beautiful to some, and ugly to others! Behind all this lies a huge breadth of people’s perception of beauty. And it is impossible to come to one standard. Secondly, a person’s perception of beauty is constantly changing. During the Renaissance, judging by the paintings of Rubens and Rembrandt, plump women with powerful calves were considered beautiful. Nowadays, beautiful women are considered “hangers” - thinness, a large mouth, slanted eyes, a “triangle of youth” of the cheekbones, tapering towards the chin... As people develop, they themselves change the standards of beauty. Why? Our idea of beauty is influenced by the external environment. Our civilization is developing along a technical path. The mechanisms are getting better and better. Life is getting faster and faster. This cannot but have a reverse effect on a person. That calm, peaceful, full-bodied woman in Rubens’s painting, lying in the garden and being a symbol of peace, tranquility, maintaining a home, raising children, is now of no interest to anyone. Now the racehorse is interesting - an energetic business woman who is sexy, will break through everywhere, and will feed the man herself if necessary. And thirdly (this is the most important thing): external beauty without internal beauty, without spiritual beauty, is dead. It's like a vessel without any fire inside at all. When it is not there, the vessel fades. This shows up in everything. A spiritual person does everything through the prism of his inner fullness. He looks differently, which means his view changes. He speaks differently, which means his lips move differently. He moves differently, which means his gait becomes more meaningful. A person who is beautiful from the inside manifests this beauty in his external movements; this, as it were, illuminates his outer shell. The same is true vice versa. You have more than once met people with regular facial features and body lines, which in all their external parameters correspond to modern ideas about “beauty”. But when you start communicating with such a person, sometimes you get unpleasant, disgusting impressions! There's nothing inside him! You can admire its external parameters for no more than 15 minutes! Then it starts to get boring. How long can you look at a cold porcelain figurine if there is no fire inside it?
– That is, we love “fire” in a person?
– We love a combination, a perfect combination. Surely you have noticed that there are people who seem to be not very attractive in appearance (I, as a specialist, can immediately detect some small aesthetic defect - for example, the tip of the nose is too wide or lips are too narrow), but as soon as you start with them communicate, you completely forget about it! The defect seems to dissolve and ceases to attract attention. And moreover, he becomes cute and gives a person a special charm. It is precisely this combination of external and internal that we most often fall in love with.
– How do you feel about physiognomy? Is it true that certain facial features always correspond to certain human character traits?
– I read about it in a women's magazine. But I myself have never found such a connection. I consider such things to be empty chatter, inventions created to attract readers. There is, of course, physiognomy according to the Lambroso system; I myself took a test on it at the institute. But there we are talking about something else - for example, about the shape of the skull, which directly depends on the volume of the brain. As a doctor, I can accept the relationship that exists here. But I don’t understand the connection between a woman’s nose and the character of its owner at all!
– What is your ideal of female beauty?
– I can’t single out just one. From my point of view, there are not even dozens of beautiful women, but many more. I like soft and calm lines of the face without angularity, without flashy, bright or predatory features.
– I wonder if your wife fits this type?
- Certainly. Otherwise my choice would not have been justified.
– Many famous TV presenters or actresses have undergone plastic surgery that, in my personal opinion, simply disfigured them. How do you feel about this phenomenon?
– Congresses of plastic surgeons periodically take place in Moscow, where we exchange experiences. Once, at one such symposium, a very well-known and respected doctor in our area stood up and shouted menacingly: “It’s time to put an end to irresponsibility! I want to demand a direct answer: who performed Dogileva’s operation?” No one stood up or responded, although it was quite obvious that this person was present in the hall. Many well-known and beloved actresses undergo plastic surgery and, to put it mildly, do not get better from it. But this cannot be approached unequivocally. On the one hand, the people, of course, are right: Dogileva, or rather her face, the roles she played, no longer belong to her. This is a national treasure. And therefore, the change in her appearance caused a protest among fans. In front of them was a completely different person, and all the roles of that former Dogileva seemed to be crossed out. But on the other hand, Dogileva is not a role or an image, she is a living person with her own worldview, with her own needs and with her own ideas about beauty! She is the master of her appearance. And she has every right to do whatever she wants with her. What right do we have to judge her? The main thing is that she likes her new appearance! So that her new image matches her soul. As Dogileva herself said: “To sneeze at all critics. I have cut and will continue to cut!”
– Until what age can you rejuvenate your face with plastic surgery?
– You can tighten the skin on your face ad infinitum, but here something else comes into play. An elderly person not only develops wrinkles, but also other signs of aging - the bones of the face become thinner, and muscle tissue atrophies. This is much more difficult to fix. American experts recommend that all women have a facelift twice in their lives – at 45 and at 60 years old. Personally, in my practice, the oldest lady who resorted to such an operation was 69 years old. We made her 10-15 years younger.
– An unexpected question: what idea can save Russia?
- Is she dying here or something?
- Well then, not to save, but to raise...
– Nowadays they write a lot about this, and I agree with this point of view: Russia will be raised RESPONSIBLE. Responsibility at all levels - the President, officials, and neighbors to each other. This is something that is almost absent in our country now.
– What do you see as the meaning of life?
– In spiritual improvement, in getting closer to God. It’s about understanding yourself, first of all.
– Are you a believer?
– Will this be written?.. (pause) But in general, there is nothing wrong with this... I’m not hiding... Yes, I am a believer, and I think that until the end of my life, it’s unlikely that anyone will convince me otherwise. I go to church, although not as often as I would like.
– I heard that doctors are very rarely believers, because they know anatomy well...
– The anatomy textbook did not convince me of the absence of God...
– What are your three best qualities that help you live?
– Sense of humor, kindness, endurance.
– What human qualities do you not forgive?
– Maybe I haven’t encountered much in my life, some kind of boundless evil... But today it seems to me that I could understand (and understand means forgive, right?) I could do everything...
– What was the brightest episode in your life?
- Birth of a son. Now he is finishing school. There is also a daughter, she is in seventh grade.
– Will you dissuade her if she contacts your department?
“There’s no need for her to come here at the moment.” Well, then... It depends on what reason she has.
– What are you most afraid of?
- Helplessness... When I myself cannot help myself, and no one around me wants to help me. When there is no friend nearby, or when there are no friends at all, because I will lose them.
– What do you miss in life, by and large?
- Unfortunately, faith... But I try...
Operation for the sake of operation
Sergei Mikhailovich said that it is worth coming to doctors with photographs of what they want to get, because sometimes they come and say: “Give me a beautiful nose.” But everyone has their own understanding of beauty.
According to Kudryashov, before the operation, the doctor and the patient must come to a common opinion on whether it is worth doing it or not, whether it will be possible to do what the person wants, whether the result will be aesthetic, and so on.
Sergey Kudryashov
plastic surgeon
There are cases when people with general obesity come, weighing 100 kg or more. They say they want to get rid of their belly. But you can’t just cut off the belly. You must first change your eating habits, visit a gastroenterologist, endocrinologist, reduce your overall weight, and then remove what is hanging down. During liposuction, we take no more than 5 liters of fat, it is safe for the body. This procedure should be done at intervals of 3-5 months.
By the way, liposuction has not changed much over the years. According to Sergei Mikhailovich, in Ulyanovsk they do mechanical, although in large cities there is ultrasonic, water-jet, and laser. Our interlocutor hopes that new types of liposuction will soon reach our city.
Sergey Kudryashov
plastic surgeon
There are times when they want to have surgery, but I understand that it will not be pretty. Or if you have a big nose, then you can’t make a very small “pippy” as the patient wants. Some come to the operation for the sake of the operation itself, “because their friends did it.” At the same time, for example, some small hump of the nose does not spoil the girl. In all these cases, I advise against surgical intervention. Many people listen to my opinion.
Sometimes you have to agree with the patient's wishes. For example, if a girl wants to make very large breasts. At the same time, we explain what consequences are possible: the implants may be visible or the breasts will sag over time.
According to the plastic surgeon, only a few people make large breasts. But there is no leading size - Ulyanovsk girls choose implants that suit their body structure and height.
By the way, implants can be damaged by a strong impact (in an accident, for example). In such cases, an ultrasound is performed, and based on the result it is decided whether it can be changed or whether it should be completely abandoned.
The desire to look better is addictive. As the doctor said, some girls first get their breasts done, then decide to change their nose, and after a while they come for blepharoplasty.
It is curious that for some operations the daughters of mothers who themselves were patients of Sergei Mikhailovich 20 years ago are brought in.
