Kobulashvili Timur Givievich
Rita 2017-01-10
I had a breast augmentation with Timur Givievich a year ago. Access is via the areola, since I am already a mother of three children and do not plan to give birth. I thought that there would be a decent scar from the operation, I didn’t know that now it’s possible to do everything and almost without traces. I'm very glad I was wrong! Because now, a year later, the scar has lightened so much that it can only be seen if you look closely. Since it's right next to the areola, it's very delicate and feels like it's just a natural part of the areola. An incision for the operation was made directly along the contour, and I am glad that everything not only looks beautiful (Natrel round implants, medium projection, 275, filled with cohesive gel), but also there are no traces of the surgeon’s intervention. I met my boyfriend 9 months after breast augmentation, and when it came down to it, he didn’t even think that it wasn’t for me. Always complimented my body. Now, of course, he already knows, but only because I told him myself. If we talk about the professionalism of the surgeon, I have complete confidence in him. I had consultations with several very famous doctors. But in the end I chose Kobulashvili, because it was during his consultation that I felt most comfortable. I felt that not only I, but also the surgeon was interested in an excellent result. There was an inspection, modeling, and a clear analysis of what I want. I only now realized how important this is, and then I thought that everything was very clear - I just want bigger breasts. I didn’t really understand these projections, etc., but the doctor explained everything, and we chose the best option for me. For me, rehabilitation was difficult for the first week - everything ached and seemed to be dragging, but then I felt better and better all the time, the scar was healing well. My advice to those who also want to undergo some kind of plastic surgery: you should definitely have assistants during the recovery period. I have a small child, and my dear mother helped me a lot throughout the recovery period. Because I wasn't allowed to lift weights, be physically active, etc. And my husband helped a lot with housework. So it is a mistake to think that you have had surgery and will quickly return to your previous routine. Better to take a vacation. Breasts are for life, it is important to maintain the result. And, of course, you need to choose a surgeon wisely. For me, my doctor is the best, for someone else a different doctor will be suitable - everything is individual! But it is very important to familiarize yourself with the surgeon’s experience, look at his work, and only then include him in your list for consultation! These are my tips, I hope they help someone! I am 34 years old, I had surgery a year after the end of lactation. But it seems possible a little earlier. The main thing is not to hesitate to ask the surgeon all the questions that concern you. Finding out on the Internet is one thing, but asking a professional is quite another. Thanks to everyone who read to the end.
Timur Kobulashvili about plastic surgery for breast reduction and lift
Today we will talk about this very relevant, but not very widely publicized operation with the leading plastic surgeon of the Clazco
, candidate of medical sciences
Timur Kobulashvili
.
— Timur Givievich, tell us, how often do patients come to you asking for breast reduction?
Timur Givievich Kobulashvili
:
Probably, compared to those who want to enlarge their breasts, asking for breast reduction and lifting is not so much. If I perform about 300 breast augmentation surgeries a year, breast reduction and breast lift surgeries account for only 50-60. I think many women simply don't know that this problem can be solved. In addition, not all plastic surgeons like it - it is lengthy, labor-intensive and there are certain nuances in the postoperative period. BUT there is a problem and it is big. Moreover, its severity varies from region to region. I think it depends on genetic background. In general, the mechanisms of breast enlargement have not yet been fully studied, although at this stage of medical development it is difficult to believe. All patients wishing to undergo breast reduction can be divided into two groups: the first group of patients whose breasts enlarge in juvenile (adolescent) age due to hormonal imbalance and patients who have excess breast tissue genetically. We refer this group of patients to an endocrinologist. The second group is those whose breast size increases due to the growth of adipose tissue. These are women aged 35-40 years, they are replacing glandular tissue with adipose tissue and, in addition to this, deposition of fat in the interlobular areas. Until the age of 35-40, a woman usually does not pay attention to shortcomings - after all, large breasts, even if they are slightly drooping, do not cause aesthetic problems, but by the age of 40, a woman usually begins to feel heaviness, pain in the neck and back, and constant traces of Wearing a bra on the shoulder girdle begins to bother her, in addition, her breasts sag. The solution is breast reduction and elevation of the nipple-areolar complex. Breast reduction surgery is almost always combined with a breast lift. In essence, this is the same breast lift, only with the removal of excess glandular tissue. How exactly these excesses are removed, with what access, depends on the specific situation and characteristics of the patient.
— You touched on a very important issue related to anesthesia. What anesthesia do you use during breast reduction and breast lift surgery?
If we talk about a breast lift, then all surgeons perform this operation under general anesthesia, and I have been doing a breast lift under local anesthesia for more than three years, while an anesthesiologist sits next to me and talks with the patient throughout the operation. But! Breast reduction is a traumatic operation, during which the breast tissue is affected; it also has skin receptors; anesthesia is undesirable, since even the administration of a local anesthetic has its own norm. Theoretically, you can inject everything, but you can exceed the dose of the local anesthetic administered, so anesthesia is more preferable. There is a full-time anesthesiologist at the Klazko Clinic! He doesn’t go anywhere on the day of the operation, he stays with the patient. Its task is to ensure the uninterrupted functioning of the patient’s cardiac and respiratory activity. When the patient wakes up - in ten minutes or in half an hour - depends on the individual characteristics of the body, there is only one goal here - safety, I can’t tell you in more detail - this is the anesthesiologist’s kitchen. For comfortable work in Klazko, we have absolutely everything; in fact, the operating room is one large intensive care unit, where there is also an operating table.
— Timur Givievich, you noted that up to 35, patients usually do not pay attention to the discomfort associated with an excess of breast tissue. At what age do people usually turn to you for help?
Usually at 35-40 years old, when the children have grown up and you want to live “for yourself”. But sometimes they come at 50 and 60 years old. What is this connected with? Some people are embarrassed to see a surgeon, others simply don’t know that plastic surgeons can solve this problem. I know that in some countries, half the cost of breast reduction surgery is paid by the state - this is an insurance event. I repeat - enlarged breasts are not only an aesthetic problem. It is also dangerous to health.
— Please tell us about what features a patient can expect during the recovery period? Do they exist?
In order for patients to accurately understand the consequences, I invite them to imagine that they have mastitis. In fact, it is so - after all, we cause injury to the mammary gland, albeit under sterile conditions. And, of course, we cause an intense response from the body to the wound we inflict. Temperatures are expected to rise for 4-5 days, but they will gradually subside. We evaluate the results of the early postoperative period approximately by the end of the fifth day. During the postoperative period, it is advisable to stay in the hospital for at least one or two days. On the second day after breast reduction or breast lift surgery, we assess the patient’s condition and decide whether he can be discharged or remain under observation.
— Are there any contraindications that are relevant after breast reduction surgery for a longer period of time?
You can't swim in the pool for about two weeks - this is the period during which all the stitches heal so much that we are sure that there will be no more infection. If even after a week we see that the wounds are dry and healing well, then we allow patients almost everything, even to go on vacation at the seaside. It should also be noted that I am against any impact on the skin after surgery - that is, now many people suggest using a fractional laser, for example, to treat fresh scars - I do not approve of this. It is better not to heat anything in the intervention zone again. Breast reduction surgery somehow disrupts the blood supply to the remaining skin flaps and, frankly, I am not a supporter of physiotherapeutic methods. Surgeons (myself included) prefer the cold. You can carry out mesotherapy with oxygen or cocktails that improve microcirculation, but this is only as needed and is not discussed with the patient - if there is a need, the procedure is prescribed and performed. Sometimes we resort to means that increase tissue immunity.
— Is it really possible to return to normal life after 7 days after breast reduction surgery?
A week is if you need to go somewhere. It's minimum. Usually we are talking about three weeks, since hematomas and swelling should go away after the operation. After this period, you can go to the south and sunbathe, since the fabric of the swimsuit covers the areola of the nipple and the post-operative scar, and swimming in the sea will only be beneficial.
— Do I need to wear special underwear after breast reduction?
I have my own point of view on this question. I suggest that my patients choose comfortable underwear without wires. It doesn’t necessarily have to be special compression hosiery, just comfortable underwear that doesn’t tighten the chest is enough. The bra gives a feeling of protection and allows you to wear special napkins and pads under it to minimize the use of adhesive tape on injured skin.
— Where is the postoperative suture? What does the breast look like after surgery?
Previously, in order to avoid scar deformation after breast reduction and lift surgery, surgeons, making an incision in the second intercostal space, fixed the breast tissue to the periosteum of the rib or even to the collarbone. But experience has shown that this technique does not work. It is impossible to unload the scar after surgery in this way; the tissue does not hold. This is why I use my technique and get good results
. I use access below the areola. This incision must always be present, since we must move the nipple. We must also remove excess tissue and skin. Therefore, we use either oblique approaches from the areola to the breast crease, or a T-shaped incision (an inverted “T”) from the areola to the crease and along the crease.
— Do you use 3D modeling methods to show the patient the results of breast reduction and breast lift surgery?
The fact is that we have repeatedly discussed this issue with colleagues and came to the conclusion that the results do not always correspond to reality - both with breast augmentation and breast reduction. Everyone has a different chest, different amounts of subcutaneous fat, and different skin conditions. I would especially like to note that often women who are bothered by back pain and other inconveniences due to large breasts are so eager to get rid of them that they are not even interested in how everything will look later. Therefore, in our Klazko clinics we offer to use the 3D modeling method, but we warn that this is just a program and it will not 100% reflect the real final result.
— Do men contact you about this issue? For example, to get rid of gynecomastia?
Yes, they exist, although they are few. Men come to us for consultation and ask questions, and in cases where it is true gynecomastia, we, of course, help and perform surgery. Moreover, no matter how severe the gynecomastia is, through a small incision in the areola we can remove excess tissue even under local anesthesia. First, of course, we rule out liver diseases that can cause gynecomastia.
— How do your patients find out about you and the Clazco group of clinics?
Approximately 80% come by recommendation, the rest respond to the clinic’s advertising campaign and its good reputation.
— And an important question: what is the cost of the operation?
This can be found on the clinic website
.
