I’m embarrassed to ask: I want to have plastic surgery, but I’m very scared. A plastic surgeon on how to understand that you (don't) need it

Dmitry Batyukov plastic surgeon, Candidate of Medical Sciences

►I want to have plastic surgery: how do I choose a doctor? And who definitely shouldn’t have any procedures done?

– Firstly, you need to analyze all available information about the doctor and pay very close attention to its sources. Here you need to understand that there is a lot of false data on the Internet: according to statistics recently provided in the USA, only 18% of Instagram posts related to plastic surgery were made by doctors and correctly, the remaining 82% are advertising, unreliable sources, etc. P.

Secondly, you need to go to an in-person consultation, and it is advisable to go to all possible consultations if you have the time and money, so that there is an adequate assessment of your situation, wishes, final result and possible risks. You shouldn’t limit yourself to one specialist – only if you are confident in him, of course.

It is very important to find out the opinions of real people about a specialist, because popular online resources with reviews are biased: on some, negative reviews are simply hidden, on others, positive reviews are written by the medical staff themselves.

After you have created a full-fledged opinion, read about what interests you, assessed the risks and realized that you really need it, you can choose one specialist.

►What to do if you don’t like the result?

– Go to the doctor with whom you collaborated and discuss. Naturally, no doctor will deliberately do something ugly, so the patient’s first task is to convey his wishes to the surgeon as accurately and in detail as possible .

If the result really could be better, there are options when repeat operations are performed. All surgeons have unsuccessful cases that could have been done better, and cases with complications. This does not depend on the type of operation, location or amount of money spent on it.

Already at the consultation stage you can draw conclusions about what the result will be. If the surgeon says within a minute that there are no problems, he can do whatever you ask, then later, when the result does not meet your expectations, he will say that you yourself, your skin and something else are to blame.

also tell you about all possible complications and the likelihood of getting them - this has all been calculated long ago. For example, it is estimated that one in every hundred patients will bleed after breast augmentation. If the doctor says that he has not had this, he is either lying or does not operate - there is no third option.

►What should I do if the result is good, but now I want to return to naturalness?

– This option can be discussed with your doctor. We perform repeated operations, but the patient must understand that new risks are added to each subsequent intervention: the more you operate, the greater the likelihood of complications or poor results .

►Do you often have to correct other people’s mistakes?

- You see, everyone has mistakes. Any surgeon periodically corrects the operations of other surgeons. According to our statistics, about a third of all operations are repeated, when we do something after operations in other clinics. There are no doctors whose operations have not been redone.

►What do you fix most often?

– We fix a lot of breasts – this is the most common. It would seem that such an operation is standard; everyone does it. According to statistics, in the United States, one in three breasts will be reconstructed in the next 4-10 years. True, there are certain problems there: everything is fine with surgeons and technology, but there are no implants, which today are considered the safest and most effective. Therefore, if you do not trust Belarusian surgeons, I would still not recommend breast augmentation in the USA - they are behind the rest.

►And if you don’t want to go to Belarus, where is better?

– You see, plastic surgery is not a choice of country, but a choice of a specific specialist that you like. He can be in any country in the world.

If you like the results of a particular doctor, first assess the risks. The question of travel is always difficult: what will you do if something goes wrong? Extend your visa, continue to pay for rent in a foreign country with an incomprehensible system, etc.? In Belarus it is easier to solve such problems, you have a doctor you know, it is more convenient for you to go to dressings, there is always support here, but abroad you are left alone with the problem.

►How can you tell if the work was done poorly?

– What is quality? This is aesthetics. We need to get a result that the doctor and the patient consider beautiful, provided that we maintain health or minimally affect it, since such operations are usually not urgently necessary.

Also, we must not forget about natural changes: the result a year after the operation and ten years later are different. And if you don’t accept this, you think that after the operation everything should stop, then this is a factor that it is not worth doing, we simply cannot satisfy you.

“Women do breasts and eyelids, men do ears and nose.”

►What procedures and operations are the most popular now?

– The statistics are approximately the same from year to year: operations on the chest, nose, anti-aging operations in the eye area or liposuction are the most popular, and one of them is always in first place. And so all over the world.

►What request do women most often come with?

– There are a lot of operations in the chest area - more often it is enlarged rather than reduced, there are many operations in the nose and eyelids.

►What about men?

– Men usually come to correct their ears and nose, upper eyelids – the skin begins to cover the field of vision at the age of about 50–60 years, and we simply remove the excess. But few of them perform operations just for the sake of aesthetics; more often in this case, women bring them to the appointment.

►What is the average age of the patient?

– There is no average age, there is a typical age for some operations. For example, we correct patients’ ears even when they are 6–7 years old before school, and recently we performed a major operation to rejuvenate the neck of a woman who, if I’m not mistaken, is 67 years old.

►So you even perform operations on children? Which?

– Most often we correct protruding ears and scar deformities. But we always have a very individual approach to such patients, because we understand that there are things that will change with age, and all this must be predicted before making a decision about surgery. Of course, if some function is impaired and it’s not just about aesthetics, there is no need to wait, the person must develop correctly.

If we are talking only about aesthetics, for example, the shape of the nose is not satisfactory, but the child breathes normally, then, of course, the decision about the operation is made after reaching adulthood, when all the processes of formation and change of the face are completed.

►Are genital surgeries popular in Belarus? If yes, which ones?

– They are made, but they are not very popular. Now spring has come, and girls will again have labia minora reductions: for some reason they are mostly not done in the fall; They're probably getting ready for the swimming season now. They rarely do anything else.

►What about men?

– Mostly they come for circumcision and penis enlargement. The latter most often comes from those who most likely should not undergo surgery, because they have a completely normal penis. In general, such a desire may be associated with some psychological problems, and this is a contraindication.

Popular types of plastic surgery

Plastic surgeons are able to correct almost any part of the body, change a person beyond recognition, or restore to him the attractiveness lost over the years. Among the available types of plastic surgery, several basic methods of correcting appearance are the most popular.

• Rhinoplasty - correction of the shape of the nose. The presented operation is often performed for medical reasons and allows not only to correct facial features, but to correct the position of the nasal septum. The final result after plastic surgery appears after 8-10 months and lasts for life.
• Mammoplasty - breast correction. This includes not only an increase in volume, but also a decrease in volume, as well as a bust lift. A mandatory step before the procedure is the creation of a three-dimensional model, which allows you not only to see the result before the operation, but also to select the correct shape of the implants.
• Liposuction is a reduction in volume in the hips, buttocks, abdomen or back. This operation does not help radically change weight, but is an excellent addition to classical methods of losing weight: proper nutrition and physical activity. Unfortunately, if after plastic surgery you give up the diet and minimize physical activity, the lost centimeters will return quite quickly.
• Abdominoplasty is a correction of the abdomen, which includes the elimination of stretch marks and skin folds. It allows you to change the appearance of this area, eliminate the unpleasant consequences of radical weight loss, or return to shape after pregnancy. The recovery period after the procedure is usually no more than 2-3 weeks.
• Blepharoplasty is the correction of the lower and upper eyelids, as well as the eyebrows. The operation is aimed at changing the shape of the eyes and eliminating age-related changes. Allows you to get rid of overhanging skin over the eyes and bags under them, and lift the corners of the eyes. Does not involve complex rehabilitation: the skin is restored in 1.5-2 weeks.
• Facelift - tightening of the skin of the face and neck. Refers to rejuvenating procedures. Allows you to correct the oval of the face, eliminate fine and deep wrinkles, nasolabial folds and nasolacrimal grooves, redistribute the skin and remove its excess, tighten the underlying muscles. The effect of the operation lasts for 10-15 years. The most common age for the presented plastic surgery is 40-60 years.

“Liposuction is not a method of losing weight”

►Is it true that breasts will always feel different to the touch after breast augmentation?

– Of course, but the question is what experience do you have in feeling a woman’s breasts? You don't have a correct idea of ​​what it is like. In plastic surgery they know that it can be completely different: very soft, very hard, displaceable, non-displaceable, etc.

If you don’t look for a scar, don’t put a woman in a certain position - when she lies on her back, the implants are standing, and the natural breasts still spread - you, in principle, may not guess that they have been enlarged. Judging by the reviews of patients, this is not a problem for them and their partners.

►What other reasons are mammoplasty done?

– Mammoplasty is the general name for all breast surgeries. There are birth defects, such as Poland syndrome or tubular breasts, that make it difficult for a person not only to be naked, but even to put on a swimsuit.

In such cases, the operation is performed not for the sake of beautiful proportions, but in order to bring the body back to normal. But this is no longer aesthetic surgery in its correct understanding, but plastic reconstructive surgery: our goal is to make a person look the way people with this weight and at this age on average look.

►Is liposuction necessary to lose excess weight?

– No, liposuction is not a method of losing weight, but a way to correct the contour and shape of the body. For example, you don’t like the excess amount of belly fat under your belly button, but otherwise you are happy with everything, your weight is stable and you feel comfortable with it.

If a person expects liposuction to be a way to lose weight, he will be denied surgery.

►How long will its effect last?

– As long as you can maintain the stability of your body. If you gain weight and lose weight, your figure will change; if not, the effect will be stable.

Which plastic surgeries on the face should not be combined?

And although combined facial operations provide different variations, there are still those that are better not - blepharoplasty (especially lower) and rhinoplasty. This is associated with severe swelling and even hematomas after nose surgery, so some plastic surgeons do not recommend combining it with blepharoplasty, although such an operation protocol still exists.

Plastic surgery on the body: beautiful silhouette and appetizing shapes

Combined surgeries can also be combined with plastic surgeries on the body, for example, for patients who want to regain their figure after having children. The whole complex of manipulations will allow you to solve all problems in one operation, which will save time, effort and money.

Mammoplasty and abdominoplasty: getting your figure back is real

Motherhood, although considered a happy and sacred role for a woman, invariably leaves its mark on her figure. Due to breast ptosis after breastfeeding and excess skin in the abdominal area, she may not feel attractive enough. In such cases, you can resort to simultaneous surgery with breast surgery and abdominoplasty. In 3-4 hours of plastic surgery, the surgeon will perform a full mammoplasty (breast lift, breast augmentation with implants) and perform abdominoplasty with navel transfer or mini-abdominoplasty, depending on the situation.

Abdominoplasty with breast lift without implants. The operation was performed by plastic surgeon Amit Khatri

Abdominoplasty for diastasis and hernia: solving surgical problems in one operation

It is important to note that during plastic surgery, problems associated with general surgery, for example, umbilical hernia and diastasis, can also be solved. This is often faced by women after pregnancy. In such cases, before abdominal surgery, the general surgeon of the Pirogov Clinic will eliminate the hernia, and the plastic surgeon will correct the discrepancy of the abdominal muscles (diastasis) and perform the rest of the abdominoplasty operation. The operation lasts about 3-4 hours, the seams are carefully placed below the line of the underwear, so they will be securely hidden from prying eyes even on the beach.

Abdominoplasty and liposuction: a beautiful silhouette without extra centimeters

In the abdominal area, not only excess skin is often formed, but also a large amount of adipose tissue. Therefore, tummy tuck alone may not be enough to achieve the desired result. Plastic surgeons often suggest improving future results by adding liposuction to the planned operation. This is the gold standard for those patients who want to get a significant effect and a beautiful waist.

Abdominoplasty and liposuction. The operation was performed by plastic surgeon Amit Khatri

Abdominoplasty and liposuction. The operation was performed by plastic surgeon Egor Andreevich Parygin .

“Seamless and proprietary methods are nonsense”

►Are there absolutely safe ways to improve your appearance?

– There is not a single safe action in life. According to statistics, the probability of dying on the operating table is an order of magnitude lower than the probability of being hit by a car when you leave here.

►Are there visible scars after plastic surgery?

– Wherever there was a cut, a scar remains. Our goal is to make sure it's not noticeable, but if you know where to look, you'll find it. There are no seamless methods - this is complete nonsense and deception of consumers. We are fighting this, informing patients, but every day someone calls and asks why we don’t use a seamless technique.

In the same way, there is no such variety of author’s techniques that people like to write about on Instagram. Any normal person will want to officially confirm his authorship; he will write an article at a minimum. So these are almost always unfounded allegations. Their essence is that the doctor makes, for example, an incision not of 4 centimeters, but of 4.5, and most likely does not do anything special at all. There is nothing wrong with this, if you are undergoing high-quality surgery, you just need to know that the attribution “author’s technique” is needed in order to sell the service.

►In general, what is the best way to rejuvenate yourself?

– If we talk about plastic surgery, then an integrated approach will work best here, since aging is a systemic process. For those who want to “correct” their eyelids, we often offer a complex of anti-aging surgeries, because in older people, age-related changes affect the entire face, rather than individual parts of it. And leaving everything else in the “old” state is illogical.

►Is it possible to maintain youth forever with the help of plastic surgery?

– It can be maintained for quite a long time, but it is impossible to do this forever; you have to learn to accept aging.

►They say that plastic surgery is like tattooing: you do one and then you can’t stop. This is true?

– Yes, this happens because a person understands that he is achieving what he wants, that most of the terrible consequences that he read about are not true: for example, the classic fear that the breasts will hurt very much after enlargement.

The main thing is that the desire to somehow change one’s appearance does not become a priority and does not determine one’s entire life. And you need to remember about possible side effects and complications.

Experts' opinion

From a medical point of view, if the patient does not have heart problems, summer has a number of advantages for plastic surgery:

• in summer, the diet is rich in vitamins and fresh foods, which enhances the body’s regenerative capabilities;

• a high level of immunity ensures that any inflammation, hematomas and swelling in the summer will go away faster;

• for the same reason, the overall rehabilitation period is reduced;

• during the summer vacation, the psycho-emotional stress is much less than at work - this also speeds up recovery after surgery.

“They make small noses and then walk around with their mouths open.”

►How do you prepare for plastic surgery?

– Like any other: a lot of analysis and research - everything is serious, no concessions. Many, by the way, complain about such a volume of research.

To make the importance of this clear: every month we detect hepatitis, and a couple of times a year we also detect HIV in people who do not suspect anything about their condition. And they wouldn't know about it for quite some time. Tests are already valuable at least for your health, so there is no need to say that there are too many of them.

►Who do you refuse surgery? Why?

– Plastic surgery is about aesthetics: both the doctor and the patient should be satisfied with the result. If you come to me, describe some situation that I don’t like, and you are not satisfied with what I offer, it would be better to just break up at this stage; you shouldn’t force the doctor and force him to do something. If what you want contradicts the aesthetic principles of the doctor, he will not even know the criteria by which it needs to be done. For example, I don’t like big breasts, I don’t do them because I don’t know how to make them beautiful. For me, all very large breasts will be ugly, if not immediately, then in a year for sure.

We refuse those who have unrealistic expectations, who want to achieve a result that is impossible for themselves. We sometimes have such patients here on their knees, crying, despite the fact that there are a lot of other people in the clinic.

Naturally, we will not engage in aesthetics against the background of any diseases or physiological conditions. For example, an operation was recently canceled because a man fell ill, and another because a woman became pregnant.

You may also be denied surgery if it leads to disruption of any body function: for example, many people want small noses, but small noses do not allow them to breathe normally - then we see these girls with their mouths always open. So what beautiful things have we done?

We refuse patients who have obvious problems accepting their appearance. Firstly, these are those who do not really need surgery: their problem is different, and they will not be happy with the result.

Secondly, these are people suffering from dysmorphophobia - a psychological disorder of not accepting one’s appearance, which causes a desire to constantly improve oneself. In this case, not a single operation will make a person satisfied; he will constantly want to improve something.

According to statistics, in the general population there are 4% of such people - every 25th, which does not seem to be very many. But among the plastic surgeon’s patients there are 15% of them, which is already one in six. A no longer living example of such a patient is Michael Jackson, whose endless operations led to severe deformation of his nose.

►How do you define them?

– There are no clear criteria, so we rely only on experience and intuition. During a face-to-face consultation, we see what the person has already done, how he behaves, listen to what he wants, and draw conclusions.

►What should I do if I want to change my appearance, but I’m afraid that my loved ones won’t understand me?

– You can consult with your loved ones, listen to their opinions, but you must make the decision yourself, because it is your body. We have a lot of cases when young girls come with their mothers, shyly telling them what they don’t like, to which their mothers say: “You’re normal, stop doing stupid things.” As a result, then they come alone and say that they are already 18 and have the right to have the operation.

Plastic surgery is the decision of one person, so if I see that parents, husbands and someone else are dictating to the patient what and how to do, then I immediately send them out the door.

►Do people often come to your house with someone?

- Yes, and that’s good. First, the patient and their loved ones receive more information, and second, they ask more questions and discuss more options.

Blepharoplasty up to 40 years

Some unpleasant manifestations occur at the age of 35-40 years. At this time, the epidermis and facial muscles begin to gradually lose their natural tone. And if high-quality anti-aging care cosmetics and procedures from hardware cosmetology are initially effective, later you will still have to choose: not to interfere with natural processes, or to correct deficiencies with the help of plastic surgery.

The reasons for surgery at this age may be:

• congenital weakness of the orbicularis oculi muscle - the accumulating lipid tissue protrudes significantly, forming bags, giving the face fatigue, an unhealthy appearance, and extra age;
• lymphoid eyelid - excess epidermis above the eyes, making a person visually much older than his age;
• the need to change the shape of the eyes, which is especially important for people with an Asian type of appearance.

In any case, the operation is always preceded by a face-to-face consultation with a specialist. Even obvious aesthetic flaws are not always a reason to take radical measures. Having considered a specific situation, the plastic surgeon often does not comply with the patient’s desire to make a correction at an early age. The doctor can offer non-invasive correction methods, such as ultrasonic lifting, microcurrent therapy, laser resurfacing. And only when other methods of correction can the need for surgical intervention be justified.

“Unfortunately, there is a big gray market here.”

►Now cosmetology seems to have become much more popular than plastic surgery. Why?

– Cosmetology is growing exponentially because it is fast, low-traumatic and complications are very rare. We can “improve” your face in 15 minutes, and after that you can go straight to the restaurant, and the effect of the procedure will last 6-10 months.

But, unfortunately, there is a big gray market here, a lot of illegals: injections in apartments, which are administered by no one knows who and how. By law, such injections can only be performed in medical institutions where there is an appropriate license and a specially trained doctor. Any beauty salon should have a medical license on the wall with “cosmetology” or “plastic surgery” written on it, and I assure you that it is not very logical to call this establishment a beauty salon if it is essentially a clinic.

If the injection is performed not by a professional, but by a home specialist in cosmetology, manicure and pedicure (yes, this is a real case!), then if complications arise, and they happen not only in surgery, but also in cosmetology, this “specialist” simply will not know what to do. And even if he does know, he won’t have the conditions or medications to help you, and most likely everything will end badly.

►Is it true that injections that remove wrinkles make facial expressions disappear?

- Yes. Wrinkles appear due to active facial expressions. Accordingly, we must reduce the activity of the muscle that is responsible for them - this is how these injections work. But we try to make sure that you maintain naturalness and do not immobilize absolutely the entire face.

►Is it true that Botox is banned in Belarus?

– Yes, Botox is not certified here, so if you see an advertisement with the word “Botox”, then this is either the use of an illegal drug, or simply an advertisement using a word that people know for sure.

We have certified legal drugs that give a similar effect - they are no worse and no better. Therefore, you should not fall for Botox and believe those who say that it is better - this person is blatantly lying to your face.

If you are offered injections of real Botox, think twice: it requires very specific storage conditions, and it is very difficult to ensure its safety when transported across borders. So here the question of your safety arises.

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Combined plastic surgery on the face and body: double transformation

Mammoplasty and rhinoplasty: a combined approach to transformation

Breast augmentation remains one of the most popular surgeries worldwide. This type of intervention is often combined with facial surgery due to the ease of performing it. For example, a combined operation with mammoplasty and rhinoplasty (rhinoseptoplasty, if indicated) is especially popular. The operation lasts about 4 hours, depending on the amount of work, and after it you get several pleasant changes in your appearance.

Mammoplasty and labiaplasty: an integrated approach to solving delicate problems

Mammoplasty goes well with aesthetic surgeries on other parts of the body. Some patients, in addition to breast augmentation, want to undergo labiaplasty (labiaplasty). Such surgical intervention in aesthetic gynecology does not take much time and may well be part of a simultaneous operation.

Mammoplasty and blepharoplasty: a young look and a beautiful body

This option of combined surgery is suitable for women over 35 years of age who want not only to change the shape of their breasts, but also to undergo eyelid surgery for a youthful look. Blepharoplasty, due to its ease of execution compared to major interventions, is considered more of a refreshing operation, but this does not make its result any less beautiful. And by combining it with mammoplasty, the patient will enjoy her reflection in the mirror for a long time.