Oksana Garashchenko - PhD, surgeon of the highest category, oncosurgeon, plastic surgeon, mammologist. Founder and chief physician of the clinic.

Oksana Garashchenko - PhD, surgeon of the highest category, oncosurgeon, plastic surgeon, mammologist. Founder and chief physician of the clinic.

Is plastic surgery a sin or an art?

So what is the main reason to go to a plastic surgeon: objective physical defects or subjective dissatisfaction with one’s own appearance in general?

There are two types of intervention to be distinguished:

- Reconstructive surgery - when a plastic surgeon removes physical defects (conditions after an accident, burns, etc.), and without plastic surgery these defects cause patients physical pain and restrict movement;

- Aesthetic surgery - when the patient herself raises the question of surgery. And sometimes she is not quite sure what she wants, she thinks that the surgery will help her to achieve some other goals: to become happier or to gain respect in society.

Therefore, it is very important to understand that plastic surgery should not treat mental disorders surgically.

In this regard, it is important for the surgeon to feel the fine line and not be carried away by the role of the creator, to understand that he works with the human body, which is characterized by all the laws of physiology and anatomy, and not to forget the medical aspects of surgery. After all, if a woman does not perceive herself in her body and her desire to improve or correct something in herself cannot be realized by surgical intervention, given the initial data, in this case, it goes without saying that even if the aesthetic effect of the operation is the best, but the patient will still not be satisfied with the result, then in the first place a psychological problem must be solved.

And now, in more detail about plastic surgery itself.
Mammoplasty is currently the most common surgery. In the course of life, a woman's breasts are affected by many factors, which in turn cause their ptosis (sagging), asymmetry, reduction in volume. Such factors include pregnancy, breastfeeding, changes in body weight (weight loss), age (flabby breast skin). There are also places with congenital traits: small or asymmetric area, large areolae, inverted nipples. But another problem is large breasts, and in fact, women also experience great discomfort from this, since the owners of large breasts eventually suffer from curvature of the spine caused by a large volume of gland tissue, discomfort, itching of the skin under the breasts and dents from the straps on shoulders. And in general, sometimes large breasts interfere with living actively. In this case the desire to reduce breasts is a physiological need, which improves the quality of life of the patient, rather than a desire to visually change something in the body.

In fact, breast reduction (reduction mammoplasty) is a more surgically complex operation, so patients are more often satisfied with the result and grateful to the doctor. Breast augmentation with implants (augmentation  mastopexy) is not considered so complicated. But there are cases when the patient does not really know what she wants. That's why preoperative conversations are very important, so that the patient's desires are in line with the possibilities of surgery.

Women's breasts can become sagging with age. If the breasts are not large enough or the patient wants to enlarge them, an implant lift (augmentation  mastopexy) is needed. If the volume of the breasts is sufficient, but the sagging (ptosis) does not satisfy the patient aesthetically, a simple breast lift (mastopexy) will be enough. It varies depending on the size and severity of the ptosis. In cases of slight sagging, the skin around the areola is tightened and resected, which removes the sagging, changes the diameter of the areola, and visually transfers the nipple to a higher position (circumareolar dermatopexy). In cases of grade 2 ptosis, access around the areola is augmented with an additional vertical incision - a tennis racket-like lift (vertical dermatopexy). With sufficiently pronounced sagging, when the nipple faces downward, an anchor lift (inverted T mastopexy) is used. With the latter type of lift we have two incisions: a vertical incision and a horizontal incision in the breast crease.

Definitely, it is up to the surgeon to decide which of the above methods of breast plastic surgery to choose, having previously taken into account all the wishes of the patient, as the purpose of any breast plastic surgery is the volume and natural beautiful shape of the breast, which improves the quality of life and increase the patient's self-esteem.

There is no special preparation for mammoplasty. Preoperative tests and examinations are usually sufficient and can be performed on the day of surgery. Postoperative hospital stay varies from one to two days.

Now let's talk about implant selection.
An implant is a hard-shelled silicone that can never burst or rupture on its own. Implants are often placed under the muscle, but in some cases they are placed under the glandular tissue. Breast implants come in round and drop-shaped (anatomical) shapes, on a round or elongated base, of different projection (protrusion to the outside), which determines their volume. The selection of the implant is usually performed by a plastic surgeon, taking into consideration the patient's physiological and anatomical data: skin quality, nipple location, presence of glandular tissue, presence or absence of ptosis. After marking, the surgeon asks the patient about her desired postoperative result. Only after comparing the woman's wishes with the initial anatomical data, the course and technique of the surgical intervention are determined, so that the result is acceptable for the patient and the surgeon.

Patients who have lost weight need excision of excess skin and tissues of the abdomen - abdominoplasty, of the forearm area (brachioplasty), of the inner thigh (femoroplasty).

The decision about plastic surgery should be made by the patient himself/herself, understanding that it is an intervention, and it has its own risks. The patient clearly defines his/her desires for changes in his/her body, and the surgeon brings them to life, clearly guided by all the physical and anatomical features of the patient's original data, comparing them with different surgical techniques. And this is art indeed!