Udruženje estetskih plastičnih hirurga Srbije



During the last decade in Serbia there is a craze for cosmetic surgery, but when it comes to who "goes under the knife", there are more and more ordinary people who want a smaller or larger correction on the face or body. While some praise and proudly show off their new look after cosmetic surgery, more often we can hear and those who,  following the intervention of plastic surgeons, complain and say that they did not get what they wanted. Plastic surgery can help a person to feel better and more self-confident, but individuals sometimes go too far with the corrections and go to the full extreme. If everything is prepared for surgical procedure to go well, undesirable results may be due to medical error.

Requests for cosmetic surgery exist for many years, in the last decade it is openly talked about it and thus it becomes more exposed. Since it is exposed, it is subject to public opinion and strictest judgment of the public. The tastes are not the same, so everyone sees the surgical work in different ways, some praising it and some condemning it. This happens only if cosmetic surgery steps over the boundaries of natural and violates the harmony of one's face or body. To satisfy a personal relation of the patient's to an aesthetic demand, and the demand of public opinion is one of the biggest challenges for every plastic surgeon. Accordingly, the requirements of patients have to be harmonized and directed by the surgeon so the result doesn’t come to be judged as a medical error because there is not synchronization with the body and the face.

The attitude towards plastic surgery, that is more accessible to the general population, if the one is not abused, should certainly be part of everyday life and embellishment. Prolonged lifetime of people, accelerated life style and some new standards that are set in front of us, are forcing us to be young and enthusiastic, because youth is something that counts.

Often we witness failed cosmetic surgeries in the world and in our country; what may be the most common cause?

The reason for the success or failure of the cosmetic surgery can be versatile, depending on whether there are physical and functional damages or it is a question of someone's judgment ("good /bad taste").

Cosmetic surgery is, by vocation and the process of work, surgical branch that carries all the possible complications of any surgical process; however, the results of these surgeries are in a "shop window" and publicly exposed. These patients most often forget sometimes the only the question posed in the first e-mail contact "How much it costs?!” That relation they do not have to any other doctor, but they seriously tackle their problem, before deciding to do anything. It really remained unclear to me during all these years. So, one answer is definitely the choice of the wrong surgeon.

Another reason can be lack of understanding between the surgeon and the patient and the unconditional fulfillment of the desire of the patient, regardless of the consequences.

Third and most important is exploring the possible surgical complications and do everything possible to reduce the risk to a minimum. It is done with a good and quality preoperative discussion with patients, inform them of the postoperative course and care, in order to avoid possible complications, which are related to the performance of the same. Of course, of high importance is preoperative testing of the patient's health condition and special preoperative preparation, in terms of abstinence of certain foods or medications, if possible. If not, then include the drugs to offset the potential consequences of taking them.

What is recommended in case of mishap?

What to do in case of mishap!? That is a difficult question, but I've had it with my nose surgery. I really care a lot about beauty. I'm working on it in all segments: I eat a healthy diet, swim and exercise daily and do some fine-tuning on myself. When I met with complications and dissatisfaction, I decided to continue to live with it as if nothing happened and slowly started asking around for the best nose surgeons in the world. I went to interviews in Texas, Chicago, and Stuttgart. I especially liked the surgeon in Stuttgart; he was reasonable, realistic, professional, without excessive promises. I was his guest on operations, every year for a week in the fall and spring. I knew I had to wait at least a year to do another surgery, so I waited six years and finally got operated. I chose the right one!

Do you remember some drastic cases due to the cosmetic face correction?

Seven or eight years ago, the patient came after facelift with complete paresis of right side of the face, lower eyelid was turned out (ectropion), and eye position was not symmetrical. I asked her to wait for a year, to do massage and exercises and a lot of things would fix that way. And so it was. She came every week for a chat, she says it was easier for her like that, and after a year it all has been back in place, so we did only a minimal correction.

What are the most common cosmetic corrections?

Still leading ones are all operations of breasts: augmentation, lifting, reducing followed by ultrasonic liposuction and body reshaping.

In some cases, after correction of the eyelids, some people get the bulging eyes look, why is that?

Eyelids look like a simple intervention, as it is, if the surgeon detects asymmetry, remains within the limits of natural, finds if there is a problem only with the eyelids or maybe also with forehead and fallen forehead/temporal/ medium-personal region, or there is a problem in the corners of the eye. Periorbital region is quite complex and if the surgeon does not recognize the problem and try to solve it only through eyelid surgery in a very extensive way, then certainly every patient can expect an unnatural appearance. Examination and analysis of the problem, as well as all elements of aging, is the key to good operation.

What are the most common problems during the nose surgery?

You have found the expert! The best is when you feel it on your skin!

Very large number of plastic, ORL or maxillofacial surgeons underestimate the nose and when the patients turn to them, they say it is a piece-of-cake operation that’s done quickly and it is very cheap.

Nose is the only organ that has all the tissues (mucous membranes, cartilage, bone, muscle, subcutaneous fat, ligaments and skin), each tissue heals differently and has its own story. So, if you underestimate it or you do not recognize a problem that nose has, you’ll have a large problem, which won’t appear after the surgery or a month after, but after a year, two or three! The nose is a pyramid, and if I pull one brick randomly, it will eventually crush down- you'll stop breathing! Complications are functional and esthetic. Functional can be: inability to deep breath in because sticking of nostril occurs, perforation (a hole in the septum), you do not have enough pressure and air flow in the nose at discharge or during inhalation, left over curve partition (septum) leads to the obvious aesthetic problems (the nose is curved). From aesthetic complications there are open "roof" of the nose, seen as bumps on the nose, too wide or narrow tip of the nose, low or high top, long or short nose. Remained high bony part of the nose (hump) or cartilaginous part of the septum (cockscomb), too low nose,  "saddled" or similar.

What should women, who want to correct their breasts, know before the intervention, and not to go too far?

First they need to know the material of their breasts, to do an ultrasound to rule out any possibility of the existence of any changes in breasts. In consultation with the surgeon, they should always pay attention to the size they can carry at a given moment, but also in their mature years. "Big breasts- big concern".  Breast should be taken care for, to pay attention to the type and quality of bras, they always need special attention so the nice result remains for many years! They should choose implants that are reliable, with more natural look, a lifetime: type and shape of implants play important role in the beauty of breasts.

It happens that the distance between the breasts is too large after surgery, why?

That is the question of surgeon's ability to make adequate bearing for prosthesis! Of course, postoperative treatment in the following month is very important, where special attention is paid to the positioning of implants. There is a list of obligations for patients, how they should behave in order to avoid implants in the wrong place!

What are the most common complications during installation of breast implants?

If you choose a good-quality implant, choose the right kind of surgery that is adequate to the chest and the quality of the tissue, and the patient is disciplined in the postoperative period (coming for regular checkups to a year) and listen to the doctor's advice – there are NO complications! If something is missing from this list, then the following complications are possible:  contracture (spasm of prosthesis), prosthesis infection, shooting prosthesis, dislocation of the prosthesis and breast asymmetry, seroma, hematoma, numbness, feeling of coldness usually caused by excessive implants and the like.

How to choose the right esthetic surgeon?

Each patient has his/her own surgeon- it is simply a rule. The point is to visit different doctors, see a lot of their work, and ask about all aspects of preparation for surgery, on surgery and postoperative course and possible complications. Wait until everything settles; choose the right time for surgery (colder days, good health condition, monthly cycle, etc.). Operation only needs to be done once, so you will feel which doctor will be your surgeon!

Why some patients, after the first correction, very quickly decide to go back "under the knife"?

Most often because they are satisfied with previous surgery and it's nice to be fresh and rejuvenated!

What is your advice to someone who wants to do some procedure?

To ask, think and decide!

Violeta Skorobac Asanin MD, MSc

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