BOLS
Russia entered the top 15 countries in the world in terms of the number of plastic surgeries on the face and body Sharp nose, fresh look, luxurious chest, flat stomach - all this can be achieved with the help of a plastic surgeon. There is no end to those who want to fix something. Both the world and the Russian market, according to its participants, is growing at a frantic pace.
Cosmetics company Boots in April released data from its survey, in which it found that only 60% of middle-aged British women are satisfied with their appearance. Among Russian women, who are known to be more scrupulous in this matter, the percentage is even lower, even if we include the younger generation in the calculation. In 2017, a poll by the Lady Mail. Ru project showed that in Russia, 70% of women and 63% of men are dissatisfied with their natural data.
No more taboo
According to the analytical center of the specialized magazine Vademecum, Russia is in the top 15 countries in the world in terms of the number of aesthetic surgeries. If in 2016 153.7 thousand operations were performed, for which patients spent 12.1 billion rubles, then in 2017 there were already 158 thousand for the amount of 12.3 billion rubles. Thus, from 2013 to 2017, this market grew by 33%.
“More and more people understand that it’s easier to correct imperfections in appearance than to live with complexes that have bothered many since childhood, all their lives,” says Maxim Vashin, a plastic surgeon at the Institute of Plastic Surgery and Cosmetology. "For example, someone from the very school days has been suffering from lop-eared or too large nose, and this prevents him from living a full life."
As Boris Mirzoyan, a board-certified plastic surgeon in France, Switzerland and Russia, noted, the increase in the number of plastic surgery patients is a global trend, and Russia in this sense does not differ from other countries. And the main reason is that life expectancy is increasing. “People live longer, and they have a need to maintain, shall we say, presentable appearance,” he said. - The second reason is popularization. As early as 10-15 years ago, confidentiality was important for people resorting to the services of a plastic surgeon. Now women often discuss among themselves what operations they performed, to whom they turned. This topic is no longer a taboo."
The third reason for the growth in the services of plastic surgeons lies in the change in surgical techniques. “They have become minimally invasive,” the specialist explained. - If 20 years ago aggressive facelift surgeries were performed, now we have learned how to do them in less traumatic ways. For example, endoscopic operations, when we introduce thin instruments and an endoscope through small incisions and, looking at the screen, perform operations."
Size difference
Plastic surgery is, in a sense, always a tribute to fashion. It's no secret that Asian women, wanting to look like European, massively change the shape of their eyes. In Brazil, one of the most demanded surgeries is buttock augmentation. Among Russian women, according to the surgeons surveyed by Profil, breast augmentation is still popular. Only requests for its size change. According to Maxim Vashin, today many even replace their old large-sized implants with more compact ones. “The trend towards naturalness is already in vogue, not Pamela Anderson’s forms,” he said.
“I always recommend enlarging breasts to no more than 3.5 sizes,” says Boris Mirzoyan. The problem with large breasts is that they impair the quality of life. These are pains in the cervical spine, back, difficulties in choosing clothes and playing sports. “The volume of the breast must correspond to the growth and structure of the body, must be in harmony with the physique,” the plastic surgeon believes. - If the breasts are too large in comparison with the physique, then it brings discomfort. You need to understand that the larger the implant that we install, the statistically greater is the risk of complications. This is a pattern."
In addition to breast augmentation, blepharoplasty (changing the shape of the eyelids, eye incision), liposuction (removing fatty deposits) and rhinoplasty (changing the shape of the nose) are most often done in Russia.
“Girls want to have a graceful nose shape, without a hump,” says Alena Kutalia, CEO of the network of plastic surgery and cosmetology clinics. “And most people want breasts of the third size. But such operations are mainly performed by young women. Ladies of elegant age are more likely to seek liposuction, facelift, abdominoplasty (restoration of the proportions of the abdomen. - Profile) and blepharoplasty."
According to Vashin, today harmony and proportionality are held in high esteem. “The outdated facelift has been replaced by SMAS-lifting, a rejuvenation method that involves the muscular-aponeurotic layer located under the skin layer and subcutaneous fatty tissue,” he said. - With this method, the facial features remain their own, but the person looks 10-15 years younger. Liposculpture is also in vogue. If earlier the fatty tissue obtained during liposuction was thrown away, now with its help the patient can add volume in the chest and buttocks, correct the lips and facial contours and even remove wrinkles."
Psychologists are, as a rule, wary of the development of plastic surgery. Undoubtedly, if a person really has some kind of congenital or acquired physical disability, then this greatly spoils his life. Getting rid of it boosts your self-confidence. “In other cases, we are dealing with a neurotic need that is unsaturated,” said clinical psychologist Mikhail Vladimirsky. - Wherever a person goes, he takes himself with him. You also can't hide from your problems by changing your clothes or appearance."
Often, how we evaluate ourselves and how others see us do not coincide. And since we are usually more strict with ourselves than with others, this comparison is usually not in our favor. So, the character of the book Mariam Petrosyan "The House In Which", nicknamed the Smoker, is surprised to discover that his acquaintance nicknamed the Lord, whom he considers divinely beautiful, does not like to look at himself in the mirror. The Smoker compares him to a young David Bowie, while Lord himself groans that he looks like an elderly Marlene Dietrich.
Non-insured events
Perhaps that is why operations on medical grounds account for a small share - 20-25%, according to experts interviewed by Profil. Aesthetic reasons predominate. “As far as I know, more often operations on medical grounds are performed in public hospitals, and not in private clinics,” said Alena Kutalia.
For example, in Russia, oncologists very often refer their patients to plastic surgeons. And they carry out the reconstruction of the removed breast or restore the shape of the nose, eyelids, ears. “In general, all these operations to remove oncological neoplasms of the skin on the face in European countries are carried out with a plastic surgeon,” said Boris Mirzoyan. - Because only a plastic surgeon trained in reconstructive techniques can close this defect as aesthetically as possible so that it is less noticeable. And in some countries such operations are performed only by plastic surgeons”.
The inclusion of plastic surgery in compulsory health insurance (MHI) policies would help to rectify the situation. Conversations about this arise at different intervals. The last time such an initiative was made by a member of the Federation Council Committee on Social Policy Tatyana Kusayko was in February this year.
Plastic surgeons think this is a good idea. “This will help people who have survived serious illnesses, such as oncology, to return to normal life,” said Kutalia. - Because often such patients do not have the financial ability to go to private clinics, and their quality of life deteriorates. In addition, not all oncologists, urologists, and other specialists are good at plastic surgery from an aesthetic point of view. And if hospitals have the opportunity to attract professional plastic surgeons, and the cost of treatment is covered by insurance, this will be a solution for patients."
“In European countries, in particular, in France, where I specialized and worked for 13 years, some of the plastic surgery operations are included in the compulsory medical insurance,” Mirzoyan said. First of all, these are breast reduction surgeries, for this reason one of the most popular in France. “Sometimes patients come to whom the bra straps cut through the shoulders, posture disorders appear - stoop, scoliosis, back pain,” he explained. - That is why it is held free of charge. Provided that at least 300 grams are removed from each side. This is usually no less than size 4-5”.
In addition, the compulsory medical insurance in France covers operations to remove the “apron” of the abdomen, which sometimes forms after pregnancy. This is a fold of skin that covers the pubis and interferes with wearing clothes, causes inconvenience in terms of hygiene - diaper rash appears, especially in the summer. “If a slight excess of skin is formed, which simply looks unaesthetic, then no,” the plastic surgeon explained.
The insurance also covers congenital breast conditions such as tubular breasts. Or hypotrophy of the leg muscles after poliomyelitis, when the leg is very small. “If there are breathing disorders and at the same time a hump on the nose, then it is allowed not only to operate on the nasal septum, but also to correct the hump,” Mirzoyan noted. - In some cases, breast augmentation is also included in the CHI. And, of course, reconstructive and post-traumatic surgeries, which are also covered by insurance in Russia."
Gender issue
The vast majority of clients of plastic surgeons are women. The percentage of men, according to expert estimates, fluctuates around 10%. “Of course, there are more women who turn to the services of plastic surgeons, but recently men have also begun to be attentive to their appearance,” Vashin said. - They seek to get rid of bags under the eyes with the help of blepharoplasty, correct the nasal septum and nasal injuries with rhinoseptoplasty, and reduce overdeveloped breasts with liposuction. Unfortunately, the desire of men to change their appearance for the better is still condemned by society, but despite this, the number of men who have decided on an aesthetic transformation continues to increase."
Shutterstock / Fotodom The majority of plastic surgeon clients are women, but more and more men are turning to them. The most common operations in Russia are breast resizing, blepharoplasty, liposuction and rhinoplasty.
However, rhinoplasty in men really cannot be considered an aesthetic operation, Kutalia noted. Most often it is done for the sake of health, after work or sports injuries. But blepharoplasty for the sake of a "fresh look" and getting rid of the "beer belly" are really popular. For a more athletic appearance, for example, getting rid of a breast (gynecomastia), they turn to less often.
“They often go to plastic surgeons after losing a lot of weight,” Mirzoyan added.- They have the skin of the abdomen, the skin on the chest, and they come to tighten it. And, of course, facelift surgeries. Usually these are men who have already become a professional, about 50-60 years old, and who want to stay in shape. For them, looking young is a social status. They feel the age-related competition in the professional environment from the younger and fitter ones."
In the wrong hands
According to Mirzoyan, prices for the services of plastic surgeons in Russia vary too much. In Paris, the cost of a particular operation will be approximately the same regardless of the clinic. In Moscow, however, you can find an absolutely incredible range of prices. There is also a dumping factor.
“But I would really think about whether to trust the doctor who offers the lowest price,” Vashin, in turn, remarked. In general, according to him, it is really very difficult to recognize a real professional among a huge number of doctors. “I would advise you to pay attention to education: it must be of higher medical education, the residency in plastic surgery must be completed,” he advises. - Choose a clinic carefully, do not be afraid to ask for documents (certificates for the provision of services, licenses, etc.) - they should all be in order and provided to you without any problems. Read reviews and come to consultations, the choice should not be spontaneous."
In July 2018, amendments of the Ministry of Health came into force on a new procedure for the provision of medical care in such clinics. Now, in the center of plastic surgery, the X-ray department, the department of anesthesiology and intensive care, a clinical diagnostic laboratory and a blood transfusion room should operate around the clock.
“You can check whether these requirements are met, whether all these offices are available, because this is a guarantee of the safety of your life and health,” Kutaliya said. “In addition, according to the new requirements, clinics are obliged to send patients to the hospital after any plastic surgery for a period of at least one day. Also, the Ministry of Health prohibited outpatient surgical interventions that were previously practiced by doctors. Therefore, if the doctor says that literally in a few hours after the operation you can go home, it is better to find another specialist and a clinic."
According to her, a good doctor will not impose other operations and will not agree to requests for, for example, 12 breast size. The personal qualities of the surgeon are also important - perfectionism, a sense of beauty and empathy for the patient, added Mirzoyan.
In the second half of 2018, Roszdravnadzor detected violations in 70% of clinics providing plastic surgery services. These are 820 organizations, of which 663 are private. As a rule, this is the lack of round-the-clock medical supervision, the use of substandard, expired or falsified medicines, non-compliance with the conditions for their storage, the lack of the necessary equipment according to the new rules, and insufficient professional training of surgeons.
Therefore, the advice to pay attention to the education of a doctor is worth listening to. Officials, in particular, identified a case where the duties of a plastic surgeon were performed by an ophthalmologist.
Materials based on the results of 162 inspections were sent to law enforcement agencies to initiate criminal cases. In another 1,350 cases, protocols on administrative violations were drawn up for a total of 21 million rubles. The activities of seven clinics have been suspended in court. Another 252 organizations closed on their own, including 65 clinics in Moscow.
