CHAPTER 17 PLASTIC (RECOVERY) SURGERY

CHAPTER 17 PLASTIC (RECOVERY) SURGERY

The field of surgery concerned with restoring the form and function of tissues and organs is called plastic or reconstructive surgery.

The task of plastic surgery is the elimination of various defects, they can be congenital or acquired, arise as a result of injuries, diseases, surgical interventions and cause functional or anatomical changes. Any surgical operation contains elements of plastic surgery, as it involves the restoration of tissues and organs.

In ancient India, to restore a nose defect, plastic surgery was performed with a skin flap on a leg, cutting it out on the forehead. The method came to Europe and is still called the "Indian method of rhinoplasty". In Italy, in the 15th century, another method of rhinoplasty appeared - they used the skin of the shoulder area, it was called Italian. N.I. Pirogov (1852) developed a method of osteoplastic amputation of the foot, which provides a good supporting function of the limb. V.P. Filatov (1917) proposed the transplantation of a migratory skin stalk (Filatov stalk). Ts. Ru and P.A. Herzen (1907) developed an ante-thoracic esophagoplasty with a loop of the small intestine.

Nowadays, plastic surgery has acquired a leading role in all areas of surgery, and a new section has appeared - organ and tissue transplantation. In addition to purely surgical problems, its task is to study the issues of conservation of organs and tissues, tissue compatibility.

Types of plastic surgery

Depending on the source of transplanted tissues or organs, there are the following types of transplantation.

Autogenous transplantation: the donor and recipient are the same person.

Isogenic transplantation: donor and recipient are identical twins.

Syngeneic transplant: donor and recipient are first-degree relatives.

Allogeneic transplant: donor and recipient are of the same species (human-to-human transplant).

Xenogeneic transplantation: donor and recipient are of different species (transplantation from animals to humans).

Prosthetics of organs and tissues using synthetic materials, metals or other inorganic substances.

The most widely used autoplasty, as well as prosthetics of organs and tissues. Xenoplasty (heart biovalves, vascular xenografts, embryonic tissues) is rarely used because of the difficulty of overcoming tissue incompatibility.

Types of tissue plastics

Tissue transplantation is possible with complete separation of the graft from maternal tissues - loose plastic, or transplant. There are the following types.

Transplantation of tissues and organs - moving them from one part of the body to another or from one organism to another.

Replantation - the affected tissues and organs are transplanted back to their original place (scalp, severed limbs or their fragments).

Implantation - tissues or cells are transferred to a nearby area.

not free,connected, or plasticity on a feeding leg, provides for the connection of the cut tissue flap with the original bed until the displaced part completely grows into a new place.

Skin plasty

Skin grafting is the most common type of tissue grafting. Skin autoplasty, its free or non-free variant, is more often used.

Loose skin grafting

Free skin grafting has a century-long history. In 1869 J.L. Reverden (J.L. Reverden) first transferred several small pieces of skin to a non-healing granulating surface in the elbow area. Subsequently, S. Shklyarovsky (1870), A.S. Yatsenko (1871),

M.S. Yanovich-Chainsky (1871), as well as J.S. Davis (J.S. Davis, 1917) developed and improved the grafting of skin in small pieces on the granulating surfaces of wounds in detail.

Yatsenko-Reverden method

Under local anesthesia with a scalpel or razor, small grafts (a thin layer of the epidermis) 0.3-0.5 cm in diameter are cut off from the outer surface of the thigh, forearm or anterior abdominal wall and transferred in a tile-like manner to the wound. Then, a bandage with indifferent fat (vaseline oil) is applied to the wound with transplants for 8-10 days. The method is rarely used due to the rapid destruction of the epidermis.

Yanovich-Chainsky-Davis method

The grafts are prepared to contain all layers of the skin, since full-layer grafts do not autolyse or dislodge. Pieces of skin are placed in a checkerboard pattern on the granulating surface at a distance of 2.5-5 mm from one another.

Thiersch's method

With a razor or a sharp knife, strips of the epithelium are cut off to the tops of the papillary (Malpighian) layer 2-3 cm wide and 4-5 cm long. It is better to form grafts on the anterior surface of the thigh. The surface of the defect is covered with wide epidermal strips of skin and an aseptic dressing is applied on the 6-10th day. This method allows you to achieve good long-term results. It is more suitable for the treatment of long-term non-healing wounds and trophic ulcers.

Lawson-Krause method

A large graft cut into the entire thickness of the skin is transferred to the granulating surface and fixed with separate sutures to the edges of the defect. Disadvantages of the method: a transplant taken in the entire thickness of the skin takes root worse; the large size of the flap makes it difficult to close the donor site.

With the introduction of the dermatome into clinical practice, it became possible to take a flap of any area and thickness. Currently, manual and electrodermatomes are used; with their help, extensive skin defects (up to 2000 cm 2 in area) can be covered in one step. With the use of

By forming a dermatome, it is possible to obtain long split skin flaps consisting of the epidermis and part of the skin proper. The transplant is taken under general anesthesia. Through cuts of a certain length are applied in a checkerboard pattern on the resulting split thin flap with a special apparatus. When such a graft is stretched, it is possible to obtain a surface with an area 3-6 times greater than its original dimensions. Mesh autografts are widely used to close extensive wounds (Fig. 179).

Non-free skin grafting

Non-free skin grafting involves the formation of a flap of skin and subcutaneous tissue that maintains a connection with the mother tissue through the feeding leg. The pedicle of the flap must be wide enough to ensure a good blood supply. The leg should not be squeezed with a bandage, and when moving the flap, twisting of the leg around the longitudinal axis should be avoided.

Local (regional) skin grafting performed using the surrounding tissues by moving them.

In some cases, after mobilization of the surrounding tissues, the skin defect can be sutured in the usual way.

Relaxation incisions, made at a distance of several centimeters from the edges of the defect, allow you to bring the edges of the wound closer together and suture.

Z-shaped plasty is used for skin deformation with rough scars to restore normal ratios of body parts altered by scar adhesions. After excision of scar tissues, skin flaps are cut out and moved (Fig. 180).

A rotating tongue-shaped skin flap is cut out on a healthy skin area next to the defect and, by moving it, the defect is closed (for example, rhinoplasty according to the Indian method). The donor area is closed with a free skin flap or sutured in the usual way (Fig. 181 a).

Plasty by moving the flap from distant parts of the body, they are used in cases where there are no tissues in the defect circumference suitable for the formation of a flap.

Direct transplant a skin flap from distant parts of the body is used if it is possible to closely compare the donor site and the defect site, i.e. make a one-time closure of the defect - the Italian method (Fig. 181, b, c, 182, see color incl.).

Rice. 180.Options for closing skin defects. Roman numerals indicate the types of operations, Arabic - the stages of operations, Latin letters - landmarks of movement.

bridge plastic, recommended by N.V. Sklifosovsky, is used for plastic surgery of skin defects of the fingers, hand, forearm. The donor site can be a skin flap on the abdomen, in the area of ​​the forearm. Two parallel incisions are made in the area of ​​the donor site, a skin area is mobilized between them - a “bridge” is created, under which the damaged fragment of the limb (finger, forearm) is placed so that the detached flap covers the defect. The flap is sutured to the wound. Engraftment, as with the Italian method, occurs on the 10-15th day. At this time, it is possible to cut off the flap from the pedicle.

Rice. 181.Plasty with a skin flap on a pedicle using Indian (a) and Italian (b, c) methods.

Migratory flap plasty involves the formation of a flap in distant parts of the body, it is gradually moved to the defect.

stalked flap are formed by stitching the edges of the skin flap together with the formation tubular stem in the form of a suitcase handle - "Filatov stem" (Fig. 183). On the anterior surface of the abdomen, two parallel incisions are made (1) to the muscle fascia (the length of the skin incisions depends on the size of the defect), the edges of the skin-fat flap are sutured (2), and the place where the flap was taken is sutured (3, 4). The ratio of the length of the skin stalk to the width is not more than 3:1. After 10-14 days, blood vessels sprout into the stem, after 4 weeks the end of the stem is cut off, sutured to the arm (5, 6), and after 10-14 days it is sewn into the defect site (7, 8).

Rice. 183.Skin plasty with a tubular skin flap (“Filatov stem”). Explanation in the text.

Round migratory stemare used in the plastic surgery of extensive skin defects, trophic ulcers and non-healing amputation stumps, facial plastic surgery (creating an artificial nose, lips, closing the "cleft palate"), in surgery of the esophagus, pharynx, trachea, in vaginal plastic surgery in case of its atresia and in the treatment hermaphroditism.

If, for some reason, autotransplantation cannot be performed, allotransplantation is used.

allotransplantation

Skin allotransplantation is used for extensive burns or in cases where the general severe condition of the patient (intoxication, sepsis)

sis, etc.) does not allow the use of one or another modification of autoplasty.

Fresh and preserved skin allografts are used in the early stage of burn disease (on days 14-21) or after excision of necrotic tissues. Short-term (for 2-3 weeks) coverage of a large surface with a graft improves the general condition of the patient. Often, autotransplantation is combined with allo- and even xenotransplantation.

Brephoplasty- transplantation of the skin of a stillborn fetus (gestation period is not more than 6 months). With this type of allotransplantation, it is necessary to take into account the isoserological compatibility of the donor and recipient.

Currently, for large skin defects, free transplantation of a segment of the skin and subcutaneous adipose tissue with vascular anastomosis using microsurgical techniques is increasingly being used. In this case, the presence of a well-pulsing artery and at least one vein with sufficient drainage capacity is mandatory, vessels of small diameter are sutured under a microscope.

Muscle plastic

Leg muscle transplant sometimes used for filling bone cavities in patients with chronic osteomyelitis and bronchial fistulas. Regional muscle plasty is used to close defects in the muscles of the abdominal wall, in the plastic of inguinal hernias, hernias of the white line of the abdomen, to eliminate the insolvency of the anal sphincter.

Transplantation of muscles on the leg is possible, provided that blood circulation and innervation are preserved. Tissue flaps, including an artery, allow for the replacement of extensive tissue defects.

Free muscle plasticity used in surgical practice to stop bleeding from parenchymal organs, filling damaged sinuses of the dura mater.

Tendon and fascia plasty

Tendons are transplanted to restore the lost functions of the limb, as well as the functions of a group of paralyzed muscles. In this case, the tendons of neighboring potentially healthy synergistic muscles are implanted into paralyzed ones.

Tendon plasty with primary suture is performed for tendon ruptures. If diastasis is detected between the ends of the damaged

Rice. 184.Tendon plasty: a-c - options for local plastic surgery.

tendon, various options are used local plastic surgery(Fig. 184).

Fascia plasty is used in plastic surgery. Free plasty with a flap of the fascia lata is used to strengthen the joint capsule, replace a defect in the dura mater, and form an artificial rectal sphincter. Canned fascia allografts can be used. Fascia plasty is used to close tissue defects in hernias of the spinal cord and abdominal wall.

Bone grafting

To restore the lost functions and cosmetic form of the organ, bone grafting is performed using bone grafting, eliminating the defect of the cranial vault or jaw, while restoring the shape and functions of the organ.

not freeplastic was first used by N.I. Pirogov (1852), who performed osteoplastic amputation of the foot with restoration of the support function of the lower limb. R. Greeley and Yu.K. Shimanovsky developed osteoplastic amputation of the lower leg.

Osteotomy according to the “Russian lock” method (N.V. Sklifosovsky) is used to fix bone fragments. In craniotomy, skin and bone grafts are used to close tissue defects.

Freebone grafting is used in the form of autotransplantation or allotransplantation.

Autotransplantation is used to fix bone fragments in case of delayed consolidation of fractures in false joints, to fill bone defects in chronic osteomyelitis.

Bone allografts are preserved by lyophilization or quick freezing (-70 to -196°C). Transplanted allografts dissolve after 2-3 years without inhibiting the ability of the bone to regenerate in the transplant area. Bone allografts are used as fixators during operations on the spine, resection of a joint or bone section.

Nerve plasty

The purpose of surgical intervention for injuries of the nerve trunk is to bring its ends closer together and eliminate the causes that interfere with regeneration. The use of microsurgical techniques has increased the efficiency of plastic surgeries on the nerves.

Options for operations on peripheral nerves are different: primary or secondary suture, nerve transplantation, neurolysis. The primary suture is used during the operation - during the primary surgical treatment of the wound against the background of a good general condition of the patient, the absence of crushing of tissues in the wound, with an injury prescription of not more than 12 hours. In other cases, nerve restoration is postponed, secondary stitching of the transected nerve is performed.

Before suturing the nerve, both of its stumps are resected within healthy tissue in the transverse direction. Sutures are placed on the connective tissue sheath without piercing the "cables" of the nerve itself, using atraumatic needles and threads 6/0 or 7/0.

When applying an epineural suture, tension should be avoided, for which it is necessary to mobilize the ends of the nerve. With a significant defect of the nerve, its transplantation is performed.

Vascular plastics

Restoration of blood supply to organs is increasingly being used. Use a manual or mechanical (hardware) seam. Microsurgical vascular technique allows restoring the patency of vessels up to 1-2 mm in diameter.

Used in vascular surgery autografts veins and arteries or synthetic prostheses from dacron, teflon, teflon-

Rice. 185.Prosthesis of an artery: a-d - stages of suturing a vascular prosthesis.

fluorolone, polytetrafluoroethylene, etc. The replacement of arteries with an autovein is widely used. The wall of the implanted vein thickens with time, “arterializes”, aneurysms are observed very rarely.

Of particular importance in vascular plastics is vascular prosthetics(Fig. 185). Vascular prostheses are used for vascular resection, bypass grafting, or for "synthetic patches" (eg, aortic plasty). In some cases, preserved allografts (umbilical cord vessels) or xenografts are used.

Organ transplant

Transplantation of organs and tissues has become increasingly important in recent years. More than 130,000 kidney transplants, about 6,000 heart transplants, more than 4,000 liver transplants, and 1,500 pancreas transplants have been performed worldwide. The maximum follow-up period after kidney transplantation exceeds 25 years, heart - 15 years, liver - 12 years, pancreas - 5 years. In our country, more kidney transplants are performed (about 7,000 operations), transplantations of the liver and pancreas have begun, since 1987 heart transplants have been resumed.

Allotransplantation of organs from donors at the stage of brain death is used, organs of a corpse or close relatives are less often used (transplantation of only paired organs, such as a kidney, is possible).

Preservation of tissues and organs

Tissues and organs of people who died as a result of accidents (traumas) or died suddenly from various causes (for example, myocardial infarction, cerebral apoplexy) are suitable for transplantation. Contraindications for the removal and preservation of tissues and organs are such causes of death as poisoning, AIDS, malignant tumors, malaria, tuberculosis, syphilis, etc. It is advisable to take the internal organs from a potential donor immediately after ascertaining brain death. Tissues (skin, tendons, cornea, etc.) are removed and preserved in the first 6 hours after death.

The removal of tissues and organs for transplantation is carried out in special rooms in compliance with the rules of asepsis and antisepsis. The taken tissues and organs are thoroughly washed from blood and tissue fluid and then preserved using various methods.

Placement in solutions containing antiseptics or antibiotics, followed by storage in cooled solutions, plasma or blood of the recipient.

Rapid freezing at temperatures from -183 ?С to -273 ?С with subsequent storage at temperatures from -25 ?С to -30 ?С.

Lyophilization (freezing followed by vacuum drying) is used to preserve bones.

Immersion in paraffin, solutions of aldehydes (formaldehyde, glutaraldehyde). In special containers, tissues and organs from the laboratory are delivered to the clinic, where they are kept in special solutions at a temperature of 4 °C.

Complete engraftment of tissues and organs is observed during autotransplantation, transplantation from identical twins (syngeneic, or isotransplantation). With allo or xenogenic transplantation, a rejection reaction develops - a reaction of transplant immunity.

transplantation immunity response

The reaction of transplantation immunity (graft-versus-host disease - GVHD) develops in the recipient within 7-10 days after transplantation and is aimed at transplant rejection. Cells of the immune system, in particular T-killers, play a direct role in the rejection reaction, but macrophages and T-lymphocytes are involved in the implementation of the process.

In the first 4-5 days after transplantation, engraftment of the transplanted tissue occurs, the recipient's immunocompetent cells in this

period identify foreign antigen. From the 4-5th day, microcirculation is disturbed in the transplanted tissue, edema develops, invasion of the transplanted organ by mononuclear cells begins. T-lymphocytes acquire cytotoxic properties, and the B-lymphocyte system synthesizes antibodies, as a result, the allograft or xenograft is rejected. Repeated allotransplantation from the same donor causes a transplant immune response 2 times faster, since the body is already sensitized.

The modern immunological concept of tissue and organ transplantation is associated with the interaction of subpopulations of T- and B-lymphocytes, where the leading role is assigned to subpopulations of T-lymphocytes (helper, killer and suppressor cells).

Each living organism has a certain immune status, and its assessment creates the basis for typing the immune compatibility of the donor and recipient. According to the basic laws of genetics, each individual has HLA-sublocus antigens, referred to as tissue compatibility antigens, they are localized in cell membranes. The presence of several SD- and LD-determinants of the HLA complex determines the difficulties that accompany the selection of compatible donor and recipient. The probability of selecting an identical genotype is no more than 1:640,000.

The selection of a donor and recipient is based on immunological typing according to the main systems of antigens: AB0, Rh (erythrocyte antigens) and HLA (leukocyte antigens - histocompatibility antigens). The creation of organ banks that record and register thousands of recipients facilitates the selection of organs. Special recipient cards contain complete information about the immunological, hematological and clinical status of recipients. There are several such banks in Europe.

In order to increase the efficiency of allotransplantation, various activities are carried out.

Nonspecific immunosuppression - blockade of the recipient's immunocompetent system with antimitotic agents (azathioprine), glucocorticoids (prednisolone) and antilymphocyte sera. As a result of such exposure, a state of immunodeficiency is formed in recipients and resistance to infections is sharply reduced.

Replacement of the recipient's hematolymphoid system before allotransplantation by total radiation suppression of lymphoid tissue, followed by transplantation of the donor's bone marrow.

Selective elimination of T-killer cells with simultaneous stimulation of the activity of T-suppressor cells. A similar selective action is characterized by cyclosporine.

From the point of view of tissue compatibility, transplantation of one's own organ or tissues is ideal.

Replantation

Replantation of a severed limb or its fragment is possible in the first 6 hours after injury, provided that the severed limb is stored at a temperature of 4 °C, with perfusion of its vessels before transplantation. After the primary surgical treatment, the bone is restored, then the plastic surgery of the vein and artery is performed, after which the nerves, muscles, tendons, fascia, and skin are sutured. In the postoperative period, measures are taken to prevent the syndrome of traumatic toxicosis, using hypothermia, an abacterial environment.

kidney transplant

Kidney transplantation is widely used today. The indication for kidney transplantation is its functional insufficiency with increasing uremia. The kidney is usually transplanted in a heterotopic position - it is placed retroperitoneally in the iliac fossa. The blood flow is restored by anastomosing the vessels of the donor kidney with the common iliac artery and vein of the recipient; the ureter is implanted in the bladder (Fig. 186). Before surgery and in the immediate postoperative period, hemodialysis sessions are performed to reduce uremia. A sign of kidney rejection is the appearance of lymphocytotoxins in the blood and lymphocytes in the urine.

Rice. 186.Heterotopic kidney transplantation: 1 - iliac artery; 2 - iliac vein; 3 - ureter; 4 - bladder; 5 - transplanted kidney.

Liver transplant

The indication for liver transplantation is its rapidly progressive insufficiency (cirrhosis, malignant tumors, atresia of the biliary tract in newborns).

After removal of the recipient's liver, the allogeneic liver is transplanted into a normal bed in the right upper sector of the abdominal cavity. (orthotopic transplant).

For heterotopic transplantation the donor liver is placed in another area of ​​the recipient's abdominal cavity.

Liver function for a short period can be supported by short-term extracorporeal perfusion of the liver of a corpse or animal (pig, calf).

Heart transplant

Heart transplantation is performed in severe heart failure associated primarily with progressive cardiomyopathy, aneurysms of the left ventricle of the heart, uncorrected congenital heart defects, including a two-chambered heart, atresia of the right atrioventricular (tricuspid) valve, etc.

The rationale for heart transplantation in the clinic was the experimental studies of A. Carrel (1905) and V.P. Demikhov (1946-1960). A. Kantrowitz in New York repeated a similar operation on an infant. Later it turned out that the first attempt at heart transplantation was made in 1964 in the state of Mississippi by the American J. Hardy, who performed xenotransplantation of the heart of a chimpanzee to a 68-year-old patient.

The heart is implanted in an orthotopic position (in place of the removed organ) under cardiopulmonary bypass. The recipient leaves the posterior wall of both atria with the mouths of the vena cava, thus preserving the zone of autonomic innervation of the heart. Transplantation begins with the suturing of the posterior wall of the left atrium, the interatrial septum and the right atrium, then the aorta and pulmonary trunk are connected.

Signs of heart rejection are first detected on the ECG (tachycardia, extrasystole, a decrease in the voltage of the teeth). Repeat endocardial biopsies of the heart confirm the diagnosis.

The use of a mechanical heart is of particular importance. Currently, an artificial heart with a pneumatic drive is used for short-term replacement of the heart in the absence of a donor.

Transplantation of endocrine glands

The clinic uses transplantation of the thyroid gland, pituitary gland, adrenal glands, testis, pancreas.

Free transplantation of endocrine glands has been performed for a long time, but the functions of the glands are realized only until the implanted tissues are resorbed. Transplantation of endocrine glands on a vascular pedicle preserves the entire structure and function of the gland.

The collection of endocrine glands for transplantation is performed in the first 6-10 hours after death. At the same time, the vascular pedicle of the gland is isolated with washing of the vessels with special solutions and then frozen at a temperature of -196 °C. Most often, the vessels of the glands anastomose with the femoral or brachial artery. The functional effect of transplantation is clearly manifested: after the transplantation of the testis, inhibition and inertia disappear in men, ejaculation appears; in women after ovarian transplant menstruation appears; with myxedema, thyroid transplantation is effective; tetany, convulsions are eliminated by transplantation of parathyroid glands; in diabetes insipidus, pituitary transplantation significantly reduces the feeling of thirst. In addition to effective transplantation of the pancreas (body, tail, lobe) with vascular anastomosis in the iliac fossa, a hormonal effect was obtained by transplantation of isolated islets of Langerhans or the smallest fragments of the pancreas into the liver through the portal vein.

1279

Plastic surgery for stars has long been an integral part of life - lifting the face or lifting the eyelids for many of them is as natural as washing and brushing your teeth. Now the culture broadcast from the screens has stepped into the masses - more and more people decide to improve their appearance with the help of surgery or injections. They want to stay young as long as possible, and a wrinkle-free face and a toned figure best demonstrate this to others.

But not only for beauty invented plastic surgery. In addition to aesthetics, plastic surgery solves health problems: breast reduction allows a woman to live without pain in the spine, abdominoplasty with diastasis of the abdominal muscles prevents the development of intestinal infringement, and intimate plastic surgery relieves urinary incontinence.

History of plastic surgery

Plastic surgery and cosmetology have existed since ancient times. Translated from Latin and Greek, the term means the creation of form. There is evidence that the aesthetic side of the operation has been of concern to people for at least 3000 BC. In India in 800 B.C. did rhinoplasty with their own tissues. In China, manuscripts have been preserved describing the operation to correct a cleft lip. In Europe, until the 16th-17th centuries, plastic surgery was practically not practiced - the only exception was the manipulation of breast reduction in men. During the Renaissance, aesthetic surgery became an independent direction, and was called "beauty surgery". The work of the Italian G. Tagliacozzi on the reconstruction of the nose with tissues from the forearm has survived to this day.

The foundations of modern plastic surgery appeared in the 19th century, when new tools and methods were developed, and antiseptics were invented. After the First World War, plastic surgery became more and more popular - many people who were injured began to turn to surgeons with a request to improve their appearance. This led to the development of techniques for tissue grafting, excision of fatty tissue, and maxillofacial reconstruction.

Medicine and plastic surgery received a second impetus after the Second World War: methods of skin grafting were improved, new drugs for anesthesia appeared, and local anesthesia began to be used.

What trends are typical for modern plastic surgery?

• Striving for naturalness.

In the distant past, there were huge lips, impressive busts and a tightening to the shine of the skin. Today, such work of a surgeon, which others do not notice, has become an ideal. Therefore, for women, plastic surgery offers small-sized implants that increase the breast by 1-2 sizes. Noses that cannot be distinguished from natural ones are now in fashion, and lips are enlarged with fillers based on hyaluronic acid, which gradually dissolve - this means that you can correct their shape or completely abandon a new injection.

• Minimally invasive procedures instead of extensive intervention.

Clients are offered injections, and if surgery is necessary, it is performed endoscopically or with a laser, which avoids scars and reduces recovery time. According to the statistics of the last decade, the number of minimally invasive procedures has more than doubled, and plastic surgeries have decreased by 20%. Manufacturers of drugs and devices have responded to changing customer preferences - more and more methods of non-surgical or minimally invasive effects are emerging. So, blepharoplasty is now performed from the inside of the eyelid so as not to leave scars and avoid complications in the form of an unplanned change in the shape of the eyes or exposure of the sclera. An endoscopic facelift is becoming popular, performed through two small incisions at the temples. Excess skin is no longer cut off, but pulled from the problem area into an inconspicuous area.

• Modern plastic surgery offers more and more combined procedures, when two or three problems are solved in one go.

At the same time, the patient experiences the recovery process once, and not twice and thrice, as it would be with 2-3 operations, and also saves money on anesthesia and stay in the clinic. The possibility of carrying out combined interventions is determined individually by a plastic surgeon.

• The number of male patients who have decided on plastic surgery is growing.

There can be many reasons for improving appearance: the desire to correct unfortunate traits inherited; the desire to correspond to a young life partner; struggle with children's complexes; the need to have a presentable appearance (this is true for politicians, public people, businessmen). Responding to rising demand, the best plastic surgery clinics offer men liposuction, Botox and hyaluron injections, hair transplant, eyelid lift and nose reshaping.

State plastic surgery

To date, there is no state plastic surgery in Russia - it is impossible to eliminate the consequences of burns for free, restore the mammary gland after tumor removal, and remove scars from wounds. Until now, officials believed that such physical disabilities do not interfere with a normal life.

However, patients are in dire need of the services of state plastic surgery, because not everyone can have an operation at their own expense, and the number of people with burns, scars, scars after amputations is growing. At the government level, discussions are underway on the inclusion of part of the services in the compulsory health insurance program. Representatives of insurance companies, clinic owners and plastic surgeons believe that in the current economic situation, it will not be easy for the state to shoulder additional costs for the payers of mandatory medical insurance contributions, and therefore the likelihood of changes in medical legislation is small. Yes, and the introduction of free services for patients is possible if private clinics with rich experience in operations are interested in providing them under the CHI system.

The current commercial cost of operations, below which clinics do not agree to work, is much higher than the price at uniform rates established by compulsory health insurance. Therefore, one should not expect a rush in filing applications for CHI from private medical centers, and it is unlikely that state plastic surgery will appear in the near future.

What should be the best plastic surgery clinics? There are several requirements for them:

• A permanent staff of doctors who have repeatedly worked together and perfectly understand each other and the situation.
• The equipment of the clinic should be modern. Resuscitation equipment must be available in case of unforeseen complications.
• The clinic must have a license, and the patient must be offered an agreement and voluntary informed consent for medical manipulations, a cash receipt or a receipt for review and signature.
• In the best plastic surgery clinics, the patient and the doctor speak as equals. The patient cannot force the doctor to perform the operation that he wants, and the way he wants - the doctor, based on his knowledge and experience, must offer ways to improve the appearance in accordance with the wishes of the client.
• In a good clinic, they honestly talk about the possible consequences and complications, and call the actual recovery time after the operation.
• Serious medical institutions strictly monitor the materials and medicines used, purchasing only those that are certified in Russia and have a guarantee.
• The best plastic surgery is one that takes care of the health of patients and performs operations on people who have no contraindications.

How to choose a surgeon for plastic surgery

Plastic surgery services differ from a traditional operation performed for the purpose of treating a disease in that plastic surgery is done exclusively at the request of the patient. The appearance of a person and his self-esteem depend on how plastic surgery is performed. Therefore, choosing “your” doctor for plastic surgery is no less important than finding a specialist in the surgical treatment of diseases. How to do it?

You need to start with a list of doctors with the specialization you need. Plastic surgery services are provided by many clinics and individually working doctors, and the list can be impressive.

Each doctor from the resulting list needs to be analyzed in terms of specialized education and advanced training; work experience; accumulated professional skills; the cost of the operation in its execution. It is important to evaluate where the surgeon works - perhaps he accepts in one of the best plastic surgery clinics or an author's medical center in another city or even country. Therefore, it would be nice to evaluate whether it is convenient for you to go there.

The next step is the subjective assessment of the doctor. Here, reviews from the Internet, all kinds of ratings, the opinion of his colleagues about him, the stories of patients about the manner of communication and the experience of communicating with this doctor will come in handy.

Having chosen several of the best surgeons from your list, it is worth signing up for a consultation with him to simulate the result of the operation. At this stage, it will become clear whether your ideas about beauty coincide, and whether the doctor will be able to realize your desires.

The last stage is the final choice of a doctor based on the results of modeling and consultation. Pay attention to how frankly the surgeon talks about possible ways to solve your problem without surgery, about complications and limitations after the intervention, and the terms of rehabilitation. A good plastic specialist is not intrusive or self-confident, he uses terminology competently, explains the details clearly and confidently answers any questions.

How does a person change before and after plastic surgery? In dreams, he sees himself prettier, handsome and self-confident. But you need to understand that:

• After plastic surgery, noticeable scars may remain, which are completely impossible to remove.
• Plastic surgery is medicine, which means that there is a risk of complications, the worst of which is death. And although the percentage of troubles during aesthetic operations is quite low, it still exists. At the same time, the problem is not always the low qualification of the surgeon - the outcome of the intervention can be affected by unpredictable ones. characteristics of the skin and tissues of patients.
• If a person has a certain temperament, operations can become a kind of drug when you want to change more and more new facial features and body parts. In plastic surgery, the surgeon determines the contraindications for the operation, but to decide how long the nose wants, or how much the patient can breast - and the decision does not always decorate, not disfigure.

What makes people resort to plastic surgery again and again? During preparation for the operation, which, in fact, is stressful for the body, adrenaline is released into the blood, and it causes a state of euphoria. After a while, the euphoria either passes without consequences, or the person decides to reshape something else in his body. As a rule, victims of plastic surgery are characterized by:

• Dissatisfaction with oneself and the erroneous opinion that a change in appearance will bring happiness.
• Fear of someone else's negative assessment of one's own face and body.
• Violation of the idea of ​​\u200b\u200bone's uniqueness and the desire to correspond to a third-party ideal.
• The desire to preserve youth, albeit visual.
• Psychical deviations.

Plastic surgery for women

Women have long been seriously passionate about improving their appearance. For this, the fashion industry and medicine offer breast plastic surgery, cosmetic procedures, face and body skin care products. But that's not all. Plastic surgery for women affects the most intimate part - the correction of genital organs that have lost their tone and original appearance. What does medicine offer the fair sex?

• Plastic surgery of the labia minora allows you to achieve their symmetry and ideal shape. There are no scars after the operation.
• Plastic surgery of the labia majora is aimed at eliminating cosmetic defects, achieving symmetry, and improving the appearance of the organs.
• Intimate plastic surgery of the vagina is especially relevant after several births, when the tissues are significantly stretched, and sometimes torn. The entrance to the vagina and its internal space becomes too wide, which interferes with a full-fledged sexual intercourse. An increase in intake can also occur due to age-related and hormonal changes, limitation of physical activity, chronic constipation. Stretching the internal space of the vagina is fraught with omission and rupture of the walls with scarring, overstretching of the muscles. Against the background of the disease, bladder prolapse, urinary incontinence, uterine prolapse and rectal hernia may develop. All this helps eliminate plastic surgery for women. There are several options for operations - plastic surgery of the walls of the vagina, due to which its volume decreases and tissue tension improves; plasty of the vestibule of the vagina to narrow the entrance.

Today, men are willingly using the services of plastic surgery. And it's not just about an eyelid lift, a hair transplant, or a facelift. Often, representatives of the stronger sex are interested in intimate plasticity:

• The lengthening of the penis due to the implant allows a man to feel full and relieves psychological problems.
• Implantation of phalloprostheses in the cavernous bodies of the penis makes it possible to get rid of impotence. The prostheses are invisible to outsiders, while the man retains the possibility of orgasm.
• To thicken the organ due to its own adipose or muscle tissue, a special gel is resorted to when the penis is too thin by nature or the partner has an excessively wide vagina.
• Enlargement of the head of the penis occurs by introducing a special gel.
• Plastic surgery of the penis frenulum is necessary if it is too short and injured during intercourse, or a man has problems with rapid ejaculation.
• Plastic surgery services also offer treatment for a curved penis. Curvature can cause discomfort during intercourse. It can be congenital or is the result of certain diseases. During the operation, longitudinal sutures are placed on the inner membrane of the penis.
• Injuries and diseases can cause the absence of testicles. A physical defect causes a man to feel inferior and embarrassed during intimacy. During plastic surgery of the testicles, the surgeon inserts prostheses that completely imitate their presence.
• The narrowing of the foreskin (phimosis) does not allow the head of the penis to be exposed - this usually happens in boys from birth or in adult men after suffering infectious diseases of the foreskin. Surgical treatment consists in excision of the leaves of the foreskin.

Plastic surgery for stars

Plastic surgery for stars is very popular today. Celebrities are cutting their faces and bodies with might and main to become even more beautiful and popular. The best plastic surgery and doctors are available to them, and for some, their own transformation has become the road to a dizzying career:

• Halle Berry - despite the title of the first vice-miss in the US beauty pageant, the world fame came to the actress after her appearance became perfect thanks to a nose job and breast augmentation.
• Blake Lively is a good example of moderate plastic surgery of stars: masterfully performed rhino- and blepharoplasty, implantation into the bust made a real star out of an outwardly mediocre actress.
• Bollywood star, Miss World-94 Aishwarya Rai is also no stranger to plastic: to acquire a more European appearance, the Indian woman used rhinoplasty and eye shape correction, and also installed fillers in her lips. Thanks to the operations, the celebrity began to look even more interesting, and the traces of plastic surgery are invisible to prying eyes. After a pregnancy that brought extra pounds, Aishwarya resorted to liposuction, which allowed her to return to her former shape.
• Another celebrity who is an example of successful plastic surgery of stars is Jennifer Lopez. Only an experienced doctor will understand that J. Lo's face has changed under the influence of rhinoplasty, chin correction, injection procedures, and implants are sewn into the chest - so successfully that one can assume that a first-class professional worked on the appearance of the actress and singer.

While some stars diligently retouch their appearance with plastic surgery, others are not afraid to age beautifully without medical advances:

• Meryl Streep has never used the services of a plastic surgeon - and this did not stop her from making a brilliant acting career. Meryl still plays leading roles in the highest quality and most successful films, and is considered the greatest actress of our time.
• Kate Winslet is an example of the struggle for naturalness - the actress, who has never been on a diet and has a 41-foot size, not only did not do plastic surgery herself, but even created the British League against Plastic Surgery.
• Another star without plastic surgery is Julia Roberts. The actress has never had surgery, which did not prevent her from starting a modeling career at the age of 40.
• Julianne Moore reached the age of 56 without a single plastic procedure. Moreover, the star even uses makeup only at social events and filming, and in everyday life she prefers a face without a lot of makeup.

Types of plastic surgery

Reconstructive plastic surgery

What is reconstructive plastic surgery? This branch of medicine involves work to restore the functionality and shape of an organ or part of the body. Indications for reconstructive plastic surgery are disorders due to trauma, previous operations or congenital anomaly. The work of the surgeon is to transplant their own tissues, implantation of foreign organs and tissues, artificial implants. Typically, the intervention takes place in several stages and includes elements of aesthetic surgery.

What operations are performed as part of reconstructive plastic surgery?

• Plastic with restoration of facial tissues after burns, traumatic injuries, congenital defects.
• Breast reconstruction after trauma, failed plastic surgery or mastectomy, to treat congenital anomalies (for example, funnel chest) Sometimes plastic surgery is necessary to improve the functioning of the lungs and the cardiovascular system.
• Reconstructive plastic surgery in gynecological and urological practice is needed for the treatment of acquired and congenital anomalies of the external genitalia (descent of the vaginal walls, expansion of the vaginal inlet, urinary tract defects, etc.).
• Reconstructive tummy tuck involves the removal of hernias, suturing the divergence of the abdominal muscles to prevent prolapse and infringement of the intestine.

Plastic aesthetic surgery involves improving the appearance of a person by correcting congenital and age-related changes on the face and body. It enables people to experience a feeling of youth longer, feel beautiful, get rid of complexes and feelings associated with their own imperfection.

The uniqueness of plastic aesthetic surgery is that doctors are dealing with a healthy person, and the task is not to cure the patient. The doctor must change the appearance, and with it the attitude of a person towards himself and the world around him. Therefore, it is extremely important for a patient who decides to undergo aesthetic plastic surgery to find “his” doctor and be on the same wavelength with him.

Plastic surgery and cosmetology

For a long time, plastic surgery and cosmetology have been living in close cooperation, because the union of a cosmetologist and a surgeon helps the client become beautiful, young and self-confident.

Where is the boundary between plastic surgery and cosmetology? The cosmetologist, acting with therapeutic methods, improves the condition of the skin: his manipulations allow you to adjust the color, elasticity, elasticity of the skin. It can also work with subcutaneous fat. Plastic surgery is focused on working with fiber and muscle layer, surgical removal of scars and scars from the surface of the skin.

The decision on whether a patient needs an operation or a cosmetic procedure is made individually in each case. Obviously, with an extremely small breast size, cosmetology will not help in any way, and the woman needs to be sent to a plastic surgeon. And if the patient has small wrinkles around the eyes, it is pointless to do the operation, since there are no serious indications, and you can limit yourself to cosmetic procedures.

Plastic surgery services

What can be improved with facial plastic surgery?

• Reshape lips.

You can increase them by injecting special preparations or transplanting your own tissues, and reduce them by removing tissues. Incisions are made on the inside of the lip or outside along the contour. The operation lasts 2 hours, the rehabilitation takes a week.

• Another type of facial plastic surgery is a facelift.

It can be circular (rhytidectomy), when the skin of the front and side of the neck, forehead, temples, cheeks, the area around the mouth and the middle part of the face is stretched. The operation takes a long time, requires a three-day hospital, and full rehabilitation with the convergence of edema will take 2 months. Endoscopic lifting is much less traumatic, although it lasts 1-5 hours - it is done through mini-incisions under the hair and in the oral cavity. Recovery takes 10 days.

• Forehead plastic.

A fairly simple, low-traumatic operation in which the skin is pulled up and fixed. Rehabilitation takes 10 days.

• Facial liposuction.

One of the options for facial plastic surgery is liposuction (pumping out excess fat through tiny incisions in the skin). The procedure is performed on an outpatient basis and takes only 30-60 minutes.

Contour plastic has gained great popularity in recent years. It is executed:

• Fillers (gels) - hyaluronic acid preparations are administered to patients subcutaneously. The effect consists in smoothing wrinkles and nasolabial folds, correcting the lowered corners of the mouth. Through fillers, you can change the shape of the chin and lips, the line of the cheekbones.
• Lipolifting - with this manipulation in plastic surgery, the surgeon works with a fat mass taken from the same person, but from another part of the body. The procedure is performed to smooth wrinkles and improve the facial contour.
• Implants (usually silicone) are used on the cheekbones, lower jaw or chin to add volume. The operation takes 1-2 hours, rehabilitation - 1 week. Implants are designed by a specialist on an individual basis.

Eye plastic surgery offers the following types of operations:

• Canthoplasty - correction of the incision of the eyes (due to age or an ugly natural shape).

The operation involves fixing the tissues of the lower eyelid on the periosteum. Hospital stay is limited to one day, recovery takes one week. Canthoplasty is good because the effect after it persists for a long time (5-10 years or more).

• Blepharoplasty (eyelid surgery) is another type of manipulation in eye plastic surgery.

The operation is performed to eliminate wrinkles, "bags", folds. Blepharoplasty can remove overhanging upper eyelids. Before manipulation, you should consult an ophthalmologist. After the operation, patients stay in the clinic for 1-2 days, swelling and bruising disappear within 14-15 days, contact lenses cannot be used for 30 days.

• Eye plastic surgery also offers patients a browlift (eyebrow surgery), which allows you to get rid of age-related drooping of the eyebrows, which is associated with a decrease in skin tone.

Browlift is usually combined with a forehead lift. The manipulation lasts from 1 to 3 hours and consists of cutting the forehead muscles, pulling the skin up and fixing it. The effect after the operation lasts up to 15 years.

Nose plastic surgery

Nose plastic surgery allows you to change the unfortunate shape of the nose. It should not be performed on people under the age of 18 (except when surgery is needed to treat injuries). It is optimal to perform the operation after 20 years, when the facial skeleton is already fully formed. Previously, patients should be examined by an ENT and a dentist and receive a conclusion that there are no contraindications for intervention, and a CT scan of the brain should be done. The operation lasts about 1 hour and requires hospitalization for 1-2 days. Recovery after rhinoplasty takes a little over 1 month.

How is the operation going?

• To reduce the nose, the cartilage that supports the wings of the nose is completely removed, and partially the bone from the back and septal cartilage.
• Reduction of the wide nostrils involves the removal of the alar cartilage and part of the wings of the nose.
• To correct the back of the nose, fragments of bones protruding above the surface are removed.
• Correction of a sunken back in nasal plastic surgery is done using bone implants or the patient's own bone taken from another part of the body.

Breast plastic surgery is perhaps the most popular among the representatives of the beautiful half of humanity. The desire to find the bust of your dreams is understandable, because it is the personification of beauty and attractiveness. Looking at the sites of clinics, women see a lot of pictures before and after plastic surgery, and decide on an operation:

• Breast augmentation.

It is carried out using implants (fillers) with a silicone shell, filled with hydrogel, silicone or saline inside. The shape of implants can be round or drop-shaped. The most modern models are those that have a rough shell and are filled with a solution - they almost do not give complications and last longer than silicone ones (about 20 years). Breast augmentation, made by installing implants under the thickness of the pectoral muscle, does not limit a woman in breastfeeding - she can safely feed her baby. A contraindication for surgery is the presence of tumors and severe prolapse of the breast. Implants are placed through incisions under the breast, around the areola, or under the armpit. The patient discusses the shape and size of the future breast with the surgeon before the operation, because, in addition to the desire to get a larger size, there are considerations of aesthetics and health safety. A complication of implantation is the formation of a fibrous capsule. It can be eliminated by dissecting the capsule shell, and sometimes subsequent replacement of the implant is required.

• A breast lift (mastopexy) is necessary if the former shape is lost.

During the procedure, the surgeon removes excess skin, moves the nipple and areola to the right place, gives the breast a new shape and sutures the tissues. With moderate descent, the sutures are located around the circumference and to the side of the areola. If the sagging is strong, the seams go from the areola to the crease under the breast. Mastopexy should not be performed if the patient is diagnosed with a breast tumor. A rare complication of the operation may be necrosis of the areola or loss of sensation around it.

• Reduction mammoplasty is a type of breast plastic surgery that involves reducing the breast.

This is a rather long operation (3-5 hours), during which the surgeon removes excess skin and tissues, moves the nipple and areola, and forms the contour of the breast. If necessary, fat is removed from the armpit through liposuction. Another type of breast reduction is called a breast lift. During this operation, fat is sucked out through punctures made along the contour of the breast. Experts recommend breast reduction plastic surgery after a woman has given birth and nursed children, and no longer plans to become pregnant.

There are several types of plastic surgery for excess weight:

• Plastic surgery of the stomach (gastroplasty) - the formation of a narrow long gastric sleeve for slow evacuation of food through laparoscopic incisions.

Unlike other methods (insertion of balloons, bypass surgery), gastroplasty does not require intermediate manipulations (adjustment) and avoids recurrence of weight gain, because during the operation the gland that increases appetite is removed. The operation is done with a high body mass index (from 35), especially if obesity is accompanied by complications.

• Elimination of subcutaneous fat deposits with the help of liposuction (suction of fat) is the destiny of plastic aesthetic surgery.

Liposuction is performed if the person's skin is not stretched, and there is no risk that it will sag a lot. The operation is recommended to be done at a stable weight - that is, you first need to lose weight, and then point-wise remove the remaining problem areas.

• Abdominoplasty is indicated when, in addition to fat, there is excess skin on the abdomen, sagging in the form of an apron, and stretched muscles.

All this cannot be removed either by diet or by the gym, so it remains to resort to the help of a plastic surgeon.

• Body contouring is performed if the patient has a lot of excess skin, which happens with a sharp weight loss with the help of bariatric surgery.

Do not hope that the operation will eliminate problems with excess weight. Nutritionists say that before and after plastic surgery for obesity, it is necessary to follow a diet that will allow you not to gain extra pounds and not aggravate health problems.

Operations in plastic surgery

Plastic surgery operations are usually performed at the request of the patient to improve his appearance. Therefore, there are not so many medical indications for interventions. For example, breast plastic surgery (reduction) is indicated for a large bust, when a woman experiences back pain due to excessive load. Breast implants can be used to reconstruct breasts after a mastectomy (removal of the breast for cancer).

Plastic surgery of stretched vaginal walls is needed to avoid rectal hernia, urinary incontinence, vaginal prolapse. The operation of plastic surgery is needed to eliminate diastasis of the abdominal muscles, which is fraught with prolapse and infringement of the intestinal loops. Plastic surgery of large postoperative and post-burn scars is often performed to restore the functionality of the organ. Correction of facial defects in children with cleft lip is designed to ensure normal (not probe) nutrition, proper development of the facial skeleton, bite and teeth, and normal self-esteem of the child.

Contraindications for surgery

There are a number of contraindications for plastic surgery operations. Absolute - these are those in which intervention is completely impossible:

• Tumors - in any type of oncological diseases, surgery cannot be performed. This is especially true for mammoplasty: a qualified surgeon will definitely require a mammogram to make sure there are no neoplasms. If the breast is removed during surgery for breast cancer, breast reconstruction is possible only after a thorough examination for the absence of metastases and recurrence.
• A bleeding disorder that can cause massive blood loss during surgery.
• Allergy to drugs used during anesthesia and during the intervention itself.
• Infectious diseases are dangerous because they can cause the spread of pathogenic microbes in the body.
• Chronic internal diseases - plastic surgery can cause serious complications and even death.
• Age under 18 is also a relative contraindication (unless the patient requires otoplasty).
• You can not do surgery during pregnancy and lactation. If we are talking about breast augmentation, after the end of feeding, at least six months should pass.
• Until recently, diabetes mellitus was an absolute contraindication, as it is accompanied by poor wound healing and is accompanied by dysfunction of internal organs. But now operations are allowed if a person's diabetes is well compensated, as there is an endocrinologist's conclusion.

Relative contraindications to surgery mean that manipulation is possible, but there is a certain risk. The final decision is made by the surgeon after studying the patient's history:

• Older age - people over 60-65 years old have a number of comorbidities that can lead to complications after anesthesia.
• Menstruation - during them, the risk of bleeding increases. Therefore, surgeons in plastic surgery recommend planning operations in the middle of the cycle.
• Colds and flu.
• Smoking - nicotine impairs healing. To avoid complications, you need to say goodbye to cigarettes for 2 weeks before the intervention and during the entire postoperative period.
• Tendency to keloid scars - in such patients there is a high risk of forming an ugly dense scar, which can only be eliminated by additional cosmetic procedures.

Plastic surgery is beauty medicine, and the success of the operation is determined by the skill of the surgeon. But to achieve the best result, it is important to follow the recommendations for rehabilitation after discharge from the hospital. Thanks to restorative procedures, you can quickly get rid of hemorrhages, swelling, pain and see your transformed face and body in all its glory.

Plastic aesthetic surgery involves a fairly extensive intervention affecting the vessels. The blood supply to the operating area changes as a result, and swelling and inflammation may develop. Blood leaking through the incisions soaks the tissues. Decaying hemoglobin changes the color of the skin in the place where the hemorrhage occurred - bruises appear. At the site of the operation, metabolic processes slow down, nerve impulses are transmitted worse.

Rehabilitation after plastic surgery should include measures to detoxify, improve blood microcirculation and skin condition, increase muscle tone, reduce pain and swelling, accelerate healing and form a neat thin scar. The procedures are prescribed by a dermatologist or a rehabilitation specialist, taking into account the characteristics of the patient's health, on the second or third day after the operation.

What methods of rehabilitation after plastic surgery and cosmetology are used most often?

• Microcurrents for muscle contraction. The procedure is needed to reduce swelling and relieve pain, has anti-inflammatory, tonic and lymphatic drainage effects.
• Ultrasound exposure (phonophoresis) facilitates the administration and absorption of drugs, has an anti-inflammatory effect, promotes the resorption of scars.
• Cosmechanics - pinching manipulations of the device on the skin of the face and subcutaneous fat layer, imitating manual massage. The procedure reduces swelling and soreness, helps to cope with bruises.
• Pressotherapy normalizes the outflow of lymph, relieves swelling and improves the elasticity of the skin.
• Endermology (special LPG postoperative program) – body massage with two rollers and vacuum through a layer of compression underwear or a special suit. The technique allows you to improve microcirculation, remove hematomas and stagnation, form a new skin frame due to the active production of collagen.
• Wearing compression underwear after some operations in plastic surgery is necessary to prevent swelling and relieve excessive stress on postoperative scars.
• Mesotherapy - injections of drugs into the dermis - promotes rapid skin regeneration, improves its tone and elasticity.
• Biorevitalization, or intradermal injection of hyaluronic acid with a special device, deeply moisturizes the skin.
• Cosmetics and preparations based on silicone are used to restore the skin and prevent the formation of unsightly scars.

Complications after plastic surgery

What complications can occur after plastic surgery?

• infection

The risk of infection entering the body is always high, so in the postoperative period, the doctor prescribes antibiotics for prevention. Proper suture treatment can reduce the likelihood of complications.

• Hematoma

Hemorrhage under the skin or into internal tissues - can happen with any type of intervention: in plastic surgery of the face (during a nose lift or correction), chest and abdomen. They are dangerous because they can soften and fester. You can remove the hematoma during the operation or after it with the help of special medicines and a tight bandage.

• Seroma

Accumulation of fluid under the skin after damage to the capillaries of the lymphatic system. Seroma usually occurs after liposuction, when patients lose a large amount of subcutaneous fat. To get rid of it, you need to drain the postoperative cavity.

• Thickening and thickening of postoperative scars

It is treated conservatively, with drugs to improve blood microcirculation in tissues. Surgical treatment is indicated only if the scars have changed very much.

• Implant displacement

Most often found in plastic surgery for women with breast augmentation. It occurs due to the fact that patients violate the regimen and stop using compression garments too early. Sometimes the implant can be replaced conservatively, but surgery may also be required.

plastic surgery victims

The victims of plastic surgery are those who, in their desire to transform, cross the boundaries of common sense, damage their health and disfigure their own appearance.

People of public professions - actors, singers, TV presenters - suffer the most from this. Therefore, among the "stars" there are so many victims of plastic surgery:

Perhaps the most famous victim of excessive plastic surgery is Michael Jackson. In addition to the disease, which forced the king of pop to hide from the sun and apply a thick layer of cosmetics to the skin, Jackson's face was constantly changing after operations. The singer repeatedly changed the shape of his forehead, cheekbones, nose, reduced his lips and tightened his eyelids to get closer to a European look. A botched intervention on his nose resulted in difficulty breathing and additional surgeries were required to allow the singer to breathe normally.

American actress Joan Rivers has had more than 700 surgeries in her lifetime. Repeated nose plastic surgery, facelift, blepharoplasty are just a small list of what Joan has done. The actress herself admitted her own dependence on plastic surgery, and said that she visits the clinic weekly for the next procedure. At the age of 79, Rivers refused Botox injections: the tight skin on her face did not allow her to speak normally, and the celebrity could not even blow out the candles on her birthday cake.

Donatella Versace, designer and co-owner of the company of the same name, became addicted to changing her appearance after she first improved the shape of her nose. This was followed by operations on the lips and chest, numerous Botox injections. The result was a face like a mask.

The transformation story of Jocelyn Wildenstein began in the 70s. From a beautiful blonde, she gradually turned into a woman with cat features: in this way, Jocelyn wanted to rekindle the fading interest of her billionaire cat lover husband. However, the husband did not appreciate the aspirations and filed for divorce.

Actress Lolo Ferrari - the owner of the largest breasts in the world - survived 28 operations on her face and body and achieved that each breast weighed 3 kg, and the girth was 130 cm. Lolo wore a special bra, and doctors, fearing for the integrity of the implants, forbade her air travel.

There are also victims of plastic surgery among Russian stars. Lyudmila Gurchenko, at first, all the changes were to her face, but over time, from merciless braces, the skin lost its elasticity. As a result, bumps, an artificial smile, incomplete closure of the eyelids and blurred vision appeared. In addition, operations at a respectable age had a negative impact on the general state of health. Perhaps, without them, the star of Soviet cinema would have lived longer.

Masha Rasputina repeatedly went under the surgeon's knife: her nose, chin and lips changed, the cut of her eyes was redrawn, her breasts were enlarged. The singer became completely unrecognizable. New coarse features combined with bright makeup and active facial expressions look strange.

The list of "stars" with unsuccessful plastic surgery can be continued. Despite the fact that the best plastic surgery is available to them, the result is often not pleasing to fans. And it's not the bad work of doctors. Having gone through one operation and having enjoyed pleasant changes, celebrities can no longer stop, and cut themselves beyond recognition.

More and more people are joining plastic surgery who want to keep their youth on the outside longer. The beauty industry offers many options to improve yourself on the outside, and shows impressive before and after photos of plastic surgery. But in the pursuit of beauty, the main thing is not to lose yourself and your health, and therefore the choice of an operation and a doctor must be approached with all responsibility.

There are many surgical operations with which doctors make the image of the patient more attractive.

You can change almost any part of the body and make it perfect by trusting an experienced surgeon.

New discoveries in this area have changed plastic surgery beyond recognition, and its possibilities are simply amazing.

It seems that there are no impossible tasks for her, since any part of the body can be changed and improved.

This is a branch of surgery that, with the help of surgical intervention, eliminates defects in organs and tissues on its surface.

Types of plastic surgery are conditionally divided into two main ones:

• Reconstructive surgery deals with the elimination of defects in tissues and organs, both congenital and acquired. Thanks to such operations, a person can again return to a full life and feel healthy. They are often performed for medical reasons. This type of plastic surgery is used to correct defects in the mitral valve of the heart, nasal septum and eye problems caused by excess skin on the upper eyelid.
• Cosmetic surgery is the use of plastic surgery methods to correct appearance. With its help, each person can get rid of the shortcomings of his body that he does not like, and improve the quality of life.

Studies conducted in different countries show that non-invasive interventions (injections, injections, grinding, peeling) are leading in the world. These procedures are widely used for rejuvenation and prevention of skin aging. In second place is plastic surgery of the face, hair and chin.

Plastic surgery to change the shape and size of the mammary glands and liposuction take third place. Each country may have its own trends, such as the reshaping of the buttocks in Brazil or the penis in Greece.

The demand for certain types of plastic surgery is directly related to the beauty standards adopted in a particular region.

There are people who do not want plastic surgery:

• the presence of psychological diseases;
• pathological desire for perfection of the face and body;
• people who can't stop and have plastic surgery multiple times.

These are the categories of people who need a good psychologist, not a plastic surgeon. They almost always remain dissatisfied with the result, and their problems only get worse from this, no matter what types of plastic surgery they have performed.

Types of plastic surgery - an opportunity to become more beautiful for everyone

Medical discoveries have taken plastic surgery to a whole new level. What once could only be dreamed of is now being successfully applied in practice.

Various types of plastic surgery are created so that a person can achieve the perfection of his body. Regardless of whether he wants to correct congenital or acquired defects. Every day, scientists are looking for new methods to make operations easier and better results.

Plastic surgery: what are the aesthetic and reconstructive surgeries

Plastic surgery is an opportunity to make your body more attractive. To use it or not, everyone decides for himself.

There are many people who have entrusted themselves to professionals, and this has made them happier, because some physical disabilities can greatly reduce the quality of life.

Of course, in everything you need to follow the measure and listen to the advice of a doctor, these types of plastic surgery are shown to you or it is better to refrain from them, since there are a number of contraindications that can lead to complications after surgery during the rehabilitation period.

Types of plastic surgery and their brief description will help you to know what kind of surgery on what parts of the body is possible.

Unfortunately, not everyone knows about the possibilities that he has to achieve beauty. Human life sometimes presents unpleasant surprises, and our body loses its attractiveness under the influence of special conditions and external factors, and there is nothing wrong with the desire to restore its former beauty to its appearance and remove defects that interfere with life.

• Hair transplantation- an extreme measure for baldness, when other means of preserving and restoring hair are ineffective. No one is safe from hair loss, neither men nor women, and if this happens, then sometimes only their transplantation can correct the situation.
• Mammoplasty (breast plastic surgery) will help women correct the shape of the mammary glands. No matter how beautiful your breasts may have been in youth, their shape changes over time. The force of gravity, pregnancy and breastfeeding, hormonal imbalances and weight fluctuations can change her appearance beyond recognition. Sagging, stretch marks, loss of shape and elasticity can make it far from ideal, and beautiful breasts are the pride of any woman and the key to attractiveness for men.
• Abdominoplasty and liposuction (tummy tuck) performed to correct the abdominal area. During surgery, excess fat and skin are removed. In this case, a circular incision is made near the navel and on the bikini line. Its implementation requires a certain level of skill from the surgeon, since it is important to observe symmetry when sucking out fatty deposits.
• Gluteoplasty- a complex of plastic surgeries aimed at changing the volume and shape of the buttocks. Volumes are increased with the help of silicone implants when sports do not bring the desired result. If the buttocks are lowered and the folds under them are smoothed out, a lift of this part of the body is indicated.
• Brachioplasty works on the upper arms. It is prescribed when the skin on the area from the shoulder to the elbow has become flabby and hangs ugly when the arm is raised. This operation helps to restore the tone of the forearms and their lost beauty.
• Cruroplasty and Femoroplasty are operations that help you achieve perfection in your legs. These names mean plastic surgery of the legs, as well as a lift of the inner side of the thigh.
• Labioplasty corrects defects of the labia minora in women, corrects their size and shape.
• Hymenoplasty (plasty of the hymen) carried out by women at their request, whatever their motives.
• Vaginoplasty (Vaginoplasty) one of the most sought after operations in intimate surgery, as many women experience changes in the vagina after childbirth. Correction of this part of the body will not only restore the natural attractiveness of this area, but also restore its functionality. After vaginoplasty, sexual sensations for both partners become more intense and brighter.
• Phalloplasty (penile plastic surgery) is an operation to partially or completely restore the penis, as well as its urinary function. Through surgery, you can correct its size and thickness, remove the consequences of injuries and anomalies in the development of the penis.
• Platysmaplasty (neck plastic surgery) indicated for excess skin in this area, the presence of excess fat and loss of neck muscles of their tone. In this zone, the first signs of aging appear, it is not surprising that many people want to correct its appearance, since the cosmetic effect after the operation is very noticeable.
• Panniculectomy (skin tightening after weight loss)) is an operation that will help eliminate loose and sagging skin on the abdomen after a sharp and significant weight loss or pregnancy.
• Torsoplasty (combined plastic surgery) It is used to eliminate the problems that sagging skin creates after a sharp or very large weight loss. Performing an operation covering most areas, such as the sides, abdomen, hips and back, requires a certain skill and experience from the surgeon, as it is one of the most difficult plastic surgeries.

Reconstructive plastic with massive external lesions, it can return a person to normal life after serious injuries, burns, accidents or birth defects. Skilled surgeons can repair or reattach severed organs and limbs. These are the most complex operations that are performed under a microscope.

For their implementation, material is taken from another area of ​​​​a person, donor or implant. With massive lesions, it may be necessary to apply more than one type of plastic surgery and carry out a large number of operations, how many of them will need to be done, the doctor will tell you after an examination.

Types of plastic surgery on the face

Every person, whether he admits it to himself or not, wants to be beautiful and to please others. Our face is like a business card, it is first noticed when meeting.

What is its beauty?

The most famous surgeons have come to the conclusion that true attractiveness lies in the correct proportions between the cheekbones, eyes and lips.

If they have the right size and shape, and are also located harmoniously relative to each other, then others will perceive a person’s appearance as attractive or even beautiful.

External data at birth are not always ideal, and with age they are also subject to the effects of aging, so there are people who decide to turn to a plastic surgeon to correct the imperfections of their face and make it more attractive. To know how you can improve your appearance, it will not be superfluous to know what types of facial plastic surgeries are.

• Rhytidectomy (facelift, facial rejuvenation) became a real discovery in plastic surgery. Signs of aging sooner or later appear in every person, and it is quite natural to want to get rid of deep wrinkles on the forehead and neck, as well as nasolabial folds and crow's feet. With the help of rhytidectomy, you can restore the beauty and elasticity of the skin. The key to the success of this operation is the skill of the surgeon, the absence of a mechanical effect on the skin of the face at first, and the ability of the body to recover after it. This is a cardinal and very effective method that will help erase the signs of aging from the face.
• Front lift (eyebrow and forehead lift)- this surgical operation is indicated for people who have drooping eyebrows, excess skin of the upper eyelid, drooping of the nose tip, wrinkles at its base and the presence of deep transverse furrows on the forehead. Front lifting can be performed both by the classical method and endoscopically. With its help, youth returns to the face, and age-related signs of fatigue are effectively removed. Front lifting is used to achieve the effect of facial rejuvenation.
• Blepharoplasty (eyelid surgery) is an operation aimed at eliminating the imperfections in the appearance of the eyelids and the area around the eyes. This zone is the most sensitive and subject to age-related changes. With the help of blepharoplasty, excess skin is removed, and fat is redistributed or removed, the so-called bags under the eyes disappear. The operation can be performed at any age, but most often it is a period of 35-40 years.
• Rhinoplasty (nose job) will help not only improve the appearance of the nose, but also restore its functionality lost for various reasons. Rhinoplasty is one of the most difficult operations in plastic surgery. It is very important to find a good surgeon who is a master of his craft and can meet your expectations. Not all surgeons can skillfully perform all types of plastic surgery on the face.
• Septoplasty is an operation that corrects a deviated septum. In addition to the aesthetic effect, it is also justified in terms of health. This defect is present in many people, in difficult cases it prevents normal breathing through the nose. Therefore, septoplasty is often prescribed for medical reasons.
• Cheiloplasty (lip plastic surgery)- This is a plastic that corrects the shape of the lips and their size. Whether it's a congenital feature that does not satisfy the patient, or age-related loss of their plumpness, experienced surgeons can make this facial feature much more attractive by correcting it.
• mentoplasty is a plastic surgery that corrects the shape of the chin. It can be both increased and decreased, depending on what needs to be done to form the correct proportions of the face. With the help of this operation, you can radically change the image, because a beautiful chin is an important part of it.
• Malyarplasty is an intervention that changes the shape of the cheekbones. It can be both decreasing and increasing. The surgeon gets the necessary access to the cheekbones and jaw, both from the side of the mouth and by making an incision in the temporal region and behind the ears. It is possible to install prostheses made of solid silicone, if you need to add volume, or bone tissue is simply removed by active grinding, if you need to reduce it. Previously, the operation was performed more on older women for visual rejuvenation, now it is also performed on young girls who are dissatisfied with flat cheeks.
• Cervicoplasty is a plastic surgery to restore the contour of the neck and chin, often combined with the removal of excess fat deposits, skin tightening and excision of its excess, as well as lifting the subcutaneous muscle. Most often, cervicoplasty is performed on men and women aged 40-50 years, after it, very noticeable improvements in appearance can be observed, and the remaining scars from the incisions made are almost invisible to others.

Which of the plastic surgeries will suit you best - the specialist will tell you, since a person tends to be too critical of his appearance.

Guys, we put our soul into the site. Thanks for that
for discovering this beauty. Thanks for the inspiration and goosebumps.
Join us at Facebook and In contact with

Nowadays, you will not surprise anyone with the correction of appearance, plastic surgery has gone to the masses, and we have all heard about rhinoplasty (nose plastic surgery), mammoplasty (breast plastic surgery) and liposuction (fat removal in a certain area of ​​the body).

But plastic surgeons are always ready to offer their patients new types of changes in appearance that are in line with all the latest fashion trends.

website I learned what operations are gaining popularity and what else people are ready to go for to create the perfect image. At the end of the article you will find bonus, which will tell you what can be changed and what seemed impossible to change.

1. Hair transplant

Hair transplantation can be done not only on the face, but also on the whole body. For example, you can increase the hair growth on the chest and lower abdomen to create a more masculine look. And of course, surgeons have come to the rescue of those who cannot grow a fashionable beard.

2. Implantation of muscles

If you do not want to spend time in the gym, but the desire to look spectacular does not leave, then there is a surgical method. Of course, this will not add strength, but the look “as from the cover” is guaranteed.

3. Move your own fat

Surgeons have learned how to move a person's own fat through his body, and now silicone implants have faded into the background. This procedure allows you to move the pumped fat from unnecessary places to the right ones. In slender people, fat is taken on the inside of the knees, where almost everyone has small fat deposits.

4. Creating dimples on the cheeks

Now the dream of cute dimples can become a reality. But you need to understand that there is no way back - it is impossible to remove the dimples after they have formed. Therefore, as before any other intervention, you need to think very carefully.

5. Changing the lines of fate

For those who have everything according to Feng Shui and who meticulously examine the lines on their hands in an attempt to discern significant moments in their own lives, surgeons offer to stop hoping for fate and draw what you want. With the help of the surgical method, you can draw a new line of life, and all other lines that you want.

6. Calf enlargement

The fashion for sports calves has led to a new service in plastic surgery clinics. Silicone tabs will help to make your legs smoother and give the impression that you have never parted with sports.

7. Navel

If a woman has ceased to find visible (for herself) flaws in her own appearance, then just like that, she still will not stop. Surgeons know this and are happy to offer a procedure such as reshaping the navel to be perfect in every detail.

8. Chest for a day

The most insidious surgical intervention imaginable. A saline solution is injected into the chest, which increases it to 2 sizes, in about a day everything will return to normal.

9. Toe shortening

Women make any sacrifices for the sake of beauty and do not even want to hear about protruding bones, varicose veins and other horrors that can become a reality from spectacular heels. The surgeons decided to ease the suffering a little and offer to get comfortable insoles that will always be with you. To do this, injections of one's own fat are injected into the feet, or Botox can be injected into the soles to reduce sensitivity in order to walk for hours in heels and not get tired. And to make shoes with an open toe look perfect, you can shorten your fingers.

10. Eye color change

Lenses are no longer the only way to change eye color. The surgeon implants a silicone prosthesis of the color you choose through a small incision in the cornea into the iris of the eye. The procedure can be repeated by replacing the implant with a new, different color.

Introduction

In modern society, it is very important how a person looks, therefore, more and more often, not only women, but also men pay attention to their appearance. Nowadays, seeking help from a professional in the field of plastic surgery is not considered uncommon. According to marketing research experts, every fifth woman in the world is not averse to resorting to services to improve her appearance through a surgical knife, and men's interest in plastic surgery almost doubles every year.

Do not forget that initially this type of surgery set itself the task not to change the appearance for the better, but only to solve serious health problems.

plastic surgery aesthetic knife

Plastic surgery, types of plastic surgery

Plastic surgery is a branch of surgery that deals with surgical interventions aimed at eliminating deformities and defects of any organ, tissue or surface of the human body.

The goal of plastic surgery is to restore most often the superficial tissues of the body, leveling defects in such a way that they do not attract the attention of others. The end result is that the patient acquires an appearance with which it is possible to lead a natural lifestyle.

Also, plastic surgery operations are associated with the displacement or movement of tissues using local tissues, their free transfer from distant areas to create new forms.

Plastic surgery has a sufficient number of methods for eliminating defects. Very important in predicting the results of the operation is: the choice of method, indications and contraindications for the intervention, the high qualification of the surgeon, the correct assessment of the general condition of the patient and the competent description of the defect.

The term "plastic surgery" was introduced in 1798 by the French surgeon Desolt, and came into wide use in 1893.

"Plastikos" (Greek) - to create a form;

"plasticus" (lat.) - forming.

Plastic surgery can be divided into two main types - reconstructive and aesthetic.

Reconstructive (restorative) plastic surgeries help eliminate deformations, defects of tissues and organs, and restore their functions using plastic surgery methods. Such operations are performed on people who have received bodily injury as a result of injury, illness or birth defects. A successful reconstructive operation can radically change the quality of a person's life, helping him regain a sense of a fulfilling life.

Aesthetic plastic surgery is the application of plastic surgery techniques to improve appearance. Thanks to such operations, people can not only prolong their youth and feel their beauty, but also get rid of the emotional stress of realizing their real or imagined imperfections, and thereby also significantly improve the quality of life. Aesthetic plastic surgery can be classified according to the area of ​​performance:

facial rejuvenation (skin tightening) - facelift

brow and forehead lift - front lifting

eyelid surgery - blepharoplasty

rhinoplasty

Rhinoplasty is the correction of congenital or acquired deformities of the nose, as well as the complete restoration of the missing nose.

septoplasty - surgery to correct the shape of the nasal septum

plastic surgery of the auricles - otoplasty

neck plastic - platysmaplasty

lip plastic surgery - cheiloplasty (using injections and implants)

hair transplantation

chin plastic - mentoplasty

cheekbone surgery - mandibuloplasty

change in the severity of the zygomatic areas - malarplasty

plasty of the neck and subchin area - cervicoplasty

breast plastic - mammoplasty

tummy tuck - tummy tuck

change in the nature of body fat - liposuction

buttock plasty - gluteoplasty

hand plastic surgery - brachioplasty

shin plastic - cruroplasty

plasty of small and large labia - labioplasty

hymenoplasty - hymenoplasty

vaginal plasty - vaginoplasty

penile plastic surgery - phalloplasty

skin tightening after weight loss

removal of the skin-fat fold on various parts of the body - panniculectomy

elimination of ptosis - torsoplasty

laser resurfacing of the patient's skin

excision of post-traumatic scars

combined plastic - two or more areas

reconstructive plastic - with massive external lesions

Nowadays, the following are considered the most popular aesthetic operations: nose, chin and ear correction, facelift, forehead and neck lift, blepharoplasty, eyebrow plastic surgery, lip correction, Botox injections; liposuction in the abdomen and waist, breast augmentation, reduction and correction, hand rejuvenation; buttock augmentation, liposuction in the "breeches" zone, reshaping of the labia minora and labia majora.

In reconstructive surgery - restoration of the shape of the breast after oncological diseases, auricles after injuries, skin after negative thermochemical or chemical exposure. Most of these types allow a person to change his life for the better in the near future.

However, Robert Goldwyn, a famous American plastic surgeon, argues that every operation that starts as a reconstructive one always ends up as an aesthetic one. The difference between them, he believes, is "a purely academic concept."