Youth and Beauty at All Costs?

Since 2011 there has been an increase in the number of people attending plastic surgery services in Cuba, who should be aware that this type of intervention is not without risks.

Posted: Saturday 29 September 2018 | 10:15:43 pm.
Author: Ana María Domínguez Cruz 
digital@juventudrebelde.cu

A CubaNews translation.
Edited by Walter Lippmann.

Since 2011 many people have turned to plastic surgery services. Author: Falco Published: 29/09/2018 | 10:03 pm

Aesthetics and health. The debate is still endless because the search for beauty, beyond the superficial, can also be a guarantee of emotional health, psychological stability, high self-esteem and general well-being.

Plastic surgery professionals also work in the field of reconstructive surgery and caumatology, and say that in the first place the safety of the procedure and the training of the professionals who put it into practice should be paramount.

According to data released at the 2nd Congress of the Cuban Society of Plastic Surgery and Caumatology, held from September 5 to 7 on the Island, from 2001 to 2016, 309,469 plastic surgeries were performed in Cuba  The majority (200,508) were aesthetic and the rest reconstructive.

They added that there is a considerable increase every year starting in 2011, which places us in line with the rest of the world, where each time the number of people who come or need this specialty grows.

Dr. Ariel C. Prada, a third-year resident in Plastic Surgery and Caumatology at the Hermanos Ameijeiras Clinical Surgical Hospital, recently arrived at the Multimedia Editorial Office of Juventud Rebelde to answer questions related to the discipline in the country, its potentialities and perspectives, as well as its risks and complications.

The professor instructor and editor of the magazine Cirugía Estética y Reparadora [Esthetic and Reparative Surgery] clarified not a few doubts of our readers -some teenagers and young people-, from whom we offer a selection.

Dr. Ariel C. Prada, third year resident in Plastic Surgery and Caumatology, Hospital Clínico Quirúrgico Hermanos Ameijeiras. Photo: Roberto Ruiz

Lissa: What are all the plastic surgery services that we can access for free?

Ariel C. Prada (ACP): You can access all plastic surgery services (including cosmetic surgery and reconstructive surgery) free of charge, after a medical assessment to determine whether or not you qualify for that intervention. There are procedures in which alloplastic materials are used (breast implants, buttocks, etc.) that in the case of cosmetic surgery must be acquired by the patient, having first the indication of its model and volume by the plastic surgeon.

Susel: Is it necessary to be of legal age to access an operation or is it only possible with the authorization of the legal guardian?

ACP: Like any medical-surgical procedure it has a legal background and risks. If you are a minor must have the approval of parents or legal guardians. We do not know the nature of the procedure you wish to  be performed, but we always recommend that, if it is not strictly necessary, you wait until the age of majority, either to seek better aesthetic results or because they are purely elective surgical interventions (cosmetic surgery), not essential for your life. Remember that undergoing surgery, in this case, is a very personal decision that requires full awareness and maturity.

Hope: I want to remove the “crows feet”, a little fat from my belly, my neck wrinkles … How many cosmetic surgeries can a person do, and how long should you wait between one and another?

ACP: There is no specific number of cosmetic or reconstructive surgeries that can be performed on a person. Above all, it must be evaluated by a specialist, who will determine, according to his opinions, which is the best aesthetic option, according to factors as varied as the type of patient, age, basic diseases and magnitude of the procedure, among others.

“Our specialty is a complement to improve the quality of life of people. Thus, it in no way replaces healthy habits such as a good diet, avoiding toxic habits or frequent physical exercise. In fact, many times our intervention is not necessary or its magnitude decreases, with much better results. The patient must be aware and responsible for their own health, to have lifestyles that maintain the results of the procedure performed.

Yaima: I have black skin, am 52 years old… Does race influence this type of surgery?

ACP: In medicine, and particularly in plastic surgery and caumatology, one of the elements taken into account is the racial biotype. Age is also a factor that is considered depending on the patient’s desire.

Iris: How is the procedure so that a woman who was operated on a radical breast can have access to the reconstruction of this part of her body? Where should she go?

ACP: Surely you were seen in a center with oncology service. Your oncologist, after considering that you are free of the disease (at least for a year) can refer you to a reconstructive surgery service, either in an oncology hospital or clinical-surgical, to begin the process of breast reconstruction which can be done in several stages.

“The National Breast Cancer Program contemplates the free reconstruction of all women affected by this pathology, with quality and first-class breast implants in centers such as the National Institute of Oncology and Radiobiology (Havana), Hermanos Ameijeiras Clinical-Surgical Hospital (Havana) and Conrado Benítez Oncological Hospital (Santiago de Cuba). You should consult with your oncologist in which center, according to the regionalization of health services, you should be treated.

Carmen: Those of us in our third age can opt for simple procedures, such as, for example, one that allows us to lift our drooping eyelids?

ACP: Although there are “simple procedures”, all require the expertise, experience and “aesthetic vision” of a plastic surgeon. We mean that there are sick people, not diseases (an old medical adage). Therefore, each treatment must be individualized, because what a patient requests is not always the best aesthetic or technically possible option.

“In the elderly, we must take into account the compensation of their basic illnesses, because we are talking about purely elective procedures, in which the risk must be minimal and the benefit, the highest possible.

Yeny: What practices should a patient follow after having a lipectomy*? How long should she wait to perform physical exercises and which are the most recommended? Is it normal to feel punctures in the abdominal region two years after this type of surgery has been performed? 

ACP: First of all, you must have followed the indications of the plastic surgeon who operated on you, because s/he knows the characteristics of the patient, the details of his procedure and therefore the limitations and possible evolution, among others.

“Generally, three months after the operation, as long as they have not been complex dermolipectomies, patients can gradually resume themselves into their lives fully, without excesses. Physical exercises should be dosed and increased progressively. Aerobes and any activity that tones the muscles improve the results of the procedure. Consult your surgeon about the symptomatology presented, because s/he will surely offer you a more exact explanation and a solution.

The returning breast

Surgeries do not replace healthy lifestyle habits, but they are a choice many make.

When we speak of plastic surgery, the term also includes reconstructive surgery, which guarantees not only an aesthetic result, but also the return of function to the affected area.

In this sense, Dr. Yamilé León Rodríguez, who works at  Hermanos Ameijeiras Hospital, tells Juventud Rebelde that oncological, traumatic or congenital deformities in the face, in the breast due to cancer and ulcers in dissimilar parts of the body, among others, are treated in this way.

“We have a multi-disciplinary breast cancer care group that includes oncologists, mastólogos, radio-oncologists, imageologists, psychologists, psychiatrists and specialists in reconstructive plastic surgery, who enter the process after it has been decided how the ablative surgery of the patient will be conducted.

“The defect to be corrected may be in the breast, when a partial or total removal of an organ or body tissue is performed in a radical mastectomy, or to correct a defect that remains in the chest wall, as a result of an ablation of a large tumor.

“We have developed several techniques, including reconstruction with the local tissues of the breast, with muscles, especially the abdominal rectum and the broad dorsal, as well as through flaps obtained from the abdomen, or the novel technique applied in the country of the sentinel ganglion, which determines the degree of spread of cancer.

León Rodríguez points out that patients of different ages, from 18 to 85 years old, have been treated with this type of aesthetic reconstruction. “The results show that it is not mandatory to perform total exeresis and that the subsequent reconstruction, with or without the use of prostheses, gives the woman back one of the classic attributes of femininity”.

Perfect face!

Rhinoplasty is a complex but generally not life-threatening procedure.

Dr. Julio Cesar Galvez Chavez recognizes that in the desire to look younger, more and more patients come to his office. They should know that there are also selection criteria for cervicofacial rejuvenation surgeries.

“If there are signs of aging, then we can consider this type of surgery. We can find these elements in young people, perhaps because they have very white skin. In general, however, we perform them in patients over 40 years and up to 60, although the age limit is not as determinant as physical conditions and health.

“Many people believe that this is a magical intervention that will return them to the freshness they had at 15 years. This isn’t so, because, although it is guaranteed to make you look younger, you can’t turn back the clock.

The fundamental motivations for performing a surgery in the environment of cervicofacial rejuvenation are related to the fall of the eyebrows, the appearance of horizontal or transverse wrinkles in the eyebrows, the excess of skin on the eyelids and the appearance of fat pockets in that area, the loss of the contour of the jaw and the presence of the so-called marionette lines, the fall of the chin and the loss of angularity in the neck, among others.

Gálvez Chávez is also an expert in rhinoplasty, an aesthetic procedure indicated for those who wish to modify the size and shape of their nose as well as to improve their respiratory function in case of deformities in their septum.

“We perform reductive rhinoplasty in those noses of large dimensions and augmentative for flat or underdeveloped. In addition, we can make other procedures to model or perfect the features according to aesthetic patterns worldwide, either in the tip of the nose, the wings, the back, the nostrils and in general in all regions of the nose.

“Rhinoplasties are not recommended for people over 40 years of age because the skin’s ability to adapt to structural changes is important. This is most noticeable before the age of 30,” says the specialist, who notes that, although vital rules of care must be respected after rhinoplasty, it is not a life-threatening surgery.

Molding the body

How many people yearn for an aesthetic surgery after which they will look slim and slender? Dr. Heizel Escobar Vega, a specialist at the Hospital Clínico-Quirúrgico Hermanos Ameijeiras, states that this is the main reason why patients come to her practice. They ignore the fact that liposculpture is not a method for treating obesity.

“Liposculpture is the surgical treatment we perform to treat the areas of the body where fat deposits are found, such as the abdomen, the trochanteric regions and the arms, among others. Not only is it a question of removing those fat accumulations, but also of performing the lipo-injection in other areas in which they are desired.

“With this procedure, we obtain a corporal mold, as much in men as in women. Lately, they want to lose fat, in the abdomen and lumbar regions. They also request high definition surgery to obtain the well-known “squares”, an increased request also in recent times in the female population”.

Escobar Vega insists that not everyone can be a candidate for this surgical intervention. “We are rigorous in the selection of patients. Although people generally think that it is a simple surgery, due to the fact that it is among the most performed globally, it is certainly one of the riskiest and has the highest mortality associated with it, depending on the time and volume of fat extracted. Moreover, its realization leads to the modification of the metabolic, biochemical and hepatic mechanisms of the organism.

“Follow-up after surgery is essential, and the patient must respect the measures indicated by his attending physician.

Dr. María del Carmen Franco Mora is a specialist at the Juan Bruno Zayas General Hospital in Santiago de Cuba. She explains that the demand for gluteal lipo-injection has grown, a procedure that requires prior liposuction or liposculpture, from which the fat extracted is injected into that area of the body.

“The most frequent general complications are associated with the most feared, ranging from fatty and pulmonary thromboembolism, septic shock and severe anemias, to local infection and hematomas, among others.

“The criteria established for the classification of the patient must be very respected. We do not operate on people with a body mass index above 30 until they lose weight before, nor on those with a history of thrombotic diseases in lthe ower limbs or with the presence of varicose veins, nor on those who take oral contraceptives, among other exceptions”.