In the RKB named after. N.A. Semashko successfully performs plastic surgery on the face

In the RKB named after. N.A. Semashko successfully performs plastic surgery on the face

In modern society, appearance is given great importance. Many people see in their appearance something that they sometimes want to change. But in some cases, surgical intervention simply cannot be done...

We talked with a doctor from the ENT department for adults of the Russian Clinical Hospital named after. N.A. Semashko Valery Shiripovich Ayusheev. Valery Shiripovich is a doctor of the highest qualification category, with 35 years of experience as an otolaryngologist. In 1981, he graduated from the Tomsk Medical Institute with a degree in general medicine and completed an internship at the ENT department of the Republican Hospital named after. N.A. Semashko, clinical residency at the ENT department of the Irkutsk Medical Institute. He specialized in endoscopic functional rhinosurgery under the guidance of Corresponding Member of the Russian Academy of Medical Sciences, Professor G.Z. Piskunov (RMAPO, Moscow), and underwent professional retraining in plastic surgery under the guidance of Professor L.L. Pavlyuk-Pavlyuchenko (Moscow). Our colleague is a full member of the Russian Society of Plastic, Reconstructive and Aesthetic Surgeons of Russia, the Society of Plastic Surgeons, Otorhinolaryngologists of the Republic of Buryatia. Has been practicing plastic surgery for 10 years.

The doctor told us about the most popular areas in plastic otolaryngology today - rhinoplasty, otoplasty and blepharoplasty.

— As you know, the nose is the most noticeable part of the face, so many of our patients come to us with a request to change the shape of the nose, because everyone wants to be attractive. Rhinoplasty is a plastic surgery to change the size and shape of the nose, aimed at eliminating aesthetic and functional defects and hiding post-traumatic complications. We eliminate congenital defects - curvature, impaired nasal breathing, disproportion of the nose, as well as acquired deformity as a result of trauma. These are humps on the nose, a thickened or drooping tip of the nose, snub nose, excessively wide wings of the nose or elongation, etc. Operations are carried out using two methods: closed and open. In the first case, the incisions are made on the front of the nose, in the second - inside the nasal cavity, under the wings. Currently, we perform one-stage surgical intervention, the so-called septorhinoplasty, for deformation of the external nose and curvature of the nasal septum under the control of a microscope and endoscopes.

— How are the preparations for the operation going?

— First, we invite the patient for a consultation, examine the functions of external respiration, intranasal structures, the nasal septum, assess the degree of curvature, and the condition of the skin. Photography in standard projections reveals contraindications to surgery. If all is well, the patient undergoes all the necessary tests.

- What method is used to relieve pain?

— The operation is performed under general or local anesthesia, depending on the wishes and general condition of the patient.

— How does the operation itself proceed? How long do you need to stay in hospital?

— You will be admitted to the hospital on the day of the operation and will undergo a short preparation for it. The duration of the operation is on average 1.5 - 3 hours, depending on the complexity. After the operation, a plaster bandage is applied to the nose for 7-10 days, and in order to fix the nasal skeleton in the correct position, tampons are inserted into the nose, which are removed after 1-2 days. Incisions in the skin and mucous membrane of the nose are made in such a way that the scars formed after the operation are practically invisible, which can be detected upon careful examination. Scars are located on the column of the nose (visible part) and on the inner surface of the wings of the nose (invisible part).

— Discharge from the hospital is carried out on the 2-5th day after surgery. You will be prescribed a course of antibiotics and painkillers. To speed up healing, physiotherapeutic procedures (UHF, ultrasound, laser, microcurrent, etc.) are recommended. Usually light work is possible after 5-7 days.

After the operation, it is forbidden to wear glasses for 2-4 weeks, it is necessary to limit thermal and physical activity. You cannot sunbathe for 3 months or perform any cosmetic procedures on the skin of your nose for 3 months.

The immediate results are assessed after 3 months, and the final results - 1 year, when the process of scar formation is completed.

Doctor's works:

- Fine. Many people complain about the shape of their ears. Tell us about otoplasty.

— One of the most common indications for surgery is protruding ears, which is a disorder of the anatomical structure of the ear. Prominent ears are characterized by insufficient development of the antihelix of the auricle, partial or complete absence of its smoothness. A uniform enlargement of the auricle is also considered to be a type of protruding ears. Surgery to correct the shape of the ear can be performed on children from 6 years of age. When the patient reaches six years of age. Otoplasty will allow you to change the shape of the ears, does not leave marks, the incisions pass along the back surface of the ear and are absolutely invisible. Modern methods of otoplasty surgery make it possible to simulate cartilage tissue, forming a natural and correct shape of the auricle.

Preparation is carried out in the same way as for rhinoplasty - consultation with a specialist, contraindications are identified, and if all is well, all the necessary tests are taken. The duration of the operation is 1.5 hours. The correct shape of the auricle is formed, the wounds are sutured, and a bandage is applied. After surgery, you must wear a compression bandage for 7-10 days. The stitches are removed after 7 days, the bandage is replaced with a forehead tape, which is recommended to be worn at night for 2-3 weeks. Swelling and bruising disappear within 2-3 weeks. For the first three weeks, it is advisable to limit yourself in physical activity. It is recommended to engage in extreme sports no earlier than 6 months after surgery. Most patients return to their daily activities within 3-5 days after surgery. Children will be able to return to school in a week. The final result of otoplasty 6 months after surgery.

Doctor's works:

- And finally, blepharoplasty - eyelid surgery.

— Yes, this is a popular service, especially among women. Blepharoplasty of the upper and lower eyelids eliminates excess skin and fatty tissue and tightens weakened muscles around the eyes. The operation is usually performed under local anesthesia and lasts 1-1.5 hours. To make the scar invisible, the incision is made in the fold of the upper eyelid; with an incision along the ciliary edge of the lower eyelid or with an incision along the inner mucous side of the lower eyelid. The suture is removed after a week, and after another week the scar is almost impossible to find. Blepharoplasty for Asian eyes

carried out in order to change the shape and shape of the eyes, giving them a “European” appearance. During surgery, excess skin and fatty tissue are removed, the epicanthus is smoothed and a fold of the upper eyelid is formed. During the day after the operation, the patient is in the hospital under the supervision of medical personnel. In the first days after surgery (3-4 days), the patient uses antiseptic eye drops, swelling and bruising disappear after (10-14 days). The stitches are removed on days 4-7. For a month, it is necessary to protect your face and eyes from ultraviolet radiation; solarium, bathhouse, and sauna are not recommended. Complete recovery occurs within 2 months.

— Thanks for the interesting interview! It is gratifying that medicine is now helping people not only improve their quality of life, but also make it more beautiful and fulfilling.

Consultations are held every Tuesday in room 39 of the clinic of the N.A. Semashko RCH from 16.00 by appointment. Phone numbers for inquiries: 430-304, 436-387, 418-779. E - mail : rkb - marketing @ yandex . ru

How much does blepharoplasty cost in our city?

I've been wanting to get blepharoplasty for a long time. I first thought about this about 2 years ago.

I went for a consultation with 5 plastic surgeons, having previously selected the best (judging by the reviews). I live in Moscow, so I was the first to visit Moscow surgeons. Not a single surgeon showed me photos of the results of the operations. Moscow people said that everything is on the site. Usually there is 1 patient with Asian eyes, and the result is not impressive: the eyelid is small, not done neatly. in some cases it turned out worse than it was. They refused to answer my request to show me, saying that the patients did not want to be photographed. How will I know if they are doing well or not? just at random or what?

1) Salidzhanov Anvar (video from his operation at the beginning of the topic). consultation is free. The clinic is located in a residential building, on the 1st floor. the staff is very friendly. in general, almost all surgeons immediately put you at ease. he performs blepharoplasty (eyelid shaping) surgery in several ways. after examining my eyes, he said that he would make 2 incisions near the bridge of the nose to tighten the muscles (since the structure of the eye is such that the muscles need to be tightened in order for the eye to “open”). when asked how to walk with scars on the bridge of the nose, he replied that all his patients walk, no one complains. covered with foundation. I somehow didn’t like this. the cost of the operation is 78,000 + they offer to take all tests from them for 2,400 rubles.

2) chest Alexander. consultation is free. The clinic is located on Leninsky Prospect, in a good area. The clinic has a luxurious renovation. I studied with Salidzhanov. After looking and feeling the eyes for a long time, the surgeon refused to perform the operation. He said that the structure of the eye is such that it is impossible to perform surgery. advised me to go to Salidzhanov, maybe he would agree. and I already had the cost of the operation slightly lower.

3) mouraova larisa (speak clinic). The clinic is located on Smolenskaya, in a residential building. consultation is paid, 2000 rub. I immediately agreed to have the operation. I had to persuade me to look at my eyes, she drew me with a felt-tip pen what the eyelid would look like. Then she gave me napkins to wipe it off. the surgeon is not at ease, I didn’t like the very attitude towards the patient: for them it’s like buy and sell. and immediately said that the result of the operation will not necessarily be what you expect. 82000 rub.

Then I went for consultations in our city, in UU.

4) Bazaron Alexander. consultation is free. showed a photo of a girl who had surgery 4 years ago. What I didn’t like: the operation was done a long time ago, but the eyelid still continues to “drop.” those. the stitches were so thick that it took a long time for the eyelid to droop, the result will be in about 2 years. but in general, the operation was done carefully, but the fact that the eyelid took a long time to sag did not make me happy. Walking around for 2 years with swollen eyelids is a bleak prospect.

5) Valentina Radnaeva. consultation 600 rub. Several friends had surgery with her, so I could follow the progress of the recovery step by step and see the result. After all the consultations, I didn’t really have much to ask; she explained how the operation was done. and I agreed to do it with her.

In general, I planned to go to Korea to the jw plastic surgery korea clinic. I spent a long time monitoring and selecting clinics. there are a lot of them. in Seoul there is a whole area of ​​these clinics, so after the operation you can go for a walk on the street, everyone there is special for this purpose, I met 2 Singaporeans who went to Seoul to have an operation. Korean women don’t particularly like to talk about operations, unless the horror story has turned into a beauty, but Singaporeans don’t see anything in it and happily share information. The cost of the operation starts from $800. It depends on your particular eyelid. The consultation can be completed online. The reviews about the clinic are the best, the Singaporeans provided me with photos of the stage-by-stage healing, I was happy with everything. but after the dollar soared, the trip was frozen indefinitely.

I passed all the tests for the operation and came. Bring slippers, sunglasses and pajamas (or tracksuit). It's a little cool in the operating room. Before the operation, it seemed to me that it was nonsense to lie for about 1 hour on the operating table, but only when you lie down on the table and they wipe your eyes with a disinfecting solution, you understand the seriousness of the situation. I had watched surgery videos a million times before, and everything seemed quick and easy. in real life it’s not like that: you go into the operating room, they give you shoe covers (like huge socks), you put them on, they give you a headscarf, you tie them up. braid the braid in advance, but not tightly. then you go in, lie down, and the nurse adjusts the height of the table. then they rub their eyes and stick a painkiller into the left eye. the needle is very thick. hurt. You lie there, an incision is made in your right eye with a scalpel, then the vessels are soldered with a laser, it doesn’t hurt, but it’s not pleasant. then they cut out the fat and tissue and place it on your cheek. Tweezers and a clamp holding your subcutaneous fat flash before your eyes. the lamp shines directly into your eyes. the fabric covers my nose, I try to focus on the fold in the sheet. They ask you to look down and up several times. nurses casually discuss their daily family affairs. Nobody pays attention to you. time seems like an eternity. then they start stitching it up. when the thread is passed through the cartilage, it is painful and unpleasant. The thread appears bright blue in the light of a lamp. Finally the eye was sewn up. they stick a painkiller into the right one. The left one is being stitched at this time. then they do the same with the right one. It seemed to me that the right one took less time. Several times, in a fit of despair, I wanted to jump up and run away. but one eye had already been cut, and the operation was completed. you are asked to sit down slowly. You can see your eyes in the reflection of the surgeon's glasses. remember them. This is how they should look in the final version. then cover it with a plaster. I started to shake. from tension, apparently. I held back as best I could during the operation and lay there like a corpse. The more you jerk during surgery, the longer it will take. therefore, you need to relax as much as possible, not twitch, not speak, and strictly follow the surgeon’s instructions. I sat in the room for a while. very difficult to get dressed. my head is a little dizzy. I came home and I looked the same, only there was a band-aid on my eyes. In the evening, my eyes began to swell; 6 hours after the operation I removed the patch. For some reason they told me to wash my eyes with a safeguard. I sat down on the bathroom floor from the shock of pain. very painful. Safeguard stitches hurt like hell. Once you wash your eyes, it becomes a little easier. the skin softens. I washed it 6 times. Then the skin tightened and the pain came again. took a painkiller. The temperature rose at night. eyes swollen. very much. It seemed as if the skin was stretched to its maximum and was about to burst. the eyes do not close completely. I fell asleep sitting for 2 hours. Every 2-3 hours I washed it with water or soap. On the 2nd day the stitches are pulled, the eye still does not close, the eyes are even more swollen. There was a small bruise under my eye after the operation, but it disappeared. Some doctors recommend walking and some recommend lying down. I feel it’s better to lie down. At night I managed to fall asleep for 6 hours, I put 2 pillows under my head. on the 3rd day the tumor began to fall off. The eyes also do not close completely. I can’t look straight. I've been listening to audiobooks all this time. I don’t know how people ran and went to work after the operation, I could barely drag my feet around the apartment. On the 4th day in the evening I went and made a circle around the house. the skin on the eyelids seems to have stretch marks. On the 5th day I slept 8 hours, as usual. the eyes don't close either. The stitches were finally removed. the blood on my right eye was a little dried, the thread was pulled out along with this blood, I was left with a wound in this place. Blood began to flow from the holes where the stitches were. eyes close. hooray! I barely made it home. I slept all day. my eyes were swollen again. In the evening the temperature rose. All this time I washed my eyes with a safety guard and blotted them with gauze wipes. In general, it is very difficult to wash. I haven't washed my hair for 5 days. I took a warm bath just to wash off the sweat. On the 6th day the eyes were slightly swollen. on the 10th day there is almost no swelling, I can look straight. on the 12th day I put on makeup and went public.

After the operation, you can immediately see how well the work was done. I didn’t rush the healing, I didn’t spend hours looking at myself in the mirror, it was clear that the work was done well, the seams were even, there were no bruises or bruises after the operation, it was stitched up neatly, the eyelids looked absolutely the same.

Today is day 14. the result is higher than my expectations. I didn't expect anything supernatural. the eye “opened”, the entire pupil became visible. It hurts a little to make noise. the sensitivity of the eyelid disappeared. Because of this, I don’t react when a speck of dust, for example, lands on an eyelash or the wind blows. but sensitivity should return with time.

I hope my story will help other girls make their decision. because when I was looking for information about the progress of the operation and in general information about where and how, how much the operation is performed, it simply wasn’t there, so I had to do my own “investigation.” Here in Ulan-Ude they do it no worse than in Moscow, St. Petersburg and Seoul, with an understanding of the specifics of the Buryat eye shape. the price and name of the clinic (surgeon) do not always correspond to the quality and expectations.

Below are photos after and before the operation, I like the result. Previously, the eyelashes were “hidden” and looked down.

it is necessary to soberly assess the possible outcome of the operation. here it’s not just about the surgeon and the postoperative period, but about the “source material”: the size of the eye socket, the age of the skin (elasticity), the length of the eye section. Very

Indications

• Congenital or neurological ptosis (drooping) of the upper eyelid;
• blepharochalasis (appearance of folds on the skin of the upper eyelid);
• fatty hernia of the eyelids (protrusion of fatty tissue in the area of ​​the upper and/or lower eyelid);
• drooping of the outer corners of the eyes;
• dermatochalasis (loss of tone in the tissues of the eyelids, leading to the appearance of sagging, wrinkles, “bags” under the eyes, etc.);
• entropion of the eyelid (pathology in which the eyelashes are directed towards the eyeball);
• spasm of the orbicularis oculi muscle;
• change in the shape of the palpebral fissure (eye shape);
• elimination of the consequences of eyelid injuries.

Contraindications

• Inflammatory eye diseases;
• dermatological lesions of the periorbital space;
• exophthalmos (bulging eye syndrome);
• myopathy of the eye muscles;
• increased ophthalmotonus (intraocular pressure);
• xerophthalmia (dryness of the conjunctiva and cornea);
• filler injections;
• increased intracranial pressure;
• acute infectious diseases;
• blood clotting disorders.

Treatment

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