On October 21-23, St.Petersburg will host the 4th International Live Surgery & Injections Course dedicated to state-of-the-art aesthetic surgery and medical cosmetology. This high-profile event is intended exclusively for professionals, but the new techniques on the agenda will soon be offered to us, aesthetic medicine consumers. We met with Dr Vitaly Zholtikov, PhD, plastic surgeon, director of the course, chief of medicine at the Plastic Surgery Department of Atribeaute Clinique, to talk about the canons of beauty, latest breakthroughs in plastic surgery, and the reasons why not everybody needs it.
– Dr Zholtikov, you are one of the few plastic surgeons who openly say that plastic surgery cannot become a mainstream trend because many people need no such interventions. According to some of your fellow surgeons, plastic surgery has become such a simple and routine affair that everyone with a grain of self-respect must improve something about his or her look.
– I perform a lot of revisions fixing other surgeons’ mistakes, and therefore I will never say that plastic surgery is simple or easy. It should not become routine either: it is not at all like buying a new dress. In fact, few people need plastic surgery.
They are perfectionists who build their own world guided by the top standards. They strive for perfection in everything, including their looks.
Some of them want to correct natural imperfections, others need to reconstruct their body after an injury, disease, or childbirth, still others are eager to freeze ageing, or maybe they look older than they are and find that it hinders their public or business activities. Besides, plastic surgery often solves psychological problems, eliminating not only aesthetic imperfections but also complexes and low self-esteem, thus improving well-being.
– It is important to choose the right plastic surgeon. Are there any helpful guidelines in that regard?
– Yes, they are very simple: ask a doctor you know for a reference. Your cosmetologist is your best bet. Top experts are well-known in the medical community. The second step is to look at some of the patients who had surgery performed by that doctor, talk to them on social media. Ours is the age of references, and word of mouth is your best and most reliable source of information. Finally, book a consultation, see if you trust the surgeon, consider the solutions offered to you. For example, I only see patients who request specifically my services, and it has been a long time since I adopted this practice. In my opinion, this rules out whims and spur-of-the-moment choices influenced by the latest trends. These patients have made a conscious decision and really need my help. Still, I often find myself dissuading them when I see that the problems they are trying to solve with plastic surgery are inner calamities rather than outer imperfections.
– Beauty is in the eyes of the beholder. How can you determine whether the doctor shares your aesthetic preferences?
– It is a misconception. We all perfectly understand what is or isn’t beautiful. We all like the same celebrities and models, regardless of nationality and race. Our brain automatically reads facial traits and compares them to a universal standard, infallibly differentiating between beautiful and plain faces. There are shared beauty criteria, and all of them have been described. There are countless scientific papers spelling out every little detail of each portion of the face. They are taken into consideration in plastic surgery. For example, I take about 20 measurements for rhinoplasty. A guru like Rick Davis takes up to 70, checking all the proportions, angles, slopes, distances, and even shadows…
– If the operations are based on universal calculations, does it mean you also get universal outcomes where everybody looks the same?
– In the past, when surgeons had just a couple of techniques to choose from, the resulting faces could be very similar. Today, I use between 15 and 20 techniques in each operation, choosing an individual combination for each patient, taking into account the unique starting point created by nature.
Yes, our goal is to change a specific face towards universally recognized beauty, the perfect proportions. But every time we create a new code of beauty with an immense number of inputs, and the outcome is unique every time.
It’s like DNA: there is just one set of chromosomes, but we are all very different. Therefore cookie-cutter results are out of the question. Like I said, modern plastic surgery can be neither simple nor routine.
– In other words, plastic surgery is a matter of technology rather than an artistic process?
– Definitely. Our field has experienced fundamental changes over the last 10-15 years. Even some of the things that were normal just five years ago are now hopelessly obsolete. Today, any operation involves detailed standardized technologies that let us forecast outcomes with 90-95{676c6ba72d5d0a7a659833ca743bcc2c228e448d536d4d3c3d4efcbe81211187} accuracy.
It is impossible to perform all kinds of operations equally well, so every doctor picks a speciality and keeps improving his or her craft. Niche expertise is a worldwide trend.
You need to keep up to date with everything in your chosen niche: latest findings, research, knowledge shared by fellow surgeons from all over the world. That is why events such as the one we are hosting are vital: they provide an opportunity to see international experts’ outcomes and learn from them.
– In other words, a doctor’s education is a lifelong endeavour?
– It is the only chance to remain competent. In the West, there is a point-based accreditation system where a doctor’s rating depends on the events attended, papers published, and techniques learned.
Here, on the other hand, all you were required to do until recently was attend a formal professional development course every five years and otherwise just use knowledge from medical school. Fortunately, this system is being phased out. Next year will see the introduction of a new motivation system encouraging participation in seminars and conferences. I hope our Live Surgery & Injections course will be included in the list of recommended events.
For me personally, constant learning has been the norm since medical school. As an undergraduate student, I already attended seminars and studied the work of international experts because I felt that my knowledge was insufficient for professional improvement. I was lucky to get the best medical education in St.Petersburg: I studied at the Military Academy of Medicine and the First Medical Institute, and got my PhD at the Mechnikov Institute. I had excellent teachers, such as Andrey Nekrasov and Natalya Turkina. Then again, in that epoch, my teachers often had to learn along with me. Things were changing too quickly when plastic surgery was becoming a medical profession in its own right.
– Now that you train your fellow surgeons, is professional development still a necessity?
– Of course, otherwise you would plateau. For example, right after our course, we are going to Japan for a congress. Overall, the doctors at our clinic are required to attend at least 10 professional forums a year.
– You practice daily, teach, attend events. How do you cope with such a workload? Do you ever get a chance to relax?
– Travel is my relaxation. Even if my schedule is full, I always find a couple of days to go sightseeing and get to know new destinations. A change of scenery is in itself beneficial. As to vacations, I like to visit natural reserves together with my friends. We went fishing in Kamchatka two years in a row, and now we are just back from Lake Baikal. Those places are fantastically beautiful and deserted, exactly what you need to distance yourself from the everyday and recharge your batteries.
– It is our magazine’s tradition to ask, what is your idea of perfection? It is very interesting to hear the answer of a famous plastic surgeon, a beauty expert.
– In a person, perfection is a multitude of flawless traits. Nothing is secondary here: personality, intelligence, sense of humour, taste, manners, education, everything should be great. It’s a diamond with many facets, and plastic surgery can perfect only one of them, the look. You need to put abundant effort in the other aspects as well.
Olga Nikonova for Perfection