Endoscopic techniques have been widely used in the practice of plastic surgeons for quite a long time. For patients who turn to a specialist in aesthetic medicine for the correction of appearance, the formation of scars after surgery plays a particularly important role. Endoscopic technologies provide minimal tissue trauma and the best aesthetic result. However, these methods have their own characteristics, which Pasechnik Vasily Vasilievich, a speaker of the Visiting Professor Program II conference, candidate of medical sciences and a surgeon of the highest category, spoke about in an exclusive interview for estet-portal.com.
Vasily Vasilyevich, tell me, how widely do you use endoscopic techniques in your practice?
Endoscopic techniques – these are not new technologies, as they are widely used in surgical practice. They help to solve many issues related to maintaining the integrity of the skin, which is quite important for plastic surgery.
Endoscopic surgery appeared in our country in 1998, and in 18 years we have reached a fairly high level, which is not a shame to show to foreign colleagues, who had these technologies a little earlier.
As far as I know, what we know how to do can not be repeated in all foreign clinics.
Today, volumizing techniques are widely used for face correction. In your opinion, what are the main advantages of lipofilling over synthetic fillers?
Synthetic fillers and natural fat are difficult to compare. To correct volumetric problems with the help of fatty tissue, you need an operating room, anesthesia or a fairly pronounced anesthesia, an invasive technology that is associated with bruises, and so on. The advantages of this method – these are large enough volumes that we can inject and thus correct large areas, as well as a minimal risk of allergic problems and incompatibilities. Of the synthetic fillers, preparations based on hyaluronic acid are currently widely used, which can be administered in a consulting room. To do this, the specialist does not have to be a surgeon, and this technology is more accessible to both doctors and patients.
Please share with our readers your experience of fixing the position of displaced tissues during endoscopic facelift?
The importance of fixation that we now see in our practice determines the aesthetic result that we want to see in the patient's face and its longevity. In endoscopic practice, there are a lot of nuances that do not allow for the classic conventional fixation of tissues, as in open facelift, when we pull up large arrays and fix tissues along a fairly wide line on the opposite side of the incision. In endoscopic surgery, we deal with small incisions – 1-2 cm, and it is not possible to remove these excess tissues. It is necessary to shift the entire array, as a result of which we face the problem of what to attach the tissues to. These techniques are based on planar fixations, that is, to deeper layers. We encountered this at the first steps of mastering endoscopic technologies, and did not find a single technique that would fully satisfy the requirements of surgeons and patients. Therefore, we were forced to come up with our own methodology, which later turned out to be quite adequate and logical.
In your opinion, are endoscopic techniques currently replacing traditional facelift methods?
Endoscopic surgery is quite specific, both in terms of application to the patient and in terms of complexity for the surgeon. In order to be able to operate endoscopically, the surgeon must know and understand where he is and go through all these steps in an open manner. The second moment – this is a rather complex and expensive equipment that is used, and, accordingly, the surgeon must have experience with it.
For patients in the younger age group, endoscopic techniques can practically replace the classic open techniques, given that there is no large tissue excess and sagging.
At an older age, we can also use endoscopic technologies, but we have so much excess tissue that we have to cut them off, respectively, we are again returning to the classic version of the operation.
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