One of the most important components of every doctor's success is continuous training. This is especially true for specialists in aesthetic medicine, which is progressively developing and constantly offering new methods and approaches. Ukrainian plastic surgeons received a unique opportunity to gain new knowledge in the field of breast correction. On May 13, 2017, an interactive international master class on breast augmentation from the Allergan company was held in Kyiv, with the support of the National Medical University named after A.A. Bogomolets, with the participation of a plastic surgeon from Sweden, Chairman of the Board of the Allergan Medical Institute for Plastic Surgery, Dr. Charles Randquist. Read an exclusive interview with a leading specialist about the secrets of successful plastic surgery on estet-portal.com right now.
Dr. Randquist, could you share your impressions about Ukraine?
I have been to Ukraine before: in 2012 during the European Football Championship, and also several times after that. I really liked your country: excellent cuisine, very friendly people, I feel very comfortable here. Thank you for your question.
How do you rate the level of plastic surgery in Ukraine?
This is a very difficult question. According to statistics, Ukrainian plastic surgeons predominantly use "410" style breast implants, which are quite difficult to work with, but at the same time provide excellent results. I have not seen Ukrainian plastic surgeons at work, however, they have visited my clinic in Stockholm (Sweden). And by the way and what kind of questions they ask, I can tell that your plastic surgeons have a very high level of professionalism and they are eager to constantly improve their skills.
Today you presented a paper on "Good Practice Practices for Breast Surgery Using the 5P Principles". Can you tell us more about these principles?
The concept behind the "5 P’s" ("5P") principle is to achieve the best short and long term results of breast augmentation.
The 5Ps are based on training in patient selection, proportionate thinking, planning, operation and post-operative care.
All these "5Ps" are combined to create a better environment for plastic surgeons, which allows them to correctly select patients for surgery. There is no perfect breast implant for every patient, just as there is no perfect implant for a doctor. There is also no ideal patient for every doctor. Therefore, the future depends on the doctor's ability to choose the right patient for the right implant, and even on his ability to recognize that sometimes the best operation – it is her complete absence. Therefore, the core philosophy of the 5P principles is to be able to achieve the best results for patients, based on safety considerations.
What is your concept and unique approach to plastic surgery in general?
I believe that running a private clinic requires taking into account certain ethical, moral and philosophical aspects. The ability to form a concept based on the words "I don't do this" creates an environment for your staff and patients, defines who you really are, your starting point and end goal. It is important to make it clear to patients that the doctor does not do absolutely everything, that his philosophy is based on certain principles that have something in common with the principles of the patient himself. My responsibility as a doctor is to be able to understand the wishes and expectations of the patient, as well as her intellectual ability to understand and comprehend the things we are talking about, as well as to choose the best procedure or operation to satisfy the patient's desires. If I do this with minimal risk of complications and reoperations, I will create the best possible foundation for both short and long term results. This is my passion, my calling. The most important thing for me – to build the trust that the patient expects and deserves, and in no way abuses it, in order to always be an ethical doctor.
Which access, insertion method, and which implants do you prefer to use for breast augmentation?
I tried different options: I did breast augmentation through an axillary incision, blindly, I also did endoscopic procedures, I did periareolar incisions. I now predominantly use the submammary incision for access because, in short, this approach provides more control over the pocket than, for example, an axillary incision. Also, the breast incision allows me to better control the lower crease, which I think is very important for bust beautification.
I prefer the inframammary incision over the periareolar incision as it minimizes the risk of bacterial contamination, which is very high with the periareolar approach.
I usually choose submuscular placement of implants because denser, cohesive implants can lead to tissue thinning over time. When it comes to implants, I choose the ones that I think are best for a particular patient. As I said before, there is no perfect implant for all patients or doctors. Therefore, if the patient needs an implant that gives shape to the breast, for example, in the case of a breast with a constrictive lower pole or breast aplasia, if she has good tissue and skin quality, I prefer to use more cohesive implants (style "410"). Sometimes they allow me to perform miracles. Also, such implants allow me to correct the pronounced asymmetry of the breast, since the "410" implants – matrix of various heights, projections and widths. They allow me to paint in multiple colors instead of just black and white. There are also cases when patients do not need a shape correction, but an increase in breast volume. In this case, I prefer to use softer, round implants that create the desired fullness of the breast. Some patients wish to enlarge the upper pole of the breast. To do this, I use an implant with a large amount of filler in the upper pole, in most cases, these are round implants with a more pronounced projection. Thus, I do not use only one type of implant. I don't think there is a key that fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.
There are also cases when patients do not need a shape correction, but an increase in breast volume. In this case, I prefer to use softer, round implants that create the desired fullness of the breast. Some patients wish to enlarge the upper pole of the breast. To do this, I use an implant with a large amount of filler in the upper pole, in most cases, these are round implants with a more pronounced projection. Thus, I do not use only one type of implant. I don't think there is a key that fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.There are also cases when patients do not need a shape correction, but an increase in breast volume. In this case, I prefer to use softer, round implants that create the desired fullness of the breast. Some patients wish to enlarge the upper pole of the breast. To do this, I use an implant with a large amount of filler in the upper pole, in most cases, these are round implants with a more pronounced projection. Thus, I do not use only one type of implant. I don't think there is a key that fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.
which create the desired fullness of the chest. Some patients wish to enlarge the upper pole of the breast. To do this, I use an implant with a large amount of filler in the upper pole, in most cases, these are round implants with a more pronounced projection. Thus, I do not use only one type of implant. I don't think there is a key that fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.which create the desired fullness of the chest. Some patients wish to enlarge the upper pole of the breast. To do this, I use an implant with a large amount of filler in the upper pole, in most cases, these are round implants with a more pronounced projection. Thus, I do not use only one type of implant. I don't think there is a key that fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.
which fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.which fits all locks. I am convinced that we must take an individual approach and choose the right product for the right patients.
Tell us about Allergan Medical Institute: what are its main objectives?
Allergan Medical Institute – an amazing idea because it allows me and other leading professionals from all over the world to travel, share experience and train doctors. I was put in charge of the plastic surgery direction at AMI. This allows me to share knowledge with doctors around the world, based on the principles of "5 P", both in individual events where I teach alone, and on a large scale – when AMI events provide training in reconstructive surgery, the use of toxins, fillers and various new products presented by Allergan. However, the main goal of the Allergan Medical Institute is to increase the level of knowledge and awareness, which ultimately means a higher level of patient safety, What would you wish to Ukrainian plastic surgeons? I find it very important to read the scientific articles and publications that are available today. I am convinced of the need for data-driven learning. A lot has been done and said today based on experience, and that's good – practical experience plays an important role. However, there are certain principles that provide short-term and long-term assessment and safety based on scientific publications that are peer-reviewed, scrutinized, challenged. And if they contain guidelines that help the surgeon improve his work and provide better results for patients, they must be followed, they must be believed. In my opinion, it is arrogant to assume that the things we do based on personal experience alone do not limit our mind. That's why, I advise you to read the latest scientific papers and improve your practice – it will make you more successful.Share:
Add a comment