Aesthetic surgery at Medicus Alpha – a standard of quality and safety

Surgical augmentation of the breasts is the most popular plastic surgery in world scale. A research held in 2016 by the International Association of Plastic Surgeons in 30 countries shows that breast augmentation occupies 15 % of all aesthetic surgical procedures, and second ranks by only one percent less, the liposuction procedures. Most often aesthetic surgery is resorted to at the USA, Brazil and South Korea, with about 15 % of male patients.

Precise statistics is not available for Bulgaria, however the empirical data at Medicus Alpha Clinic shows that trends among the Bulgarian population do not differ from the world’s. Our professionals always remind that although aesthetic, each of these surgeries requires the high competence of the medical team in order to attain the best result an minimize the possible risks for the health.

Dr. Gospodin Zhelev has 30-year of experience, being one of the first plastic surgery professionals in Bulgaria. Besides his practice at Medicus Alpha Clinic, he has worked for many years at the burn injuries clinic in Plovdiv, he is qualified in General surgery as well as in Repair and aesthetic surgery; member of the Bulgarian Association of Burn Injuries and Plastic Surgery; the Bulgarian Association of Plastic, Reconstructive and Aesthetic Surgery, and other international professional organizations.

How long have you been practicing plastic surgery?
I started at the Burn injuries clinic in 1987 as a young physician, and soon after that I did a specialization in Sofia. I took simultaneously two majors: General surgery and Plastic, reconstructive and aesthetic surgery. Since 1993 I have been practicing aesthetic surgery.

What surgeries do you most often do?
Among the most common surgeries is the breast augmentation. In some cases plastic surgery is necessitated by purely medical reasons leading to serious aesthetic issues – mammary gland hypoplasia, breasts tuberculosis, severe congenital asymmetry in the size and shape of the two breasts of a patient, etc. Not rare are the breast reduction and lifting up surgeries in cases of large, heavy or sagging breasts, which besides the aesthetic deformity cause spinal curvature and back pain, skin inflammation and maceration, etc. Recently, liposuction, correction of the abdominal wall, face, nose, eye lids, ears, genitals are gaining popularity. Intriguing is the tendency that male patients willing to have plastic surgeries are not an exception any more.

Isn’t it quite different to cure a burn injury and to augment breasts, for example?
Indeed, the difference is great, however these are both part of my job.
Nowadays breast augmentation is the most popular surgical aesthetic correction done. Years ago I used to recognize my patients by the voice when I hear them on the phone, now I am unable to do that – their number has grown to thousands. At the beginning of 90’s this surgery was still a kind of exotic. At that time we had to provide to our patients the special underwear that must be worn after breast augmentation or liposuction, I mean, years ago, in 96-97. This type of intervention requires special care for months on – the bra needs to be enforced underneath, the cups have to be comfortable, straps and clasp – variable so that it adheres precisely to the shape and protects to the maximum the operated tissue.

How is assessed the best size for the particular patient in breast augmentation?
The balance between what the patient fancy and that which is practically feasible without compromising safety and suitability is important. We’ve had cases when the patient wishes to have the same breasts as a given actress, for example, but this is not always possible whatever the surgeon may do. I have to measure the breasts, the rib cage, then make the calculations, and yet it means nothing to the patient. To be able to visualize for her the outcome of the surgery, we use silicone attachments called sizers. They are placed in the bra with an elastic t-shirt put on for the shape to be outlined which allows the patient get an idea how different sizes and shapes of implants would change her appearance.

Don’t you use computer aided design?
Computer design is not realistic and only provokes in patients expectations that are not supported by the specifics of their body. Implants may vary only in shape, while size remains the same, and the hight and protrusion of the breasts depend on the shape. These characteristics need to be considered for the particular patient individually – whether she is tall or short, her waist expressed, or her hips well shaped… The aim is to form a harmonious and beautiful silhouette, and this may not be measured in centimeters and grams.

Is it safe?
Breast augmentation silicone implants have been used for more than four decades and according to world statistics, occurrence of breast diseases, including breast cancer, is presented equally in patients with implants and those without. At Medicus Alpha we use implants produced by worldwide leading producers, and the quality warranty are the thousands of contented women. Besides, our clinical safety protocol requires before surgery patients to undergo full preliminary examination and laboratory tests, including echo-mammography made with the highest possible image resolution. Health is on the first place, after all.

Have you ever refused a surgery to a female patient?
Certainly, although I usually succeed to convince them by comprehensive explanation of my grounds. There have been several cases of extremely slender girls who want to have their breast augmented to a very large size. I’ve had also adult patients, both male and female, with completely unrealistic and unfeasible wishes and expectations. It would be unprofessional to suit their whims, compromising the quality and safety standards in my profession. There are aesthetic and professional boundaries that are not to be trespassed.