воскресенье, 11 июля 2010 г.

Russian plastic surgery is dangerous

Today, plastic surgery remains one of the most unregulated areas in Russian health care. However demand increases and the number of problem cases, some of which are fatal: just the other day led to the death during trivial liposuction.

Russia is booming plastic surgery. Paradoxically, this is not the richest country in Europe, however Russia stands at fifth place among countries with the highest level of plastic surgery operations. Today, market players are already talking seriously about the seasonal increase in demand for such operations: during summer season the number of clients in local clinics traditionally increases.


Russian market of plastic surgery is relatively young. Most of private clinics were opened only in the late 90-s, as well as a separate market segment of plastic surgery. It is right to say that until last year Russia even did not have specialists in plastic surgery.

A real top professionals with experience back to Soviet times are located mainly in Moscow , and come from reconstructive and rehabilitation departments of major medical centers .

The fact is that in Soviet times, plastic surgery was not known. Only the largest hospitals had offices of reconstructive surgery, where plastic surgery performed only by medical necessity - for example, for recovery from serious injuries or accidents. At the same time, most of the procedures that in the public mind are strongly associated with plastic surgery (face lift, wrinkle removal..) in fact, belongs to the so-called aesthetic surgery. Similar manipulations in the former USSR were carried out only in one place - in the Institute of Beauty on Novy Arbat, Moscow. However, to get there, patient was required to have medical prescription. It was impossible to call the clinic simply because the patient did not like his nose.

As a result, the market of plastic and aesthetic surgery in Russia during the past years was developed spontaneously or chaotically. It is illustrative to to say that even today there is no official statistics on the number of officially registered health care institutions providing plastic surgeries. There is also no exact data of how many and what kind of operations conducted were in Russia. The cardinal change in the situation occurred only last year, when Health Minister officially introduced a profession of "plastic surgeon".

"Today in Russia there is practically no legitimate plastic surgeons certified. In order to do this we need to take appropriate educational standards ", - states the head of reconstructive surgery and microsurgery of RNTSH, Academician Nikolai Milanov.

While officials and the official medical community still wonder how the system would operate training and certification of future plastic surgeons, thousands of professionals already working for many years throughout Russia, creating a private clinic and taking patients. Nowadays Russian media are full with advertising of such institutions with each of these naming themselves as "leading" industry experts. In reality it often turns out that a significant number of such leadears are surgeons, who made appendicitis cuts in local city hospital.

The result of this situation are numerous unsuccessful operations, despite the fact that Russian world of plastic surgery is so closed that even today there are no official statistics on the number of operations, and on number of the fatal operations. In early June, we received information about 27-year-old Louise S., who died after banal liposuction procedure. However legal consequences of this are still not clear, since according to law, criminal proceedings will be possible if medical examination would conclude that the woman died as a result of medical errors. So far, the autopsy showed that the patient died because of an allergic reaction to one of the drugs used for anesthesia.

The difficulty in investigating such cases is that the majority of patients before surgery did not take care about what they would do in case of failure and just easily sign a document with the words "warned about the possible risks."

In fact, "such informed consent" implies that a physician informs fully the patient about all possible risks. But in the pursuit of profit, most Russian plastic surgery clinics choose to bring to the information in the most simplified form, emphasizing the fact that these procedures are absolutely safe for health. Meanwhile, one should bear in mind that even a face lift has a very impressive list of contraindications.

According to the Moscow City Bureau of Forensic Medical Examination, about 7-10% of all civil cases against health care institutions accounts for unsuccessful plastic surgery. However, the success of the trial in such cases is highly questionable. To prove medical error patient must provide the results of medical examination conducted by colleagues of a surgeon who made a mistake. So to get objective results is not a simple task.