Plastic Aesthetic Surgery in Russia the Past and the Future

Development of plastic surgery in Russia is closely associated with the name of the great Russian surgeon, N.I. Pirogov. It was he who first paid attention to the aesthetic results of surgery on open areas of the human body. In his famous book, Basis of General War Field Surgery, he touched on the topics repeatedly. One of his followers wrote the thesis on rhyno-plasty. In 1865 another brilliant follower Y.K. Shimanovskii published the first manual in the world for practical surgeons, Human Body Surface Surgery, for which he was awarded the I. Bush prize. This unique book contains more then 150 drafts and schemes of plastic surgery procedures made with the author's own hand, many of them still significant.

A little bit later in 1869, the young Russian surgeons (S.M.Yanovich-Chainski, A.S. Yatsenko, P.Ya. Pyasetskii) took up the idea of J. Reverdin concerning free transplantation of autodermal microflaps for closing wound defects and implemented the experience in Russia. In 1898, K.P. Suslov worked out the original method of the elimination of nose defects by transplantation of free skin-cartilage transplants from the ear.

Unfortunately, during the first decades of the twentieth century, there were three revolutions and the First World War, which did not favor the development of plastic surgery in Russia. Nevertheless, in 1916 the worldwide recognized work by V.P. Filatov was published. The work was dedicated to the results of using of round fat-dermal flaps developed by V.P. Filatov. This method was the only opportunity of tissue complex transplantation right up to the second half of the twentieth century when flaps with axial blood supply came into use. Other famous Russian surgeons who played an important role in plastic surgery development are: P.I. Diakonov, N.A. Bogoraz, A.A. Limberg, A.E. Rauer, B.I.Vozchek, B.S. Preobrazhenskii, I.M. Mikhelson, and many others.

After World War II, a special system was organized for the treatment of burn patients; this played a particular role in the formation and development of plastic surgery in Russia. During this research and organization work several generations of plastic surgeons grew up, who have a good knowledge of the most up-to-date methods of free and local skin plastic surgery procedures, including those using microsurgery. The methods of skin reconstruction by means of different variants of combined autoallodermaplastics were developed and implemented. The most significant names in this field were Y.Y. Dzhanelidze, T.Y. Ariev, M.I. Shraiber, N.I. Atiasov, B.S. Vihriev, and others.

In 1930, in Moscow increasing interest in plastic surgery led to the creation of the Institute of Beauty, which is now called the Institute for Plastic Surgery and Cosmetology. In 1961 a similar clinic was opened in Leningrad. In the following decades this tendency developed rapidly, and now in Russia there are hundreds of centers working in the field of beauty surgery.

At the end of the last century, many specialists understood that plastic surgery is an independent and complex specialty that requires the long-term education of individual surgeons. That is why at the end of the 1980s and the beginning of the 1990s in Moscow the first structure for the training and retraining of plastic surgeons was included in the system of continuous medical education. In 1997 at the Saint Petersburg Medical Academy of Postgraduate Studies, the first special department and clinic for plastic and aesthetic surgery was created. Specialists in this department have experience in all methods of plastic surgery and educational work. The department provides long-term programs for the basic training of young specialists (3-5 years) and short-term programs for continuing medical education. The intensive research work of the departmental staff allows training programs to be refreshed and ongoing improvement of the surgery procedures.

All of the above means that the education of plastic surgeons is continuous and that their professional level is constantly renewed. The following events have favored the development of plastic surgery in Russia: creation of the All-Russian Society of Plastic, Reconstructive and Aesthetic surgeons; publishing of several periodicals; organization and holding of scientific conferences, seminars and master-classes in different regions of Russia; constant contact with international societies of plastic surgeons.

My colleagues and I believe that aesthetic surgery in Russia has a great future.

Professor S. Malakhov Head of the Clinic for Plastic and Aesthetic Surgery Saint Petersburg Medical Academy of Postgraduate Studies, Russia

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