Learn about breast enlargement in Prague, breast augmentation abroad and various types of silicone breast implants. Breast enlargement or breast implants are an ideal solution for many women with small breasts.

Breast augmentation abroad, also known as breast enlargement, involves the surgical placement of an implant behind each breast to increase its volume and enhance the breast’s shape. Breast augmentation is requested by women who perceive their breasts to be too small or sagging.

Types of breast implants

Basic types of breast implants by shape:

Basic types of breast implants by filler:

Nowadays novelties in the implant fillings field occur regularly. Various substances are being tried and used as fillings, including soya-gel and hydrogel. These new types of implants aren’t in regular use yet.

Basic types of breast implants by surface:

Basic types by profile:

The size of the breast implants is indicated in mililitres. The choice doesn’t depend on size but on dimension. The selection depends on many factors, such as the woman’s figure, height, width of her chest, figure proportion, size of pelvis, size of mammary gland and of course, the patient’s wishes. The most popular sizes in the Czech Republic are 200 – 300ml. (Implants from about 100ml to 1000ml are available.)

To see what size might be right for you, use a plastic bag that can be filled with liquid or boiled rice. Put it into your bra to help you choose the correct implant size.

Most commonly used brands of silicon breast implants are:

All implants have their own passport – a document that states the number and size of the implant. This passport is given to every patient after the surgery.

What does the breast implant look like?

The implant is formed with an outer pocket made from polymerized silicone gum, which is very firm and elastic. The pocket contains one more inner layer, which guarantees a higher resistance to rupture and the minimum permeability of particles. The surface can be smooth, although at present implants with textured surface are preferred. They have pores of a certain size and depth and now also have a smaller risk of capsular contracture creation. A titanium film may be on the surface of the implant (which lends itself to good tolerance with the body) or polyurethane. Inside the pocket there is soft cohesive silicone gel, saline, combination of both or even one of the other substances mentioned above. The cohesiveness of silicone gel particles enables the implant to keep its shape, lowers the risk of permeability of silicone micro-particles through the pocket and avoids the possible leakage of silicone in the event the cover ruptures. The silicone gel filled implant is used most often because of the reduced harmfulness risk on the body from silicone.

Price of breast implants

The price of breast implants ranges from about 18,000 to 50,000 CZK depending on the type of implant and the producer. For round shapes, the price ranges from 18,000 to 28,000 CZK and from 40,000 to 50,000 CZK for anatomic shapes. Prices are independent of size.

Breast augmentation abroad

When choosing a surgical procedure consider the following options.

The placement of the incision:

The choice depends on the desire and preference of the patient and on the usual practice of the clinic.

The placement of the implant:

Both methods (under the muscle and under the mammary gland) have their advantages and disadvantages. The choice depends on the quality and size of the gland, the quality of the skin and the subcutis, as well as the strength and quality of the muscle. The implant coverage has to be sufficient. If it is not sufficient, the implant can be visible and won’t look aesthetically pleasing. The pre-surgery consultation is intended to harmonize the patient’s ideas with real possibilities in regards to their body proportion, and with the advice of the surgeon.

For more information about breast enlargement abroad or breast augmentation in Prague please take a look at the linked pages.

The process of breast augmentation

In most cases, breast augmentation will be performed under general anesthesia. The surgery usually takes one to two hours and one to two days stay in hospital may be needed.

The method of inserting and positioning your implant will depend on your anatomy and your surgeon’s recommendation.
The three-four cm long incision can be made either in the crease where the breast meets the chest, through the dark skin surrounding the nipple or in the armpit. Every incision is made carefully so resulting scars will be as inconspicuous as possible.

A pocket in which the implant is inserted is created through blunt tissue preparation.

Some of the clinics abroad even use endoscopic technique by augmentation. The access for this technique is through an incision in the armpit or in the navel area.

The pocket will be filled with the implant either directly behind the breast tissue or underneath the chest wall muscle.

The size of implants must be carefully chosen in order to be fully covered by the breast tissue. Otherwise the edges of the implants can be easily seen and makes for a very unnatural look.

The cessation of bleeding is very important to avoid further complications – an undesirable capsule, a scar or poor coverage of the implant.

Drainage tubes may be used for several days following the surgery; it depends on the practice of the clinic and on the surgeon.

To close the wound, different sutures are used (mostly intradermal, eventually separate;) they are removed seven to 10 days after the surgery.

How the wound is covered is also up to the practice of the clinic. After the surgery, the breasts are fixed day and night with a special bra. It is recommended to wear this bra four to eight weeks after the surgery. For one month after the surgery, sleeping on your back and limiting sport activities is also recommended.

Are you a good candidate for breast augmentation?

Breast enlargement by means of implants is a very effective procedure. It is suitable for women with insufficiently developed breasts or when the mammary gland system is shrinking, as may be the case following breast feeding or a significant weight loss.

The optimal age limit for surgery varies. It is generally done after the development of the mammary glands is complete, which is usually after the age of 16.

It is certainly better to insert the implants into breasts that won’t change by potential breast feeding. Although it doesn’t eliminate the possibility to undergo breast augmentation before pregnancy; you have to take into account that lactation and pregnancy will change the size and quality of the mammary gland and therefore the surgery will probably need to be redone. It is better to undergo breast augmentation at least one year after the delivery and breast feeding.

Breast implants have no influence on the fetus and they do not expose it to any danger. The presence of implants does not hinder the ability to breast-feed. Studies done worldwide have not found an increased content of silicone in breast milk.

Some women request the implants to be placed as close to each other as possible to create a sexy line between the breasts. Unfortunately this effect is caused by the body’s constitutionand by the distance between the mammary glands therefore it is not possible to create it on demand.

If you are physically healthy and realistic in your expectations, you may be a good candidate for breast augmentation.

Before breast enlargement

During your initial consultation, your surgeon will explain the surgery in detail. He will explain which surgical technique is most appropriate for you based on the condition of your breasts and skin tension. He/she will also show you before and after pictures and different types of implants.

If your breasts are sagging, the surgeon may also additionally recommend a breast lift. The surgeon will also inform you which implants he or she will use and which size is appropriate for you to achieve the best result.

Because it is a surgery performed under general anesthesia a pre-surgical examination including a laboratory examination and EKG by a general doctor or internal specialist is necessary. The exam should also include a detailed health history i.e. family diseases, diseases that you have had, allergies etc. At some clinics it is possible to have these examinations done in the morning the same day of the surgery.

Before the surgery it is also necessary to eliminate the possibility of breast illness by ultrasound (sonogram) or mammogram examination depending on the patient’s age. They are performed by special oncological and gynecological clinics. This is mostly done if you are a high risk patient due to a family history of breast cancer.

Your surgeon will give you instructions to prepare for surgery. You should avoid drinking and eating 6 hours before the planned surgery. Any medication containing acetylsalicylic acid (such as Aspirin, Acylpyrin, Alnagon, Mironal etc.) can increase bleeding during and after surgery They therefore shouldn’t be taken for about a week before the planned surgery. It is not good to undergo the surgery during menstruation, although it is not a reason to postpone the surgery. It is appropriate to consult your gynecologist concerning quitting birth control. Today’s opinion is to keep taking birth control pills and preventively taking medication against blood coagulation – low molecular heparin (e.g. Fraxiparin, Clexan, Fragmin.)

It is assumed that no acute illness (viral illness, cold, etc.) will have occurred in the period at least three weeks before the planned operation. Report any illness to your doctor.

If you smoke, plan to quit at least one or two weeks before your surgery and do not resume for at least two weeks after your surgery.

The day of the surgery you should come with your armpits shaved, if the surgical method has been agreed upon.  Bring any medication that you take with you for 2-3 days, hygienic items, shoes, pyjamas, ID papers, and an elastic bra without wire support that’s the same size as the chosen implants. Some clinics have them for sale. Clothes that need to be put on over the head are not suitable for the hospital stay. Putting on such clothes after the procedure might be very painful.

While making preparations, be sure to arrange for someone to drive you home after the surgery and to help you out for a day or two if needed.

The costs of the surgery are usually paid for on the day of arrival, before the procedure. An advance deposit is paid at the booking date. Everything depends on the rules of each particular clinic. Since it is an elective surgery, it’s not covered by insurance companies. It is also necessary to take some days off of work because it is not possible to receive a sickness leave.

After breast enlargement

You are likely to feel pain for a few days following your surgery. The pain is more intense when the implant is placed under the muscle. You will take painkillers for two to five days following the surgery; the pain will slowly recede.

You will probably be released from the clinic after one or two days. Before you leave, the bandages may be changed and the drains removed. That will depend on the clinic and your surgeon. The sutures are usually removed during the check-up in seven to ten days.

It is recommended to wear an elastic bra. You will usually get it at the clinic where the procedure is performed. The length of time to wear it is decided by the surgeon. It is usually 4-8 weeks after the surgery and following that, during sport activities. The surgeon may sometimes recommend a medical belt. It is usually used if the implant was inserted through the armpit, and so it squeezes the formed canal. It can also be used if placement of the implant was under the muscle, so that it pushes it downwards, and generally in other situations when the bra is insufficient. The need and length of time to wear it is again set by the surgeon.

The recommendations of breast massages after the surgery vary, depending on the clinic and the type of implant. Some surgeons don’t recommend them at all. On the contrary long lasting pressure massages of the scars are recommended. It is recommended to wash the breasts only after the wound is healed.

Stay relaxed and quiet during the first week following surgery. Have someone help you with the house and kids for the first few days.

You can resume routine activities and lighter house work in 10-14 days. It also depends on the feeling of pain. Avoid lifting your arms over a horizontal line for 6 weeks.

Heavier work, lifting heavy loads, exercising, weightlifting and other sport activities are recommended gradually after two months following the surgery and while wearing the elastic bra. Intimate intercourse should be done very carefully within the first month after the surgery.

It is possible to visit a solarium or sun tan 14 days after the surgery, it is better though not to rush these activities too much. The scars must be covered with plaster or treated with a high SPF sunscreen for a minimum half a year following the procedure.

You should be able to return to work within 10-14 days, depending on the level of activity required for your job.

The result of the augmentation is considered permanent after three months.

If the breast skin is dry after the surgery, you can apply hydrating creme several times a day. Be careful not to tighten the skin while doing any specific movements and avoid contact with the stitched area.

You should see your surgeon immediately if your breast shape changes, the consistency changes (your breast becomes hard) or any inflammation appears. A visit to your surgeon is also recommended after any severe trauma to your breasts (car accident, fall etc.) Regular check-ups are done after one month, after three months and after one year. A check-up after 10 years also includes an ultrasound examination. The check-up system depends on each clinic. Some clinics have no check-ups at all.

Always be sure to follow your doctor´s instructions.

The implant covers approximately 20% of the mammary gland tissue during a mammogram. That’s why it is a good idea to consider another examination technique such as a sonogram (ultrasound) or magnetic resonance.

Patients that have undergone breast augmentation with implant placement must not undergo diathermy (medical organ heating through high frequency electric current.) The implant could become extremely hot and could cause inner burns and eventually the rupture of the implant.

General complications

Each surgical procedure has its possible complications and we have to consider them, although they appear in a low percentage of cases. General anesthesia has certain risks, which will be explained to you by your anesthesiologist before the planned procedure.

There are complications concerning the healing and possible infection of the wound around the area of the implant. There have been documented cases when the implant had to be removed because of infection.

Another surgical complication might be bleeding. That’s why a laboratory examination of blood clotting before the surgery is essential. Also staying in a calm environment after the procedure is important. Another problem can be scar healing.

A serious complication that can occur in any surgery in which the patient is under general anesthesia is a so-called pulmonary embolism – blocking of the pulmonary artery with a blood clot. For prevention, doctors use elastic bandages on the legs and movement soon after the surgery, the best is the first day. Hormonal birth control raises the risk of thrombosis, so it is possible to stop it or take medication against blood coagulation – low molecular heparin (e.g.Fraxiparin, Clexan, Fragmin.)

Some patients are more likely to receive so-called keloid or hypertrophic scars. Sometimes a correction may be necessary, which is relatively difficult in these types of scars.

Breast augmentation is performed with the arms stretched. Patients can sometimes feel pain shooting into the forearm and hands after the surgery. It is caused by the tension of nerves running from the armpit to the arms. These problems are temporary and fade away after few days or weeks.

Complications concerning the implant placement

Capsular contracture

It is the most often described and feared complication of breast augmentation. A fibrous cover – capsule is always formed around the implant. The tissue reacts naturally to the foreign element of the body. The capsules form in all patients and they can be thin or thick. Its creation is individual. In 5% of cases the capsule can start to shrink – this is capsular contracture around the implant. It is accompanied by pain and a firmness to hardening of the breast. This phenomenon can occur in one breast or both breasts. There are ways to avoid the forming of a capsule or at least minimize its creation. It is for example important to ensure a sufficient size of the cavity for implant placement. Also implants with a textured surface reduce the risk of capsular contracture. The shrinking capsule often has to be treated surgically. There have been documented repeated cases of capsular contractures around the implants and sometimes the rigidness can repeat so that the only possibility is the removal of the implant .

Prolapse (expulsion) of the implant

The skin is in permanent tension in the area of the wound. The size of the implant can also cause a progressive thinning to breakage of the skin and therefore the prolapse of the implant. This complication is more common in patients whose skin has been damaged in any way or scarred for example by irradiation from tumor disease.

Serom

This is the creation of liquid around the implant immediately after the surgery or later. It is manifested by pain and breast enlargement. The reason is most often physical strain after the surgical procedure, excessive sport activity or injury.

Blood coagulation around the implant – hematoma

A collection of blood around the implant is mainly caused by disobeying the relazation orders after the surgery or defective blood coagulation.

Burst and penetration of the implant

The approximate durability of an implant set by the producer is around 10-15 years. The implant slowly wears out and its surface thins, which can cause it to burst. The breast can change its shape and will hurt. In such case a change of the implant is necessary. A breast rupture can also be caused by injury, accident or extreme sport activity. Microscopic particles of silicone can penetrate through the  gel filled implant’s external cover. These particles have been found around the implant and even in other parts of body. No harmfulness has been proved.

Shrinkage of the implant

The shrinkage of the implant cover is manifested by small folds that can be touched under the skin. It can be painful and big folds can irritate the surrounding tissue. It is a problem for skinny patients with a thin skin layer, very small mammary gland and in cases of implant placement under the gland.

Sensitiveness of nipples

The change of sensitiveness of nipples, either increased or decreased is often described by women after the surgery. In most cases it gets back to normal in several months to one year. The change can be sometimes permanent.

Breasts asymmetry

Even breasts enlarged with an implant can droop or sag after some time. Also asymmetries may occur, when one side droops more than the other. It can be caused by disobeying instructions after the surgery but also for other reasons. The implant can change its position through the movement of breast muscle right after the surgery. A higher risk of such a shift is threatened by teardrop implants.

Calcification

Small particles of calcium may appear around the implant. They can be confused with a beginning stage of breast cancer.

Tiny thrombotic vessels

Tiny vessels in the armpits or under the abdominal wall blocked by thrombus may appear after the surgery. They disappear naturally within several months.

Can silicone implants be harmful for body?

There have been made many studies concerning the harmfulness of breasts implants. All the substances that form the implant have been gradually studied and examined. This includes silicone, polyurethane, which is part of the cover of some implants, and platinum, which is used by polymerization of silicone gel. None of these substances showed explicit carcinogenic effect, i.e. ithey don’t cause tumor malignancy. Further studies have been done for any relation between implants and rheumatic and autoimmune diseases, again none have been proved. Elementary silicone occurs normally in parts of the blood, breast milk, connective tissue and most organs. Its content in the body depends on a person’s diet, geographic conditions, quality of drinking water or beer consumption. Also mothers that breast feed with silicone implants do not present any risk to their babies. Silicon is part of nursing bottles, dummies, spoons and other medical products.

How long will the effects of breast augmentation last?

The final breast augmentation is permanent, if there is no change in weight and proportion of breasts (see the above mentioned pregnancy.) Regarding the change of quality of the implant after 10 to 15 yearsor the increased possibility of an implant rupture (burst), it is necessary to consider the possibility of implant replacement. Breast augmentation is a personal, serious decision, and a permanent one. If you have planned carefully, worked with your doctor and followed his instructions, then your surgery should be a successful one!

The future of implants

At Illinois University in Chicago stem cells isolated from bone marrow were stimulated to grow along the supportive skeleton, which is made out of biologically tolerant material. Due to this form the cells have reproduced into previously selected shapes. Such cultivated forms from fat tissue has already been tested on mice. It is assumed that these implants grown from stem cells will be a safe alternative to silicone implants.

Breast enlargement by filling it wiht a person’s own fat or by transplantation of their own muscle has already been performed at some clinics worldwide. There haven’t so far been any experiences with such a technique in the Czech Republic.

Want to minimize the look of ageing on your face? Photo rejuvenation and resurfacing are excellent ways of improving your look by softening wrinkles, pigment stains and other signs of ageing.

What is photo rejuvenation and what is resurfacing?

Photo rejuvenation is a general name for a variety of procedures. The basic definition is it is a thermal disturbance of the skin’s collagen. The result of this process is an activation of the healing process and the release of substances which influence the regeneration of skin cells. The cell activity is stimulated and thus new collagen fibers are created. Skin strength and elasticity therefore improves. Other skin problems that can be treated using photo rejuvenation includes the disappearance of pigment stains and tiny veins, the filling of small wrinkles and scars and a general improvement in skin quality. Photo rejuvenation is a very gentle treatment and therefore can be combined with a chemical peel, other laser treatments, application of botulinum toxin, skin implants and it’s possible to have photo rejuvenation after surgical treatments.

Resurfacing is a method of skin treatment in which a laser is used to remove the top skin layer. The skin is eliminated using a beam from an Erbium or CO2 laser. The results of resurfacing is a smoothing of wrinkles and small scars, skin lifting and general rejuvenation. Resurfacing is more invasive than photo rejuvenation.

Why photo rejuvenation Prague?

Prague has many attractive features for those considering photo rejuvenation abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and photo rejuvenation surgeons ensure you’ll receive the best possible care. Photo rejuvenation Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.

Photo rejuvenation

Photo rejuvenation is a gentle warming of the skin with low doses of light energy. The source of energy can be either intense pulse light (IPL), pulse pigment laser or diode laser. This warming causes stimulation of the cells which produce collagen fibers. The process encourages new development of collagen, smoothes out little wrinkles and stretches the skin. The light energy is partly absorbed in dilated facial veins which causes them to seal and subsequently disappear in a few weeks. Photo rejuvenation can cause an improvement of facial pigment stains as well. The healing process following photo rejuvenation is complete in approximately 7 to 14 days.

Resurfacing

This method uses so-called ablative lasers, for example the CO2 laser or the Erbium laser. These lasers cause a gentle evaporation of the skin layer, which leads to skin surface regeneration. This procedure is mainly used to treat scars resulting from smallpox or acne, or to smooth out deeper wrinkles or a rough skin surface. The smoothing of wrinkles around the eyes and upper lip is usually perfect. The procedure can be outpatient; surgeons usually recommend a one day hospitalization with other treatments such as laser bio-stimulation or intense red light, for a faster recovery. The healing process takes two to four weeks, and constant sun protection (sunscreens with high UV filters, 50+) must follow for several months. It is possible to combine this procedure with other surgical procedures under general anesthesia, for example a face-lift.

Are you a good candidate for photo rejuvenation or resurfacing?

If you suffer from rough facial skin, wrinkles, acne or smallpox scars or pigment stains, photo rejuvenation or resurfacing may be a good option for you. It is necessary to have realistic expectations and realize that photo rejuvenation does not bring as radical results as other cosmetic treatments, like a face-lift) To see before and after photos of photo rejuvenation Prague please visit our picture gallery.

Before the treatment

During the first consultation, the doctor will discuss with you your ideas and expectations for photo rejuvenation surgery. He/she will check the condition and elasticity of your skin. If your wrinkles are too deep and/or the skin too loose, the doctor may recommend a combination of photo rejuvenation and another type of treatment, or a more radical procedure, like a face-lift, to achieve the best possible results. The doctor will provide you with all instructions concerning skin care before and after the treatment.

Anesthesia

Photo rejuvenation is performed under local anesthesia, usually in the form of an anesthetic ointment. You can go home right after the procedure. Resurfacing is performed in a so-called analgosedation (controlled sleep) and a one-day hospital stay is usually recommended.

After the treatment

Both treatments are very fast. Immediately after the treatment, the skin is slightly red and oozes (in resurfacing the skin damage is more evident). During this time, it is necessary to provide your skin with some extra TLC, such as the application of cold compresses using sterile water and ointments. A total recovery following photo rejuvenation is usually after 7 to 14 days; in resurfacing the healing process can take 2 to 4 weeks. After both photo rejuvenation and resurfacing it is necessary to protect the treated areas from the sun and to use sunscreen with a high UV filter (50+) for a minimum of 2 months. No other measures are necessary.

What are the results of photo rejuvenation and resurfacing?

The results of resurfacing are excellent. Your skin can look 5 to 10 years younger. If you choose to have photo rejuvenation, you can count on good results in the appearance of your skin’s surface, the disappearance of dilated veins and pigment stains. The impact on deep wrinkles is average. The best result is the smoothing out of wrinkles around the eyes.

To achieve the best results from photo rejuvenation, it is necessary to undergo approximately four treatments in a period of six weeks. The final result can be assessed about 3 months after the end of the treatments.

How long will the effects of photo rejuvenation and resurfacing last?

The effects are long-lasting but do not prevent other signs of skin ageing such as the development of new wrinkles, dilated veins or pigment stains. After some time, you may feel the need to undergo photo rejuvenation or resurfacing again.

If you suffer from unsightly spaces between teeth, wrong teeth colour or position, multiple fillings in the anterior teeth, you can use one of the most modern solutions – application of dental porcelain veneers to the front of your teeth.

What are dental porcelain veneers?

Dental porcelain veneers are thin porcelain layers, which are stuck directly to the front of the teeth. During a normal treatment, six porcelain veneers (it can be even more) are stuck to incisor and canine teeth of the upper and lower jaw. If your teeth are healthy, two visits are sufficient to apply the veneers. At first the doctor grinds the teeth slightly under local anesthesia and makes an impression of client’s teeth. During the next appointment, the doctor sticks the finished veneers on the teeth.

Are you a suitable candidate for dental porcelain veneers?

fazkyWith the help of dental porcelain veneers, it is possible for example to remove unsightly spaces between anterior teeth, wrong teeth colour or position or anomalies in location of anterior teeth. Moreover, they represent solution to aesthetic deficits caused by fractures or erosions of teeth or multiple fillings (dental restoration) in the anterior teeth. If you suffer from any of these problems, you can be a suitable candidate for dental porcelain veneers. If you suffer from some gum diseases, for example untreated periodontitis, it is necessary to treat the problem at first and then it is possible to apply the veneers. If your teeth are very damaged (multiple fillings, defects of enamel), the application of dental crowns might be a better solution.

Before the application

During the first consultation, talk to the doctor about your ideas concerning the look of your teeth. It is important for him/her to understand what you see as the biggest problem. The doctor will also choose, together with you, the right colour tone for your veneers. Before the treatment, he/she will probably ask you about your general state of health, especially whether you suffer from allergy to some medicaments or anaesthetics, for example Mesocain, Lidocain etc..

Anesthesia

The treatment is very gentle and is not accompanied by any pain. Slight teeth grinding and application of the veneers is performed under local anaesthesia, which ensures you a painless treatment.

The application procedure of dental porcelain veneers

If your teeth are healthy, the application of the veneers is done in two phases. First, the dentist grinds the teeth slightly (maximum 0,4 mm) and takes the impression of the teeth. Then he/she will send this impression to the dental laboratory where they will create the veneers. The laboratory manufacturing of veneers usually takes 10 days, for this time you can use temporary veneers usually made of composite resin (a material from which “white fillings” are made). The final veneers will be checked during the second visit and if the functional or aesthetic problems will not come up, they can be permanently stuck. The veneers are polished after the application to make the new look of your teeth perfect.

Present technology (CEREC restorative technique) offers the whole procedure in one visit – the creation of electronic impression of the teeth, modelling of the veneers on the computer and the creation of final work and adhesion

After the treatment

The doctor will provide you with all information concerning the care of porcelain veneers. Most important is perfect mouth hygiene, which removes all plaque. The dentist or dental hygienist will teach you perfect mouth hygiene. It is necessary to be careful while biting at very hard pieces of food.

How long will the veneers last?

Today’s aesthetic stomatology disposes of dental porcelain veneers with a very long durability, minimum danger of detachment and colour stability. The life span of porcelain veneers however depends also on care of the teeth and gingiva, on quality of natural teeth and client’s manipulation with the veneers.

Interview with a top plastic surgeon MUDr. Tomáš Doležal about women, ideal of woman´s beauty and its changes during the time…

May I ask you how you interview your patients and what is the first contact like?

During the first consultation, which lasts approximately half or one hour, I learn about the wishes of my client. Then we look for a suitable solution which is technically performable and aesthetically suitable. If it is necessary, I correct my patient´s early concept concerning the results of operation, they have to be realistic. It is important to agree on all details. Both sides should be satisfied. I get acquainted with the reasons which led this woman to such an important decision as undergoing an operation. I explain the procedure of operation and present pictures taken before and after surgery. In this phase, I am more a psychologist, I try to learn why the client came to my surgery. These women do not suffer from a visible illness, but are innerly unhappy, they are troubled by their looks and their dissatisfaction includes other problems with imbalance and general dissatisfaction with their lives. After the treatment, these women are more self-conscious and they generally get on much better.

Have you ever refused an operation?

The patient´s wish to change her look should be her own firm decision, she must go for it. Sometimes I learn during the discussion that the woman decided under the pressure of someone else. In these cases, I refuse to do the surgery. I will give you an example form my experience: a woman may come to my surgery with the wish to undergo breast augmentation. I am told that she had been satisfied with her breast size until she met her boyfriend. He likes women with larger breasts and he requires his partner to have them. She submits and visits plastic surgeon. Nobody can be sure that the partnership will last. After one year, this woman may come again and ask the implants to be removed. Among the prospective clients are also women with mental problems. The feel refused by people around them, do not have many friends and other people avoid to communicate with them. These women look for the reason of unconcern of others and assume that changing it can solve their problem. That´s why they find a visible anomaly or discrepancy on their body or face and classify it as the reason of all problems. These patients are more satisfied with their looks after the surgery, but their problems persist. People around them continue to refuse them and so they either decide to have another plastic surgery or accuse the surgeon to do his or her work carelessly or wrong. I do not operate such prospective clients and try to disclose their intentions during the first consultation in my surgery.

Do you feel to be more an artist, doctor or psychologist?

All in one. First of all, I am of course a surgeon. There would be no craft of plastic surgery without medicine. It is necessary to have adequate qualification and attestation. The career of plastic surgeon is a long one, a doctor may become plastic surgeon approximately ten years after graduation. He or she should have artistic and creative talent as well. Important are imagination, aesthetic feeling and knowledge of not only human anatomy but also aesthetic anatomy of artists. I have already mentioned the role of psychologist. It is essential to find the right way for the surgeon and patient as well. We have to realize that although it is a routine branch, as all other branches, you can not to do everything just routinely. It is necessary to have empathy with the needs of your client and find out if the surgery can fulfill her wishes.

What is your most common social group of your patients? What are their most common jobs?

I can not answer your question precisely, because I do not ask about the jobs of my clients. But generally, it is the middle class who is mostly interested in breast surgeries. The women are troubled by the loss of breast shape after breastfeeding and suffer mentally. In case of breast augmentation, it is the same group of clients as in case of mammaplasty. Women wish to have recompensed the loss of breast tissue after pregnancy or sometimes there are clients who earn their living by their looks, ex. stripteasers, dancers etc. Young women who are troubled by their too small breasts come to my surgery as well.

What is in your opinion the best time to do the surgery?

It is best to be done in colder months. Hot summer is not suitable because the scars should be not exposed to sun rays for about two or three months and it is not good to sweat under the bandages during recovery. But you should not forget that there are countries with temperatures higher than 20°C all year long and plastic surgery is done there as well.

Can it happen that the body of patient rejects the implants or the scars intergrow in a wrong way and the patients are discontented? Are there complaint departments in clinics of plastic surgery?

No plastic surgeon can guarantee the operation to be 100% successful. The risks in case of breast augmentation are well known. Among the most common complications belong so called capsules. Capsule is a hard area of breast tissue caused by development of uletic tissue around whole surface of the implant. However, this problem can be solved in most cases surgically. Capsules appear at approximately 3% of patients.

What is the first reaction of a patient after the surgery when her bandages have been removed?

During the first consultation before her surgery, the patient learns about the procedure through pictures and is prepared for postoperative situation.

Do you sometimes argue the patients out of their visionary surgery for any reasons, even against their will?

I have already mentioned two examples. But generally, I refuse all operations which lie on the edge of capacities, aesthetic and technical possibilities. When I plan a surgery, the figure of the patient must be a concern and the way the surgery is going to influence her general look. It is different to do breast augmentation when the girl is tall or when she is small etc.

How many operations do you usually perform in one month?

I perform about ten or twelve operations in a week, hereof about one hundred augmentations in a year.

Finally, how would you define an ideal figure and beautiful woman?

Unfortunately, it is hardly possible. There are of course objective ideal proportions, but they are influenced by the epoch, society and limited by the place and culture. There is a different ideal in Brazil and in the Czech Republic. There was a different ideal in the twenties and there is a different ideal today. It is important to realize that ideal beauty of a woman does not exist only now but has always existed. However a different one.

Find out the most important facts about Czech cosmetic and plastic surgery. Certification, prices, how to choose a plastic surgeon. Read the recommendations of Asc. Prof. Marketa Duskova M.D. Ph.D., the president of Czech Society of Aesthetic Plastic Surgery.

Extremelly high standards (see below) of Czech plastic surgery combined with low prices and location in central Europe central place The Czech Republic among favorite cosmetic and plastic surgery destinations.

The Czech Republic is in fact home of a modern plastic surgery. Czech plastic surgeons are highly qualified, skilled, trained and educated. Clinics are located in Prague, Brno and other smaller cities. Both Prague and Brno have international airports where you may arrive. Czech Republic is a fairly small country. Even if you choose a clinic outside of Prague you will not travel there from an airport more than about 2 hours.

What are the advantages of Czech cosmetic surgery?

Czech plastic surgeons have to work in the field of cosmetic plastic surgery for 4 years under supervision before obtaining the certification.

What it takes to become certified plastic surgeon in the Czech Republic

The above are legal obligations to become a plastic surgeon in the Czech Republic. All Czech plastic surgeons are qualified plastic surgeons.

How to choose a plastic surgeon specialised in aesthetic plastic surgery?

The best plastic surgeons have usually schedule full for 6 moths ahead. Very rarely you might get a consultation or an operation within a month from now or less.

President of Czech Society of Aesthetic Plastic Surgery, recommends:

Asc. Prof. Marketa Duskova, M.D., Ph.D., President of Czech Society of Aesthetic Plastic Surgery, recommends:

  1. Your chosen specialist should be a certified plastic surgeon. See the list of plastic surgeons that are members and the list of plastic surgeons that are certified members of Czech Society of Aesthetic Plastic Surgery.
  2. It is reasonable to pass the whole process with the same plastic surgeon, i.e. the initial consultation, examination, the surgery, and post-op care. It is good to stay in contact by phone or email the whole healing period.

Why to choose the Czech Plastic Surgery ?

The plastic surgery has had a long tradition here. In European continent the foundation of this medical branch is connected with the name of the great Czech, Academician Frantisek Burian. The treatment is on the high level and the prices are available for majority of interested persons. Among main advantages of Czech plastic surgery belongs the educational system that assures the quality of medical care.

What are the main features of Czech educational system?

In the Czech Republic there are 4 steps of training:

  1. At first a plastic surgeon trainee starts with theoretical studies and watching the surgeries,
  2. 2. then she/he assists to senior surgeon,
  3. 3. she/he continues with operating under supervision and assisting to senior surgeon 4.and finally she/he carries the surgery alone.

The training lasts at least 5 years and must be provided at accredited sites, where the trainee is going through all parts of plastic surgery. To become a fully board certified plastic surgeon, one must pass the qualifying examination, which is oral and practical. To application form for the examination the candidate must attach references of main tutors and a list of performed surgeries. There are types and number of compulsory operations.

If we compare the situation in other countries, such tutoring and conditions for obtaining of full qualification may be less detailed or even sometimes missed.

How to choose a plastic surgery clinic?

Agencies and providers of cosmetic surgery packages

Going for plastic surgery on your own

You may want to arrange the cosmetic surgery trip to Czech on your own. It is simple. You can simply purchase an airplane ticket, accommodation and airport pick up on the internet within 30 minutes. Before that you should get a date for consultation or possible operation from a chosen plastic surgery specialist. Some time a clinic where you wish to undergo the treatment may recommend an accomodation or apartment near the facility as well as an airport pick up.

You might decide, you don’t want to travel alone. Well, bring a husband and send him play golf. There are more then 70 golf courses in Czech. Bring a friend and send her shopping, siteseeing, you name it…

Czech is far from a third world country. You don’t have to be afraid to get a taxi from the airport. Also, you may contact us if you wish to recommend an appartment of accommodation. The bottom line is:find a surgeon and give him a call or write an email and go from that.

Purchasing an all inclusive plastic surgery package through a middleman

Purchasing an all inclusive cosmetic surgery package through a middleman may be more expensive but you will be taken care of from your home airport on. You may have someone to chat with on the way. Some of the providers have undergone a treatment them selves. You may feel better not going alone. Agents usually know their way around the Prague and Czech. On the other hand, they do what they do for profit. Also, agents will probably recommend you only a clinic or plastic surgeon they deal with. The bottom line is: decide if you are willing to pay more for everything being taken care of for you.

We do not list the agencies here at this time. However you will find them on major search engines if you look for plastic surgery in Prague.

Czech is the home of the first plastic surgeons

The foundations of plastic surgery were laid by Czech professor Frantisek Burian in 1912. Three years later he launched the first plastic surgery ambulance in the world. Burian developed many operation procedures and techniques that are the basis of many modern plastic surgeries over the world.

Hungary has long been popular with the Germans and Austrians as a destination for low cost dentistry and cosmetic surgery. Since Hungary joined the European Union in 2004, educational and industrial regulations have become more strict in keeping with EU standards, causing professionals in the cosmetic surgery and dentistry fields to be very much equal, if not surpassing, in quality when compared to their western European counterparts. Yet the low costs for cosmetic surgery and dentistry remain simply due to the lower cost of living and the lower wages paid to medical professionals in Hungary.

Advantages of cosmetic surgery and dentistry in Hungary

Prices for cosmetic surgery and dentistry can be anywhere from 40% to 70% less than prices in the UK.
Hungary has long been popular with Germans and Austrians for low cost cosmetic surgery and dentistry, and now people from the UK are catching onto this trend to save themselves large amounts of money.
With a long history and a tradition of excellence and its convenient location in central Europe, Hungary has become one of the favorite and most trusted cosmetic and plastic surgery destinations.
Approximately 80 % of Hungarian cosmetic surgeons speak English, and most speak German as well
Hungary is a country of fantastic natural beauty, and boasts not only the world’s second largest thermal lake, Lake Heviz, and Central Europe’s largest lake, Lake Balaton, but also 400 thermal springs that locals and foreigners have long flocked to for their healing powers.
Hungary’s climate is temperate.
From any of London’s airports, a flight to Budapest International Airport is only about 2.5 hours, and a return ticket can cost as little as 25 pounds. Five major European airlines now fly to Hungary, in addition to low cost airlines like SkyEurope, Easyjet, WizzAir, Malev and Jet2.
What it takes to become a certified plastic surgeon in Hungary
Dr. Istvan B. Szemerey, director and surgeon at the Mediburg Clinic in Budapest, and also surgeon at the plastic surgery department at St. Stephan’s Hospital in the city, explains the steps necessary to become a certified plastic surgeon in Hungary. (Dr. Szemerey is a member of the International Society of Aesthetic Plastic Surgery, the Hungarian Association of Plastic Surgery, and the German Association for Plastic Surgery). After studying for 6 years at a medical university, a future surgeon must pass the final exams to obtain a general medical diploma. At this point, “there must be 5 years of practice and experience of general surgery at a clinic or hospital. Then there is the exam for general surgery or other operative surgery. After this exam is passed, you have to practice in plastic surgery for 3 years. Plastic surgery has 4 fields: reconstructive, cosmetic/aesthetic, burn surgery, and hand surgery. Then you must pass your plastic surgery exam.”

Dr. Csaba Molnar, vice president of the Hungarian Society for Plastic, Reconstructive and Aesthetic Surgery (MPHEST), explains that it takes a minimum of 14 years after the medical university degree is received before a surgeon can begin to practice.

“We have a special law: to start a practice on your own, at your own responsibility, you need to spend 5 years working under the supervision of a well-trained senior plastic surgeon,” he says.

Cosmetic and general dentistry in Hungary

Hungary has become more and more of a popular spot for aesthetic surgeries and treatments, especially for general and cosmetic dentistry. In fact, Hungary stands out internationally for its excellence in dentistry – this EU nation can boast the highest number of highly skilled and experienced dentists per capita in the world.

To become a cosmetic dentist in Hungary, a person first graduates from a general dental university after 5 years, and after graduation, he or she can either take a short course and become an implantologist, or train for at least 2 to 3 more years to become a specialized dental surgeon, such as an oral or maxillofacial surgeon.

Dentists from Hungary, unlike several other eastern European countries, are immediately qualified to work in the UK immediately after graduation from dental university, due to the fact that Hungary’s dental school requirements also meet the requirements of a particular EU directive.

For a cosmetic dentist to practice in Hungary, he or she must hold a governmental certificate and their name should be posted on the door to their office and operating theater. Five year ago, continuing education was made compulsory for Hungarian dentists, who now are obligated to attend several conferences and educational sessions a year. There are about 300-400 continuing education sessions a year for dentists to choose from. A system of points is used to ensure that dentists are frequently attending these seminars that keep them up to date with the latest technologies and techniques in their field. Also, many dentists belong to the Hungarian Medical Chamber of Dentists, so their credentials can be verified through this organization.

How to choose a cosmetic surgery clinic or cosmetic surgeon in Hungary

In order to search for a cosmetic surgeon in Hungary who is qualified and has the experience in the surgery that you would like done, it is always important to first check to see what kind of accreditations the surgeon has. Often, the surgeon’s or clinic’s website will have their curriculum vitae listed, along with all international and national medical associations that he or she is a member of. You can even look up the associations to make sure that the surgeon is listed as a member. Associations include the International Society of Plastic, Reconstructive and Aesthetic Surgery (IPRAS) and the Association of Hungarian Plastic, Reconstructive and Aesthetic Surgeons (the highest national group for Hungarian plastic surgeons). The international associations’ websites also offer excellent advice on what to consider before deciding on a surgeon.

Dr. Molnar advises that thorough research is key to working with a good clinic and surgeon.

“If you want to find a good clinic, you have to look around. Every clinic website has photos and/or descriptions of the clinics and the services offered there. The most important factor for choosing a clinic is the professionality of the surgeon(s) working there. Of course, the conditions of the clinic are also important,” he says.

“A good plastic surgeon must have sufficient experience and practice. Hungarian plastic surgeons have a society, MPHEST, and this body is responsible for making sure that all its members are well trained, experienced and undergo continuous training. Members of MPHEST have a duty to participate in conferences worldwide, which suggests that they all have a reliable working knowledge of English. It is highly recommended to choose a plastic surgeon from the webpage of this society or check the membership of a chosen plastic surgeon in MPHEST at www.plasztika.org.hu.”

“Personality is also an important factor in choosing a plastic surgeon, something that potential clients can find out about in personal meetings. The most authentic recommendation is one by a previous client,” he adds.

It is good to ask what the clinic’s success rate is for your particular operation. Find out if your clinic and/or surgeon or dentist has professional insurance, and learn what kind of guarantees that they can promise you, if at all. For example, a dental clinic may offer you a 3-year guarantee on crown or bridge work.

It is also important to enquire about the clinic’s practicing licenses, about the details and length of your specific operation, the details about your “post op” care or aftercare. This is especially important since you will be flying back home and your surgeon will not be able to see you during your recovery period. Make sure you know what results to expect according to your particular circumstances.

Dr. Szemerey admits that it can be a difficult process for a foreigner to choose the right surgeon or dentist for their needs, but there are certain ways to narrow the choices down.

“One important factor is the learning curve of the surgeon, such as his publications. Also, the letters that you receive from the surgeon – since it is important to get the answers in good English. You can also compare before and after pictures of different surgeons. Really, the best advertisement is the patient’s testimonial. We say ‘word of mouth’ propaganda. Some surgeons might have a beautiful website, but their surgery work is not so perfect. To choose a surgeon can be hard work, and through a medical broker it could be a little bit easier and safer, but not necessarily the safest.”

Arranging cosmetic surgery on your own

You can arrange cosmetic surgery in Hungary without the assistance of a medical broker or other intermediary. Once you have done the research and are satisfied with the surgeon’s qualifications and experience, and have heard positive feedback from previous patients of the surgeon, you can book a date for the surgery through the clinic. When you have the date or dates for the surgery, make sure you allow yourself enough time before and after your surgery. Using these dates, you can purchase your flight tickets online, flying straight into Budapest International Airport. Accommodation can be easily found online as well, or ask the clinic for a recommendation of a nearby hotel or apartment. If you wish to rent a car, this can also be researched and confirmed online. Ask your surgeon and/or the clinic’s contact person as many questions as you need to when planning your trip.

Using an intermediary to plan your trip for you can be more expensive, but they may also take care of all the little detail from airport pickup to post-surgery caretaker in your apartment so you don’t have to worry about anything. And again, do some research to see if you can find anyone else who has used their services before booking with them. When it comes to something as important as traveling abroad for your cosmetic surgery, word of mouth is of the utmost importance.

Bierhanzl’s ointment – a cure for baldness! A magic hair-lotion that leads to a head full of hair – the dream of 55-percent of men that suffer from alopecia (the medicalk term for baldness.) Luckily there is a certain relief; the loss of hair affects 16-percent of women as well. However, magic lotions belong only in the movies. In the real world, we have to suffer for beauty.

So I put my bald head on the surgical table and have my forehead implanted with more resistant hair from the nape of my neck. I felt like a piece of cloth in the sewing machine but I was also wondering to what extent such a surgery can change a person. Physically, as well as perhaps, mentally….

To invent a lotion, that could treat baldness and allow for a fashionable hair-style the next day, is a dream of all cosmetic producers. And because they believe it may happen, every once in a while they bring out a new and this time totally guaranteed potion in which the bald head suddenly sprouts great hair after its application.

The making of a new person – more handsome and hairy…

“I do not trust too much these magic lotions and ointments for hair-growth,” says Petr Hajduk M.D., a surgeon at GHO Clinic. “If you have an inner problem, you can hardly solve it with an external application.” In other words – neither Bierhanzl’s ointment nor an ointment from duck’s eggs will work. One possible solution may be found in pills that contain finasteride – the so far only known agent that blocks the formation of DH-testosterone, which causes baldness. There are at least four commercial preparations of this type on our market: all of them have to be prescribed by a doctor following a blood examination. The cheapest cost for these pills is around 330 CZK a month; products made in the USA cost five times more. There is only one little problem: all these magic pills have to be used long-term, which means forever in reality.

There is really only one solution for those who are serious about foresting their bald head with hillsides of hair – hair replacement. Bierhanzl’s ointment used to be for men of all types, but this surgery, called Follicular Unit Extraction (FUE,) is not that common. One graft costs 95 CZK – and surgery usually needs a thousand grafts. Although this price does include everything, from the surgery to a baguette for lunch.

Buy hair!

The first step is the most important – do I really need a hair transplant? My hair has been thinning for several years and has moved to the corners of my head. On one hand, I am not innocent any more and can eventually talk with any woman. So I don’t need it. On the other hand – why not become even better-looking? Or at least feel like I am…Moreover I am a curious person and curiosity hurts sometimes. So let’s do it! Nowadays it is a fashionable and common procedure, something like one of the many plastic surgeries for women. At GHO Clinic both men and woman have undergone this procedure and they have even more people coming for consultations.

Everything begins with a handful of various pills – if I were a drug addict I could not wish for more!

I look at my old head for the last time – it will be bloody but hairy in a few hours!

“We will take 500 hairs from here and transplant them into the bald corners,” says the surgeon Hajduk.

A picture for my memory and to archive for the GHO Clinic – smile and look kind, and bald.

“Basically, we can divide our clients in three categories,” says surgeon Hajduk at our first session. At first he checks my hair, and then he asks me about the hair thickness of my father, grandfather, great-grandfather and several ancestors fighting in the Thirty Years’ War, and then he approves my wish to undergo the hair transplant. “The first group is represented by very young men that find out the morning after a party that several of their hairs fell out and they start to panic. I mainly recommend them to wait for a while before having the hair replacement. The second category is men in their 30’s. They slowly discover that their hair doesn’t look the same as when they were 18, but they still want to look good and run after girls – they are mentally more grown, plus they can afford such a procedure; there is usually no problem. Men around 40-years-old and older belong to the third group. They don’t do it because of women anymore – usually they have wife and a lover, something like fifty thousand crowns for a new fringe doesn’t hurt them, they just want to persuade themselves that they can manage their ageing process.”

I think about which category I belong to with my 35 years – is it because of girls or the ageing process? Sometimes I feel like that mentally, I belong under the law for the protection of minors. Considering depression from progressive baldness, I have read somewhere that there are even women that are interested more in what a man has inside of his head than on it…

“Clients around 20-years-old that really suffer from heavy and genetic alopecia and they want to solve it through immediate transplantation are the worst. It is very hard to explain to them that they might have two problems in the future. One is visual, when they loose all their hair on the back of their scalp. There won’t be a donor area for other procedures. The second problem might be financial. The forehead will be full of hair because of the grafts transplanted from the nape that won’t fall out, while alopecia might proceed and they will need another transplant and another ten thousand crowns to hide it. The problem is that it is very hard to explain this to these young men – they usually have the feeling that they can buy anything today.”

A slightly drooling patient

I undergo surgery the next day. I put on surgical green cloths at eight o’clock, the nurse enters and gives me a handful of pills – antibiotics to relax, a pill against allergies, a pill against bleeding and a pill against pain – the heart of a drug addict would be pleased with such a dosage. After a while I lay down on a bed, on my stomach like during a massage. Theoretically I know exactly what to expect. The hair from the nape is genetically different than on the forehead so it doesn’t react to testosterone derivate (therefore even bald men have that well-known circle.) The hairs will be transplanted to the forehead; they will fill the empty corners, so that I won’t have to stand in the corner of society in the future. Practically, I am stressed about the expectations of future situations.

The pills are working already – the world is pink and the purple UFO in front of me seems to be in the right place

I spend hours like this. I drool uncontrollably – due to the pills and the surgeon’s legs.

The anesthesia is like at the dentist – except instead of one injection to the gum, here I get fifteen into the nape.

I lose up to 50 milliliters of body liquid during the surgery – such a blood loss!

The first step is anesthesia, a little bit like at the dentist. A syringe with supracaine is injected into the nape 15 times, each a centimeter apart. I am assured that it is a dental anesthetic that work very fast, is effective for about two hours and is low toxic. I am glad that no one can see my face doing the terrible grimace caused by pain. After a few minutes, the actual removal of grafts begins. It is helped along with a drill with 4800 rotations per minute and a small needle of 0.7millimeter average. Professionally said – the hair is cut to two millimeters in length and the needle is slid onto it; the drill screws out from the tissue the so-called follicular unit. It contains one to three hairs that are inserted into a saline solution; a mixture of glucose, vitamins and antioxidants. Described by feeling – I don’t feel anything until the anesthetics stop working and the drill starts to bite into the sensitive skin.

During the numbness, I hear something that sounds like if someone would tear thin linen. It is not an unpleasant noise, it doesn’t even touch me, I tell myself while staring at the ground. My eyes are staring at the linoleum and they touch the legs of the female surgeon that is screwing out the follicular units from the back of my head. In total five hundred of them will be removed within two hours, they are precisely counted by the nurse. The regular noise of the counting device and the heavy dosage of pills are slowly putting me to sleep. I am awakened by a quiet irregular smacking – saliva is pouring out of my mouth right onto the surgeon’s sandals. I murmur words of apology. “It’s ok, it is caused by the pills,” says the voice above my head.

Finally the last follicular unit is put into the solution, I can stand up. The surgical room is dancing in front of my eyes and a look at the trash can filled with bloody dressing makes my stomach sick. I was told that I won’t lose more that fifty milliliters of blood, which is double the amount in normal blood taking. So probably I haven’t bled to death yet. David Kraus is happy with my state and he takes pictures with pleasure. The nurse helps me to my room where I have lunch. I bite a baguette with cheese and stare into the corner of the room; I avoid anxiously looking into the mirror.

Gigolo – women’s lower

I return to the surgical room in an hour. The bed has been changed into a half-seated position, a little bit like at the dentist. And again I feel like I’m under a sewing machine. Needles are inserted into my skin and they fill my forehead with anesthetics. It even stays swollen for another several days, like if a cluster of bees would have had a picnic on it. I still recall the surgeon saying: “The anesthetics will numb the operated area, plus the contained substance will contract the vessels so the bleeding will be less. It will enable us to insert the grafts into your forehead.”

A bath for hairs that were drilled from the nape – a mixture of glucose, vitamins and antioxidants.

Unfortunately I had breakfast, the anesthetics cease to work too soon and other injections are necessary.

Baguette with cheese and water for lunch – under the pills I have no idea what I am chewing.

The second round begins – 500 holes are cut into the forehead and the same amount of grafts are inserted inside of them.

Then I fell asleep. I woke up when one of the surgeons straightened my falling head. I found out only afterwards what was happening while I was asleep: Two surgeons at each side of my poor head were implanting simultaneously. “The shorter time the grafts are outside of the body the better – saving time is important, therefore two surgeons,” explains surgeon Hajduk at my checkup one month later. Five hundred bleeding small holes are made with the same titanium needle like when the grafts are drilled from the nape, but just with a smaller average size of 0.65 millimeters. I would not wish to see my head at that point! After that, the new lawn is made with the help of two forceps in this prepared bed. The first forceps serves to widen the hole and the second one to insert the graft inside. The skin is elastic, it contracts around the graft and the bulb is sucked inside. The blood drop from each wound acts like glue – the graft is strongly fixed into the skin within two hours.

The chief surgeon Hajduk looks over his job. He is satisfied and takes pictures of me looking like the Leaning Tower of Pisa; him for documentation and Kraus for the article. I don’t mind it; I am still under the pills. I can go and change my clothes. The surgeon reminds me before I leave to wear just shirts for two days not t-shirts that have to be put on over my head. I cannot drink juice, carbonated water, coffee or tea the day after the procedure. I cannot eat citrus fruit, and for three days after the procedure avoid alcoholic beverages, no sport activities for two weeks and no work – at least something positive – I mean the job!

I get home by taxi – it is four o’clock in the afternoon but the driver stares at me like I’m from the nightmare on Elm Street, luckily he doesn’t ask me anything. In the apartment, I tumble into bed and fall asleep immediately. The gauze moves from my head during my sleep and changes the white pillow into the flag of the workers’ movement. My forehead is on fire and the top of head is itching so bad that I can’t think of anything else other than scratching it; I start to read the tabloid newspaper instead.

The situation changes the next morning – itchy crusts start to form on my forehead, the marks from the holes on the nape have almost disappeared. Five days later my head looks like I fell asleep on a cactus. I leave my house only to go to the store for necessary food, in a jumper with a hood up like a hip-hop singer. Finally I can start to peel off the crusts – gently! I have never touched any women so gently as I touch the dried blood around the very short hair. Reddish brown small crusts are snowing into the sink – together with small hair! I count quickly: 56 hairs in total, with a size of two days old hair on face! Was I insensible or should I have waited another day or two? Has my aggressive haste destroyed the result of several hours’ surgery? I call the clinic immediately. “Those were only hairs that fell out, the bulbs stayed in the skin. It was caused by the shock from the change of position from the back of the head into the front, they opened and the hair fell out. It is normal even if half of the transplanted hair falls out. In women almost all of the hairs fall out. After some time new hair will grow from the bulbs, don’t be afraid.”

Not many people have their hair counted but in case of grafts everything is precisely counted – 95 CZK per piece!

Now I don’t lose blood uselessly –this time it will serve as glue for the inserted grafts.

With the speed of a sewing machine and the help of two forceps hair from the nape is inserted into the front of the head.

I see in the Czech movie “Rozpuštěný a vypuštěný,” they call it a zero stage – the rest of the old hair disappears in order to give place to new hair of a greater quality.

This stage of treatment usually shocks the patient – needlessly. It is possible to calm yourself in a sanatorium for the mentally ill and to wait until the second stage, which leads to a surprising effect – new hair flourishes on the head like on a well-fertilized field. Moreover there are the few cases with an unforeseeable development – I still have the chance that I won’t be able to psychically stand my unexpected beauty and have to leave for San Francisco where I would start a reckless life. So I wait, months pass, and I try to hide my unpleasant reactions from the apathy of others. Not even my closest friends and family noticed that I had new hair on my head; enough to definitely get me into the musical Hair even without any singing talent. So just in case, three months after the surgery, I ask the chief surgeon Hajduk during the checkup, when the surprising result would appear and I would become the handsome man that leaves for San Francisco, and lives like a gigolo. “Until the hair gets some shape, until the skin gets back to normal, until the blood vessels grow again and the bulbs start to be fully working, it takes a while – around half a year.” I am patient. The sad thing is though that really the only person who has noticed the changes on my head was my hairdresser. In spite of the broad image of barbers, he is not gay. His interest in my hair was only professional…

The migration of cells

Exactly half a year later, I undergo second surgery – another 500 grafts, let’s call it a thickening procedure. One month later at the checkup I complain that no one has even noticed my hair change. The surgeon calms me with a story of one patient from Slovakia. “He underwent three surgeries; he was very bald – a circle on the top of the head and corners. Luckily he had a good donor place, from where there was enough to take.” Today he has a fringe almost to the middle of his face. When he meets his friends they wonder what has happened to him. He just laughs, before he tells them that he has new hair. They wonder: “Hair? You have always had plenty of hair!” He laughs even more, finally he shows them his ID with the old photo of him bald. “Oh yes, you are right, you were bald and now you have hair! But if you didn’t tell me, I would really never think of it!” So do not expect great attention from others, in case of this surgery it is mainly for your own psychological feelings. I had one slightly overweight patient from Moravia, in his 40’s, but he looked more as if he was 50-years-old. He was just about to divorce, his self-confidence was zero; he only had money left. We did several surgeries, the corners and circle disappeared. I have met him recently – he lost 30 kilos, he has a new girlfriend and he shines with self-confidence. We do not save the lives of people, but at the cost of minimum pain, we try to raise their self-confidence. Because we treat only to the depth of a maximum five millimeters and we do not cause any scars. And if we manage once in a while to improve someone’s destiny, then we are more satisfied than from all the money.

Within an hour the surgeons will plant both my corners, while I dream about my future as a gigolo.

In spite of the painful grafts I almost slept during the whole procedure – the pills are good ones!

My nape looks like this the day after surgery – the grafts disappear slowly, but they itch more.

My forehead looks as if I slept on a cactus. For the next week, I will leave my house only at night with a hood over my head.

I can confirm the statement about the surgery without scars. Nobody has noticed any change; on the other hand nobody has noticed that I have undergone hair replacement. In this respect medical science has made a great step forward. It is not that long ago when patients after hair transplant looked like they had been shot with a scattergun. For your imagination, a punch of nine millimeters average was used back then. Circles of almost one centimeter were shot from the nape and they were put into the bald part of head – without sewing, with a strong belief that the body will heal itself! And the body did – sometimes it accepted the foreign skin, sometimes not. The hair bulbs didn’t get have time to acclimatize, so only about half of the 100 nine millimeter circles survived; the rest rotted. It was necessary to come up with a new solution. So whole flaps of skin, 10 x 2 cm were cut! The cutting was then sewed with stitches and the patient looked like a samurai after a careless exercise with his sword. No hair would naturally grow at the donor place. “Sometimes there remained a small scar at the place, thin like the top of a pencil, sometimes the size of six millimeters, but I have seen a scar of ten millimeters, and once even three scars above each other, each one and a half centimeters long! The skin is elastic, so it lifts in time, but until then the patient walks permanently bent towards the sky,” surgeon Hajduk shares his experiences. I look through a book with pictures from hair surgeries that were common even recently. Such results wouldn’t be embarrassing to a makeup person for horror movies. “Truly said, not everyone was able, with this older method, to withdraw hair so that he or she wouldn’t get deeper into the skin and cut some nerves or muscles,” adds surgeon Hajduk. No wonder that even this type of method soon ended!

We live in a world of permanent minimalization, so that even the flaps of skin were gradually getting smaller and smaller – they were counted in millimeter strips but still it wasn’t right. It was difficult to insert the cut skin from the nape to the forehead – shapes and sizes of the transplant often didn’t fit well. So finally today’s method of Follicular Unit Extraction was reached. It can so far imitate nature in the best way – at least the cut circle from the nape fits to the circle cut in the forehead.

Women’s lover

It is one year after the first surgery and half a year after the thickening procedure. I stand in front of the mirror with a picture of my old self, a reflection of today’s reality in front of me. I look back and forth from the picture to my current look – there is a change! And very visible! How is it possible that no one has noticed it? To put it right, one of my friends, a girl, noticed the other week that my hair is becoming grey. Although it looks charming. But how could the sexy blond at the next table that I literally stripped with my eyes the other day during lunch miss my hair? She didn’t wear glasses! Is it true that women don’t notice these things? So what, to hell with them! The important thing is that inside of me I feel much better, more complex, and hairier. The time I spend every morning in front of the mirror in a useless effort to fix my old-new disobeying hair with extra strong gel raises my self-confidence. And my new self-confidence must shine from me – two days ago I got an offer from a radio. I won’t fly to San Francisco! And concerning women…in any case Internet dates are very trendy today.

P.S. Hairy 35-year-old man looking for…

Get to know the advantage of laser treatment in dermatology and the types of lasers, divided by the method of the skin treatment. If you suffer from acne, unsightly scars, varices, psoriasis, you wish to have your facial skin rejuvenated or to have the undesired hair, pigmentation or tattoo removed, then you will find detailed information about the devices and treatments offered by laser medicine in this article. The main task of this article is to get acquainted a curious user and a potential client that is going to undergo some of the procedures from the field of corrective dermatology, just with the amount of magic light energy flows, which is really surprising. The same can be said also about the possibilities of their usage: not just the wrinkle, vascular and pigment lesions correction, permanent reduction of undesired hair but also even the removal of varicose veins, acne and psoriasis treatment and painless skin rejuvenation.

We should have in mind that lasers are often related to magic effects thanks to the massive media campaign, which they do not have. As well as their advantages, such as simplification of treating procedures, acceleration and simplification of healing process are compensated with high price that is usually in most cases paid by the patient because the laser treatment still does belong to the above-standard treatment.

And now already a description of each group, to which are lasers that are used in dermatology, divided according to the type of skin treatment.

Lasers for Vascular Lesion Treatment

Vascular lesions are divided in congenital and acquired. To the congenital lesions belong for example so-called naevus flammeus, known as port-wine stain. It is an esthetically bad looking congenital defect, which is caused by accumulation of enlarged blood vessels. A part of the acquired malformations are for example so-called spider veins, small veins on legs, Slavic women have allegedly the biggest problems with them in Europe. Of course that there are more types of vascular lesions, but a specific laser may be of help to the majority of them.

The laser for vascular lesion treatment went through several phases of development. Already in the 80’s the argon laser was used in Bohemia (at Dermatology Clinic at General Faculty Hospital in Prague). Shortly after that it was changed by so-called dye lasers, there was achieved optimum increase of energy, although imperfect range of pulse energy. This has often led to the creation of pressure wave inside the treated vessel, and to its consequent burst and therefore small bruises were often formed. The patients did not like it too much, luckily in the 90’s the scientists finally evolved fully suitable type, so-called KTP laser with double frequency and long pulse. It enables enough deep penetrating of laser beam energy into the vessel and because the formed heat does not localize into the spot, there is no crash wave and redness. Moreover this laser works with special cooling sapphire explorer, which also prevents the redness. The cooling has also an analgesic effect. Vascular lesions are treated with this type of laser until today and its excellent complex characteristics pose it on the imaginary laser top aimed for treatment of vascular defects.

Lasers for Pigment Lesion Treatment

According to that the pigment stains can present a symptom of starting malign melanoma, it is always good to consider carefully, if it is not better to cut the stain out with classic method. Here it really is a question of health and many times even of life and the esthetic feelings have to therefore go aside. However, not every pigment lesion is a potential skin tumor. To the most frequent skin pigment stains belongs melasma, often occurring during the pregnancy or when taking oral anticonception. Unfortunately it is hard to heal it; the usage of laser is approached only in extreme cases. As for tattoos it is possible to use for example so-called Q-switched laser. This laser can evoke an effective appearance called photo-disruption, when it literally “breaks up” the pigmentation. Photo-disruptive lasers have extremely short pulse around millionths of a second and therefore it disposes of very high pulse energy. They represent with little exaggeration such laser pistols.

Laser for Vaporization of Unwanted Skin Lesions

Vaporization or evaporating is a method of using photo-ablative effect, i.e. removal of lesion by light. This technique uses vaporizing CO2 lasers or Erbium lasers. However, they are not produced anymore. Present development in the field of vaporizing lasers aims to improvement of CO2 lasers. Perfect technical characteristics of carbon dioxide laser with ultra short pulse almost crowded out even the originally biggest advantage of Erbium lasers, i.e. shorter time of healing.

Lasers for Tattoo Treatment

Here is still very popular topic tattooing – although in this case we talk about its removal. It is still very fashionable to decorate your body with more or less well done pictures, unfortunately people do not think about how is their mermaid that is tattooed on their belly going to look like after thirty years (and in many cases even after thirty kilograms) or if the name of your honey, which is now nicely surrounding your arm is going to be relevant even next year. In short, people consider the decoration of the skin still very freely and thoughtless and then they complain in the offices of the dermatologists, expecting a miracle. Instead of that a very complicated process is waiting for them and the final effect does not have to be satisfactory at all. And this even today when the surgeons use the most modern laser technique. The structure of incorporated color is not always very clear, so often unpleasant surprises occur. The usage of some wavelengths causes a change from bivalent iron to trivalent iron. The result when removing for example wrong done red lip contour is a change to more visible black color. Another problem represents still more and more popular multicolor tattoos. It is necessary to dispose of several wavelengths (i.e. several lasers) to remove them. Finally a person that had his/her tattoo done does not take into account that its removal is in most cases more expensive than its purchase. The list of lasers for tattoo removal partially coincides with the list of laser for pigmentation removal – it means again a system of “breaking up” the pigment. Here we have to take into consideration also already mentioned color tattoos. The only laser VersaPulse C Aesthetic has 4 different wavelengths in one system. The advantage of using the most modern lasers is the absence of scar after the removal. To spare you from inconveniences and even the content of your wallet it is warmly recommended to think more in advance about the appearance, placement and size of the tattoo according to coming years.

Lasers for Scar Treatment

Even though the surgeons can do many things today, they cannot still make miracles and this is valid absolutely about the treatment of scars. It is impossible to fully recover an inferior scared tissue, which is often hard to put up with for the patients. However the surgeons can contribute to an essential scar modification for better, i.e. its reduction, thinning, discoloring and so on. The ability to treat a scar also depends on the type of scars and even on a whole range of other factors, such as age, gender or photo type. The treatment is usually a combined method, in which laser therapy is only a part of it.

According to scar types (for example atrophic, hypertrophic, keloid or very unfavorable striae in women) a laser type is chosen.

Lasers for Unwanted Hair Removal

Many women and even men despair of the extent or location of unsightly hair. Even this unpleasant aesthetic problem can be solved with laser. The advantage is a permanent reduction, which means that after a repeated treatment there is no reason to be afraid that the hair will start to grow again. The development of so-called epilatory lasers has progressed a lot and the top laser among their overflow is an American, already several times improved laser, which is called LightSheer. This laser or the precedent lasers that are still in function can get you rid of the hair practically anywhere on the body.

Lasers for Varicose Veins Treatment

Varicose veins or varices – habitually known and unpleasant problem that bothers seniors and women after the delivery. For all those who expect a surgical procedure with stay in hospital and a sickness leave, we have pleasant information; even here laser methods are in use. The usage of beam brings a fundamental comfort, it is performed as an out-patient procedure, the patient can go home after not even an hour and he/she can immediately return to his/her all activities without having a sickness leave. This is very nice to hear, the reason for this is a diode laser with one-time set. The method consists in inserting an optical fiber, which is capable to transfer the laser pulses into the vein. When taking this fiber out of the vein, it is step by step sealed, which prevents the back blood flow and therefore even its accumulation in the veins. According to the amount of the patients that suffer from varices as well the fears from possible complications after surgeries, this novelty is really very exciting and it started a new era in extension of treating methods of this very frequent defect.

Devices for Psoriasis and Vitiligo Treatment

And another skin problem –psoriasis. It is a chronic disease; although life is not in danger, the disease is very severe and dragging, bringing many times a big sufferance for the patient. Prevention or specific treatment are not yet known. So as vitiligo, another troublesome skin disease, caused by drop-outs of pigmentation. The cells that form pigment die away; it is not very rare. 1-4% of all citizens suffer from it. Also here the cause is not known yet.

Nevertheless even in this case the usage of laser presents a converting event. At World Dermatology Congress in Paris in 2002 a new device was introduced in European first run BClear (producer Lumenis). It is said that the focus of psoriasis weakens already after 1-2 sessions, after total 4-6 sessions it completely disappears. The system uses focused fiber optics with therapy of high doses without damaging a surrounding healthy skin; this is performed with the help of contact ending with active size 16x16mm. It is a device made especially on requests of dermatologists. The aim of the method is to replace to a certain extent medicamentous treatment of psoriasis with the use of light. It is very interesting that even though it is a disease where a genetic disposition plays its role, in an overwhelming majority of cases a recurrence does not occur. However, it is relatively fresh novelty, to confirm long-lasting effects of this method there are not enough data. So it is good to have a certain restraint, although it has been clear even now that laser will present a big turning-point in the treatment of psoriasis and vitiligo.

Lasers for Acne Treatment

Acne vulgaris – inflammatory skin disease that is manifested by eruption of ugly, inflamed pimples, well known by almost all of us. It is also a great origin of complexes and difficulties in the puberty, in case of such troubles, that forced us to ill-judged acts that even worsened the state of the skin. Many people have these annoying pimples even in the adult age, which presents a state that is usually perceived as double indignity. Luckily there is a large amount of methods in today’s dermatology how to end up with this disease or at least markedly limit its symptoms. One of them is also a laser treatment method. The light laser treatment shows as very effective. In principle it is a usage of big amount of endogenous porphyrin, an organic chemical combination that spontaneously discharges Propionibacterium acne (co-responsible bacteria for acne creation). A selective photothermolysis works here so that these porphyrins are “turned on” with high doses of above mentioned specific light, which leads to photodestrution of these bacteria. Clinical studies prove that through this method up to 90% of bacteria P. acne are killed. This process comes approximately three times faster compared to oral antibiotics or local preparations.

Biostimulation lasers or Soft Lasers

In the list of lasers there should not be missing so-called biostimulation lasers, those are lasers used in dermatology especially as additional method for acceleration of wound healing. They are most often used in treatment of herpes, acne, decubitus or scars.

IPL

An Intense Pulse Light, a procedure known more under the abbreviation IPL (Intense Pulse Light) or among the patients it is called an iron, in the Czech Republic it has been used for last several years. It is a polychromatic not laser therapy that uses effects of various wavelengths at the same time. These systems find today their use in so-called photorejuvenation or skin rejuvenation with light. A significant correction especially of colored skin modification can be achieved, i.e. vascular and pigment defects and also improvement of skin quality, such as refinement of wrinkles and texture of the skin. For improvement of quality of drooping skin and its tonization a so far newest method is still more used, it is called:

Radio Frequency

At present uniquely dominates a system of so-called bipolar radio frequency with suction bipolar headpiece – a device known as ALUMA, a company Lumenis. The sucked skin stays untouched during the procedure; on the other hand the targeted warming of dermal collagen leads to stimulation and its regeneration and following firming of drooping facial skin.

Several celebrities have gone under the knife to get their physical features altered in procedures such as nose jobs, breast enlargements, lip and Botox injections. Some procedures have gone well while others have gone awfully wrong. Steph McGovern once said in her Twitter account that the analogy of Botox economics is that if the injections go wrong, they get toxic. Here are a few English stars who went under the surgeon’s knife and the result of their cosmetic surgery procedures.

Gail Porter

Gail Porter, a TV presenter, admitted to having a breast reduction job a while back. She said that from the time she was in her puberty at around nine years of age, she did not like her breasts and always wanted to have a flat chest. Over the years, she had to live in mental anguish for having naturally giant 28J breasts on her chest. A number of times, she had attempted to cut them but with serious effects. At one time, she had an eating disorder when she refused to eat in a bid to reduce her breasts. Luckily, her breast reduction procedure worked well, and she now loves her small breasts and almost flat chest. She added to say that she feels more confident than she was with large breasts. Gail Porter has lost all her hair on her head to alopecia.

Alicia Douvall

Alicia Douvall is a former Glamour Model and TV personality. Over her lifetime, she has gone under the surgeon’s scalpel for a whopping 350 times. The star revealed that she had an addiction to cosmetic procedures but is working to deal with the problem. Her last visit to the operating table was in 2016 where she was admitted to correct a boob job that had gone wrong. She revealed that she almost died in the procedure. In the earlier boob procedure, she had had a 30G breast implant that turned solid with blood clotting around the breast. Other procedures that the star has had over the years include 14 other boob jobs, seven nose jobs, toe shortening procedures and lots of Botox injections. Alicia is now undergoing counseling classes to let go of her compulsive desire to alter her body shape and features. She says she loves naturally looking women just like Steph McGovern pictures that have been doing rounds on the internet.

Katie Price

Katie Price is a former model for Glamour magazine who has undergone multiple procedures to enhance her face, boobs and general image. Before she started on plastic surgeries, Katie looked more like Steph McGovern photos of her youth. She was fresh-faced, had well-rounded breasts and an awesome figure. Now, the 40-year old lady has had to have an emergency face lift after too many procedures on her face damaged her facial muscles.

Botched Procedures

Katie has had about two nose jobs, breast implants, multiple filler procedures and a new set of teeth. She even had new hair extensions. The procedure that made it necessary for her to get an emergency face lift had been done around her eyes. However, it left her with dark circles under her eyes and saggy skin on her face. A while back, her breast implants had also ruptured in Big Brother reality show, causing her to seek immediate medical attention. Today, she looks so different from her former self.

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