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