“Those miraculous before and after are an absolute and total lie that can not be allowed”

President of the SGCPRE (Galician Society of Aesthetic and Reconstructive Plastic Surgery) and specialist in Aesthetic and Reconstructive Plastic Surgery.

Q_ What fields does Spanish social security cover and which are private in terms of Plastic, Reconstructive and Aesthetic Surgery?

A_Social Security only covers the plastic and repair part. Aesthetic surgery is what is usually done in private practice. Regardless that here we also do reconstructive plastic surgery. Social security does not cover the aesthetic part absolutely nothing. We are a specialty that we are a bit between the two things, complementary to each other.

Q What is the most requested after a surgery with subsequent marks or injuries? Are they coming from Social Security to the private sphere?

Q_Social Security in this country thanks to God works very well and it is rare that nothing of social security you have to do here.

A_Social Security, for example, breast reconstruction, which would be one of the things most often done by plastic surgeons, is fully standardized, regulated and covered in all cases. Yes it is true that we do some breast reconstruction in the private sector but most are done in the Social Security.

Q_When a patient demands a cosmetic surgery how do you know what is right for your health?

A_Eso is a very complicated world because you have to act as a psychologist and people sometimes ask you for absurd things. People often relate a physical improvement in a point that she is concerned with improving their quality of life or their relationships with others. And sometimes you see clearly that it is a lie. It is very common for the lady who separates with forty-something years and says “now I’m going to fix my nose, I’m going to fix my breasts and my belly because I’ve had three children and I’m fatal and then all my life will go very good” . And I tell them: “It will not go very well, life will be the same but you will find yourself better if it is indicated”.

In other words, we have to stop surgeries many times. Both surgeries and aesthetic medicine stuffs, stuffed … And you have to say: “We are stopping because they are not going to get an improvement, the result is not going to be liked and it is not the solution to your life”. And I even tell them: “As you continue visiting clinics you will find the place where they will do it and then you will come crying.”

You have to be very sensible because people see this as well as a bit of a confessional. “It’s that this is my problem in life they say” and “no, that’s not your problem in life!”. Sometimes yes, there are times that there are things that are very striking things. But it is more the change that occurs in your psychology when you operate something, in your outward attitude that others are as concerned as you in that issue that others do not even see it.

Q_Then you see that change?

A_With people you have to talk, in an aesthetic consultation sometimes you are talking for an hour or hour and not just talking and this is very important.

Patient who come to do a liposuction because they want to lose 25 kilos. And you have to explain that you can not kill birds with cannon fire.

_What is a very honest way to practice medicine …

You have to say no, you have to lose weight … and then when you are in the right weight I do not tell you that you are thin but adequate. That area that we can not lose weight or skin that you have left, that area we can adapt. But you can not continue doing what you want, eating what you want and weighing 90 kilos and say that I do a liposuction because you will not be happy.

Q_ What influence do pharmaceutical companies have on people seeking to improve through the products they offer?

A_In that kind of thing I think it’s the publicity they can do. But that is increasingly regulated, every time we are more strict with that and each is allowed less.

In my case as president of the Galician Society of Plastic Surgery for 3 years and whenever we see that there are things that are not true but misleading advertising we take measures and go to health or go to medical school and send them to cut those things and many times we get it.

Because lies, those before and after miraculous are an absolute and total lie that can not be allowed.

Q_ Patients who come to you with a post-surgery injury, how is it treated?

A_In these cases we always have a relationship with oncologists. A patient who has had an injury of this type is always evaluated by an oncologist at the same time. And the oncologist is the one who sends it and tells you if it can be done or is indicated or as I said with breast cancer, which is the most we see there are units of radiologists plastic surgeons, general practitioners, radiologists all of them jointly decide when a surgery is done or another is done as a team. When it comes, when it is rebuilt, when it is necessary to wait. Everything is done in a team.

They are multidisciplinary teams that are the ones that decide this type of things.

Q. What would you recommend to young people who start at an early age demanding a breast, nose, and lip surgery?

A_Depend on the indication you have, for example a girl with a disproportionate nose, exaggerated, because they are operated before going to college. Well, people do not remember when you are little but your new incorporation into life is very important to arrive with this issue solved. Another thing is the girl who has nothing and wants to have more lip, more breast. I do not agree with that, but with real problems with dysmorphisms, with real alterations, I think we have to do them before these young people arrive at work, at university life.

 

Q_What do you think of the people who continually operate to always look young?

A_I believe that you can have it is the highest quality of skin and structure that corresponds to your age. It’s absurd when a 70-year-old person asks me: “How old are you going to leave me?” To which I say: “Well I’ll leave you with 70 as you have, but with a more cheerful face, without that sad rictus , without that frown of annoyance, but of 70 because the other is a fantasy “.

A Coruña, July 2018. By Ania Casal