Dr. Hristo Lozanov is one of the best specialists in plastic reconstructive and aesthetic surgery in our country. He gained his knowledge as a plastic surgeon during his specialization at Aleksandrovsk Hospital and Pirogov and working at the Military Medical Academy. Department of Plastic and Reconstructive Surgery at the Academy of Medical Sciences, where he works to this day
Also works at the INSTITUTO Dr JAVIER de BENITO, Barcelona. He completed a full Fellowship program INSTITUTO Dr JAVIER de BENITO, where he worked with the world-renowned plastic surgeon Dr Javier de Benito, CENTRO MEDICO TEKNON. He also completed the master's course in plastic, reconstructive and aesthetic surgery under the guidance of Prof. Edgar Beamer, Munich.
He has been awarded the scientific degree of Doctor of Plastic Reconstructive and Aesthetic Surgery. Recently, he is also an associate professor. Head of the "Plastic Surgery" Department of the Academy of Medical Sciences
In a frank and curious interview, Dr. Lozanov answers important questions related not only to the vision, but also to the self-esteem of the Bulgarian woman.
Prof. Lozanov, in our preliminary conversation we talked about the Bulgarian woman and her undeniable beauty. It's different when these words come from the mouth of a plastic surgeon, to whom ladies go precisely because they want to be beautiful
- The Bulgarian woman is the most beautiful woman in my opinion. I have been all over the world and I believe that the beauty of a Bulgarian woman does not need to be transformed in any way.
The woman needs care, attention
Whether she is in her 20s, 30s or 40s, we can help keep her looking good by offering new techniques to refresh her beauty. But we cannot change it. The most important thing is, when we are looking for a good tailor or a specialist in something, for example, to visit at least a few in order to determine the best specialist for us. It is for this reason that I advise all patients to visit several colleagues before resorting to any aesthetic procedures. And not to go to the first person they meet.
In Bulgaria there is an Association of Plastic Surgery, of which I am a member, and which tries to impose some approximate standards for the treatment and methods regarding plastic, aesthetic and other procedures. Appearance is a very important thing these days, and in my opinion, it touches the line - how much a change in a person would be beautiful and acceptable. Therefore, it is good to visit a specialist to determine this limit. The measure by which this change will be made.
Usually, when looking for a plastic surgeon, a woman already has an idea of how she would like to look. But if you think she has gone too far in her demands, how do you go about reconstructing her view of herself?
- Very good question. To answer this way - do you know the difference between going to a hairdresser or a plastic surgeon? It is on the scale of change. One must be aware when a patient stands up against something, what the scale of the change can be; the severity of the surgical trauma; what can be accepted by the body and how physiological it is; as far as would be tolerable in relation to the psychological capabilities of the patient concerned. When I see that there are usually two women in the patient, I do not attempt to operate. And to all the more mature women, I explain that aging is like a photocopy - each successive one is paler.
There are women who want almost to preserve themselves - to outwit time as a move. But as we well know, this is impossible
- Such women are the so-called "ageless women". I know quite a few. And usually these are women who often resort to aesthetic procedures, but I assure you, they do not always find the right specialist for what they want. Yes, this type of women cannot outwit the weather or nature, but they most often bet on something that is very good at keeping not only the spirit, but also the body in good shape - sports. Such women exercise a lot and do their best to keep their bodies sculpted, but the signs of aging are inevitable. They are mostly visible on the face and cannot be rejuvenated by sports alone. And that is why aesthetic surgery is resorted to. Basically, aesthetic surgery started to be talked about when democracy came. And when a democracy enters, first comes Coca-Cola, then McDonald's, and finally cosmetic surgery. Simply because people understand that it's not all about consumption, and they also need to look good. As we said, we are now in the era of the very sporty people, especially the type of women who want to cheat the time. They generally require very small adjustments. And here is the place to mention some novelties in aesthetic surgery. For example
can now prevent face and bust sagging –
this is done by placing the so-called Siler Lift sutures, which is neither a facelift nor a major surgery, but it stops and suspends the sagging of the face, which in women is a hormonal process. It's the same with sagging busts. Back in the day, too many women did one, two, three corrections. Gorgeous body but saggy bust. Reassessing capsular contracture over time is a very important point – how far breast implants need to be replaced. Companies are constantly churning out new and new implants - for example, in a standing position, the breast looks anatomical, but in a lying position - round. I don't want to say that we follow the industry. We strive to follow life, and it is stronger than canon in my opinion.
How life-threatening can silicone be? There are countries where silicone breast implants are prohibited
- The big breast era will never go away in my opinion. And this necessitates the promotion of this operation. But it must be applied within certain limits that we talked about a while ago.
The size should not be exaggerated in any way
The size of the implants to be placed should be judged very conservatively and cold-bloodedly. Because there comes a point when it becomes very difficult to correct the patients afterwards. Otherwise, the intervention itself has two types of risks - early and late. The early risks are of infection, bleeding and in some cases extrusion of the implants, that is they start to come out if they are too big. In the late postoperative period, we must warn patients that capsular contracture is a possible complication - especially in women who actively play sports. It also happens in women with larger implants. That's why it's a challenge for us specialists, because secondary augmentation mammaplasty is not like primary - it has to prevent complications from it.
What are the current trends? What are women looking for the most today?
- The world is moving towards minimal and minimally invasive methods, that is, our patients want everything to be done quickly, to have an operation quickly and to recover quickly after it. We're going in that direction. This is a serious challenge in our work, but it is the future. And that's why operations such as the classic face lift or the classic breast lift are now done very rarely. In general, the desire and attitude of the patient changes a lot. The world and our practice is already moving towards minimal procedures.
Apart from lifting, which we found out is already done much less often, what is it focusing on today? What do women usually want?
- Most often, they do mesotherapy together with PRP – this is a growth hormone that is extracted from blood plasma. In one procedure, together with mesotherapy with hyaluronic acid, we have very good results in the direction of overall facial rejuvenation. The face looks more alive, there are not as many wrinkles and it is generally refreshed. These procedures compete, as I often joke, with expensive creams. Because if such a cream is at a very high price, such a procedure can certainly be at a much lower price, but at the same time it offers much more than that, because the cream cannot penetrate as deeply as mesotherapy can. The one that plastic surgeons usually do is the needle, because we know the anatomy well and know exactly where to apply it so that there is no damage. Needle-free mesotherapy is usually practiced by dermatologists, since it does not affect deep vessels and, accordingly, complications do not occur. But mesotherapy is popular more as a dermatological procedure. Plastic surgeons more often deal with the so-called liquid lifting, which is a combination - either of mesotherapy and Botox, or of mesotherapy and PRP.
Don't women often overdo it with Botox? We know that when you overdo it, the look becomes even grotesque
- Therefore, finding a measure is very important. If botox is placed in normal units, it can put a very long time in life without complications. But if it starts to overdo it, complications do occur, which again need to be corrected surgically. In general, when the face is smaller, it has a characteristic triangular appearance. When it starts to become square, that's when we more or less consider that gravity has started to affect it more. There is no strictly defined age from which it is good to resort to such procedures. I often like to say that when a patient comes to me with the words:
“Look at my face, what are you going to do to it?”
so this is not my patient. But if it comes with the words, "Look at that wrinkle, can it be filled out a little bit?", then I'm already in the know.
Are you a fan of hyaluronic acid?
- I've been putting one up for many years, I'm even one of the first. This procedure also carries risks. But it is very important to say that the face is not a bag - it cannot be filled to the maximum. But this is not always understood. We often see patients on the streets who have overdone the interventions. I don't want to offend anyone, but I am very careful, following this maxim that the face is not a bag. In no case should it be considered that hyaluronic acid is the panacea for a beautiful face. I often use the number Pi to find the balance - how much, where and how it can be done. An individual analysis of each patient is done without going to extremes.
In that sense, I guess you feel at times more like a psychologist than a surgeon when interacting with patients?
- Very often, patients like to talk more than they are going to do something. And it is for this reason that we, especially when it comes to cosmetic surgery, do not immediately go for the correction. We consider very carefully what the patient wants. There are patients, for example, when they are calm when something is done to them and they are pleasantly surprised by the effect. And it has to do with the inner attitude. There are patients with very high expectations, with average and with minimal. And one of our roles as specialists is to determine after consultation exactly this growth of expectations.
We started the conversation by saying that the Bulgarian woman is the most beautiful woman. Let's end it with this, is the self-esteem high?
- A Bulgarian woman must have very high self-esteem, I can say that as a specialist.