Trends in plastic surgery
Natalia Manturova: From geriatric aesthetics to artificial intelligence
Nikita Pavlyuk-Pavlyuchenko, "Snob"
Statistics show that Russians are spending more and more money on cosmetic improvements – both non-invasive and surgical procedures. At the conference BIOTECHMED chief freelance specialist in plastic surgery of the Ministry of Health of the Russian Federation, Doctor of Medical Sciences Natalia Manturova told "Snob" what breakthrough technologies are waiting in the near future for Russians who want to look good at any age.
The secret of her youth
Changes in demographics have led to the emergence of a new field called geriatric aesthetics. This is due to the trend that 60 is the new 40, with the fact that the pension reform forces a person at 50 to participate on an equal footing in the social race with 25–year-olds, while the age limit for hiring has become a "social norm". Many companies do not hesitate to say publicly that they do not consider candidates over the age of 45. It is obvious that "age-related" employees need psychological and social adaptation.
A study published in the July issue of Aesthetic Surgery Journal found that a third of patients underwent anti-aging procedures due to age discrimination or fear of such discrimination.
This means that we expect an increase in demand for aesthetic services in the age group under discussion. This means that there is a serious need for specialists in geriatric aesthetics who will be able to work with this category of patients, take into account the biological properties of the cell and the organism as a whole and diseases received by this age that affect the possibility of carrying out this or that intervention.
Geriatric aesthetics is a new direction for Russia, which is being formed right now before our eyes, unlike foreign medicine, where plastic surgery of age–related patients is more common.
In addition, it must be understood that this is not compulsory medical insurance, but paid medicine. It is necessary to take into account how people of retirement and pre-retirement age or their children are solvent, it is possible to change the pricing policy, develop less invasive, simpler manipulations. But that's another story.
Is it easier to prevent than to treat?
As a kind of prevention of aging, the anti-age movement is gaining strength in society, or the term "biohacking", which is more to the liking of geniuses from Silicon Valley. Many people reasonably hope that they will live up to 100 years or more, and want to maintain undying activity until their death.
The audience of biohacking is people 35-45 years old who want to improve their performance, are ready to invest in their health, do not want to put up with the fact that they feel and look worse.
Anti–aging medicine is a systematic approach to improve body functions and slow down aging based on individual biomarkers. This is a medical and wellness practice aimed at prolonging life and improving its quality, which includes tuning all vital functions and processes of the body – nutrition, sleep, physical activity – and avoiding factors that accelerate aging.
We are still far from Voland, but we are talking about a set of technologies that allow us to prolong life on the basis of improving the internal capabilities of the body (tissues), and this leads to an improvement in external properties. For example, the elasticity of the skin improves, color, etc.
My little secret
There is a request from patients for speed, low invasiveness and secrecy, that is, for procedures that allow you to get a good effect in a short time without any visible interventions. So that you can, relatively speaking, leave work at lunch for the procedure and tighten the skin of the face. A patient who has received such a procedure remains in a certain incognito zone, they say, I don't do anything with myself, I have good genetics.
First there was liposuction, the popularity of which, according to the latest data The American Society of Plastic Surgeons (ASPS) has declined by 30% since 2000, but still remains one of the top 5 cosmetic surgical procedures. Then came non-invasive procedures to reduce the amount of fat, such as cryolipolysis.
The latest achievement for patients who want to effectively and safely improve their body contours, without radical interventions, is High Intensity Focused Ultrasound (HIFU). HIFU technology allows you to act in two directions at once: to remove excess volumes and tighten the skin. Deep warming and ultrasound "burns" fat cells and improves the process of collagen production. Moreover, the effect of the procedure persists for years. Which again allows a person not to sit on a diet and refer to a good metabolism.
Personalization
Most often this word now sounds in the context of marketing communications of companies, but in our industry the future belongs to biotechnologies, which involve an individual approach to a particular person.
You see creams 40+, 50+ on the shelf, but each person's cell behaves differently, and its "behavior" does not always depend on age.
We are conducting research activities to assess the relationship between the patient's age, the state of the body, and the biological properties of tissues, so that over time, taking into account all the data, we can learn how to make a plan for a personalized approach to restoring the integrity of cells. This will be greatly facilitated by the introduction of artificial intelligence tools into the work of cosmetologists and plastic surgeons.
Artificial intelligence is a worldwide trend, plastic surgery is no exception here. The high speed of AI calculations can help surgeons in planning aesthetic operations and in choosing procedures for patients. AI can analyze huge databases of facial images to assess specific situations. A detailed assessment of the proportions of the face by artificial intelligence significantly exceeds human capabilities. This process is extremely detailed and includes an assessment of the symmetry of the patient's face, the evenness and color of the skin, ethnic features of the structure of the facial skeleton, which ultimately may affect the choice of the optimal surgical intervention method by the surgeon.
With the help of real-time simulations, the patient will be able to see how he will look after surgery. Perhaps the unrealistic expectations of many patients will be dispelled, and this will keep them from surgery, which will not allow them to achieve the desired image.
The AI will be able to offer the surgeon some new or alternative technique or, after analyzing all the techniques, will offer a combination of them. A doctor is unlikely to be able to do this quickly, and his recommendations will be based on personal experience, and AI is based on big data. AI is devoid of emotions – at least, we count on it – its proposals will be impartial.
The introduction of AI into medical practice will also allow us to build predictive models – how the patient will feel, how long the clinical effect will last.
How to solve the problem of the availability of implants
3D printing clearly demonstrates the gradual development of biotechnology. The creation of human organs with its help will help solve the problem of the shortage of available transplants. However, to date it has proved to be quite difficult. One of the main stumbling blocks is the lack of a functional vascular network in 3D-printed biological structures.
3D models were first received as training material for surgeons, an organ appeared in their arsenal that can be studied in detail and performed operations on it. Cellular technologies have already appeared and the possibility to plant cells in a 3D organ in the laboratory, in which they develop, replacing the matrix. This is the second step. But there is one thing: we have received a living organ consisting of cells, but it does not have a blood supply system in common with the body, that is, we cannot preserve the viability of this structure inside a person. And now scientists are struggling with the third step – the creation of a blood supply system that can be safely integrated into the general system of the body.
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