NEW ORLEANS –  There’s good news for patients who are unhappy with the appearance of their nose, but prefer the needle over the knife. Fat grafting to the nose alone, or in combination with more traditional techniques, can lead to aesthetic improvement while providing a less invasive option to reshape the nose with minimal to no surgery, according to a new study being presented at the American Society of Plastic Surgeons (ASPS) annual conference, Plastic Surgery The Meeting, October 26-30, in New Orleans.

“Fat grafting is usually a tool used in revision nose reshaping procedures on patients who were unhappy with the results of their initial procedure,” said Eser Yuksel, MD, ASPS Member Surgeon and study lead author. “In this study, we utilized fat grafting solely or in combination for primary nose reshaping. We found that even when used with traditional nose reshaping techniques, fat grafting allows for minimized dissection and improved skin quality.”

In the study, 59 patients underwent primary nose reshaping with fat grafting for nasal volume restoration and contour adjustment. Fat grafting was repeated one to three times, at different times, in various anatomical areas including the nasal tip, bridge, and base, as well as, the forehead for projection. Twelve nose reshaping patients had fat grafting alone, while 47 patients had combination fat grafting/traditional nose reshaping. Improvement was observed in those who had only fat grafting. However, fat grafting, by itself, is more effective when the defect is more planar or inherent to certain compartments, the authors note. Thirty-five of the patients who had combination fat grafting/traditional nose reshaping, saw significant improvement.

“Fat grafting alone may not be appropriate or the correct course of action for every nose reshaping patient,” said Dr. Yuksel. “Volume shifts due to gravity may occur in some cases, though it can be avoided by using specific external splints in the early postoperative period.”

The study, “Role of Fat Grafting in Primary Rhinoplasty,” is being presented Sunday, October 28, 9:00 a.m., at the Ernest N. Morial Convention Center in New Orleans.

NEW ORLEANS – It is well known that a properly groomed eyebrow can make an amazing difference in how you look. However, a new study being presented at the American Society of Plastic Surgeons(ASPS) annual conference, Plastic Surgery The Meeting, October 26-30, in New Orleans, reveals it may not only be the shape of your eyebrows that’s got people talking – it may be their projection. According to the study, the projection of your eyebrows can positively impact how others perceive your facial attractiveness.

“The eyes play an essential role in facial attractiveness and beauty and should be surrounded by high walls, similar to the principle of utilizing frames for pictures on a wall,” said Eser Yuksel, MD, ASPS Member Surgeon and study lead author. “Higher walls allow for greater projection of the eyebrow, which we found, correlates to a greater degree of perceived facial attractiveness.”

The study measured the surface area and the projection of the soft tissue from the top of the eyelid to the eyebrow, also known as the “oblique frame.” Photos of 20 patients, divided into two groups, demonstrating low and high oblique frames were examined. Additionally, preoperative and postoperative photos of 20 patients who had fat injections to increase their oblique frames were examined. Ten subjects were randomly selected to rate the photos, in terms of attractiveness, from a scale of zero to two (0 = unattractive, 1 = no inclination, 2 = attractive). The subjects rated photos of patients with higher oblique frames, as well as, the postoperative photos of patients who had fat injections to increase their oblique frames, as more attractive.

“Proper positioning of the eyebrows has long been a major component to facial rejuvenation procedures,” said Dr. Yuksel. “However, this study shows that fat grafting to the oblique frame should also be considered when rejuvenating the face, as it can significantly impact facial aesthetics.”

The study, “Sagittal Projection of the Eyebrow Versus Facial Attractiveness,” is being presented Sunday, October 28, 10:45 a.m., at the Ernest N. Morial Convention Center in New Orleans.

For Immediate Release: 10/25/2012

NEW ORLEANS – Will we ever be able to treat aging on a molecular level? How about slow down, reverse, or prevent the aging process altogether? Well, a new study being presented at the American Society of Plastic Surgeons (ASPS) annual conference, Plastic Surgery The Meeting, October 26-30, in New Orleans, aims to address just that. According to the study, for the first time, plastic surgeons have identified specific molecular changes in genome structure that occur in fat that may serve as critical markers for tissue aging and, if these changes are reversed, may someday provide people with a more youthful appearance on a molecular level – no surgery required.

“Fat is an excellent model with which to study human aging,” said Ivona Percec, MD, ASPS Candidate Member and study lead author. “Plastic surgeons strive to treat the appearance of aging in an effective and natural manner through surgical intervention, an approach that can be compromised by the limitations of aged tissue. Our goal is to define the molecular changes responsible for normal human tissue aging to identify novel, less invasive, therapies for the prevention and treatment of aging.”

In the study, fat was taken from the abdomen of healthy patients ranging from age 18-85 who were undergoing plastic surgery. Fat cells and stem cells were then extracted and genes regulating aging were examined. Significantly, the study found that specific changes that occur to histones and other molecules regulating gene activity may serve as critical makers to tissue aging. In youth, DNA is bound around histone genes in a specific pattern, but that pattern changes as we age. By identifying these critical markers to tissue aging, the authors hope to someday reverse the changes that occur in order to recreate a more youthful pattern of DNA architecture. According to the authors, future application could be administered in pill, topical, or injectable form.

“Histones and the way our genes are organized in our cells are important to aging – they affect how cells age,” said Dr. Percec. “In future studies, we will investigate regulatory molecules that reverse changes in the human genome structure in an attempt to prevent or reverse aging in these cells. These findings, and planned future studies, are critical for advancing the understanding of how human tissues age and have significant implications for regenerative medicine applications in plastic surgery.”

The study, “A Discovery of Fat Through the Ages: The Role of Histone Modifications in Aging Subcutaneous Fat,” is being presented Sunday, October 28, 9:10 a.m., at the Ernest N. Morial Convention Center in New Orleans.

Arlington Heights, Ill. - Plastic surgeons need to be aware of new approaches-and vigilant about following basic techniques-for preventing errors and protecting patient safety in the operating room, according to a special article in the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“As the importance of teamwork becomes more evident, clear communication skills preoperatively, intraoperatively and postoperatively become equally critical,” write ASPS Member Surgeon Dr. Samuel O. Poore of University of Wisconsin and colleagues. In the first of two articles, they highlight some key preoperative steps for maximizing patient safety during plastic surgery procedures.

Crew Resource Management-Preventing Errors Through Communication
Studies have shown that communication breakdowns are a major contributor to medical errors. Crew Resource Management (CRM)-an approach borrowed from aviation-is emerging as a means of improving safety in health care as well. Dr. Poore and colleagues write, “Since being widely introduced into the airline industry, CRM has been shown to improve performance, safety, communication, morale and decrease accidents related to crew error.” Initial experience suggests that CRM can also improve safety in medical settings-including the operating room.

With the increasing push for CRM in health care, plastic surgeons need to be familiar with the techniques involved. One practical approach introduced at several institutions is briefing/debriefing protocols. This involves discussing the surgical case or procedure before and afterwards-creating a “shared mental model” that sets the tone among the surgical team.

An important part of CRM is that it provides a safe setting for all members of the surgical team-regardless of rank-to express opinions and voice concerns. In one study of cardiovascular surgery, “Team members felt the briefing/debriefing process promoted professionalism and improved communication,” according to the authors.

Back to Basics-Positioning and Infection Control
Poor communication is the root cause of a major type of preventable surgical error: wrong-site surgery. One recent study estimated that there are between 1,300 and 2,700 cases of “wrong site and wrong person surgery”-or near-miss events-each year in the United States.

Plastic surgeons need to be aware of the recently introduced “universal protocol” for preventing wrong-site surgery. The protocol specifies routines for verifying the correct site, person, and operation before every surgical procedure-including marking the incision site while the surgeon is present and the patient is awake.

Safety problems can also result from inadequate attention to basic preoperative tasks. Improper patient positioning can result in problems like nerve injuries and pressure sores. “This is especially true in plastic surgery, where unusual positioning may be required for adequate exposure,” Dr. Poore and coauthors note. They discuss important factors to assess risk and prevent injuries when positioning the patient for surgery-including some risks associated with specific surgical positions.

The review addresses other essential steps in preparing for surgery, including preoperative scrubbing and preparation of the patient’s skin. The authors review the evidence behind routine steps followed by surgeons and operating room personnel, including techniques and products for handwashing and the use of surgical gowns, gloves and masks.

Attention to such basic routines-all too easily overlooked in busy surgical settings-are critical to making plastic surgery as safe as possible. “This article should stimulate all plastic surgeons to be vigilant in assessing their practice to improve patient safety,” Dr. Poore and coauthors write. In a companion article, they address safety issues to be aware of in the intraoperative (during surgery) and postoperative periods.

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

Arlington Heights, Ill. - Body contouring after weight-loss (bariatric) surgery produces long-term gains in several aspects of quality of life, reports the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“The study indicates a sustained quality of life improvement in post-bariatric patients after body contouring surgery,” concludes the study led by Dr. Eva S.J. van der Beek of University Medical Center Utrecht, the Netherlands. “This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity,” Dr. van der Beek said.

Improved Quality of Life after Body Contouring Surgery
The researchers evaluated quality-of-life assessments in 33 patients who underwent body contouring after bariatric surgery. Body contouring refers to various plastic surgery procedures done to remove excess fat and skin after massive weight loss.

The most common procedures were abdominoplasty (“tummy tuck“) and operations on the breasts. Through an average of seven years after body contouring, the patients repeatedly completed a standard questionnaire evaluating obesity’s impact on quality of life.

The results showed “mostly moderate to large, sustained improvement” in quality of life in the years after body contouring. Scores improved in six out of seven quality-of-life domains, including physical functioning and appearance, mental well-being, social acceptance, intimacy and social network.

Some domains showed a small decrease between four and seven years’ follow-up. In general, quality-of-life scores were lower for patients who regained weight after their body contouring surgery.

Overall, 55 percent of patients were very satisfied with their results. All but one patient said they would undergo body contouring again, and considered it “an inevitable step to improve daily quality of life.” About one-fourth of patients had further body contouring surgery-another 30 percent said they would do so if their insurance covered it.

Bariatric surgery produces sustained weight loss in patients with severe obesity. However, more than two-thirds of patients with massive weight loss are left with loose or overhanging skin. This may lead to decreased satisfaction with the results of bariatric surgery, as well as psychological, social and physical problems.

Previous studies have shown that body contouring improves quality of life after bariatric surgery, but the long-term benefits are unclear. “There is an ongoing debate if body contouring surgery is an optional or essential step after massive weight loss in the treatment of morbid obesity,” Dr. van der Beek and coauthors write.

The new study shows significant and lasting improvements in quality of life for patients who have body contouring after bariatric surgery. “This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity,” the researchers write. They call for further study of the long-term benefits of body contouring-including possible reasons for the decrease in quality-of-life scores a few years after surgery.

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

For Immediate Release: 06/29/2012

Arlington Heights, Ill. (June 29, 2012) – Women undergoing breast augmentation surgery report substantial improvement in several key areas of quality of life, reports a study in the July issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Cosmetic breast augmentation can have a significant and profound positive impact on a woman’s satisfaction with her breasts [and] her psychosocial and sexual well-being,” according to the report by ASPS Member Surgeon Colleen M. McCarthy, MD of Memorial Sloan-Kettering Cancer Center, New York, and coauthors.

Questionnaire Shows Benefits After Breast Augmentation
The researchers developed and evaluated a questionnaire to evaluate changes in health-related quality of life after cosmetic breast augmentation. Quality of life is increasingly regarded as an important factor in evaluating the benefits of many types of medical or surgical treatments.

The BREAST-Q© questionnaire evaluated changes in six areas: satisfaction with breasts and with overall outcome, psychosocial, sexual, and physical well-being, and satisfaction with care. Forty-one women completed the questionnaire six months before and after undergoing cosmetic breast augmentation surgery with implants.

The group results showed significant improvement in three out of the six areas. On a 0-to-100 scale, average scores increased from 27 to 70 for satisfaction with breasts, from 45 to 78 for psychosocial well-being, and from 35 to 72 for sexual well-being.

More than 80 percent of women reported “significant improvement” in satisfaction in these three areas. The gains in quality of life were considered very large-similar in magnitude to the improvement in symptoms after hip replacement surgery.

Breast augmentation is the most common cosmetic surgical procedure performed in the United States. According to ASPS statistics, more than 300,000 women underwent cosmetic breast augmentation in 2011. Dissatisfaction with breast size or shape can negatively affect a woman’s quality of life in several ways, including self-perceived attractiveness and sexuality.

In recent years, the U.S. Food and Drug Administration has urged ongoing follow-up of women receiving breast implants to document not only the safety but also the effectiveness of breast augmentation. Dr. McCarthy and colleagues write, “This means that, more than ever before, it is vital to provide reliable and valid evidence regarding patient outcomes of breast augmentation, especially…health-related quality of life and patient satisfaction.”

The new study shows that implant-based breast augmentation can significantly improve a woman’s quality of life in several key areas. It also demonstrates the ability of the BREAST-Q to “capture the impact of surgery from a patient perspective.”

The researchers believe their findings are directly relevant to plastic surgeons working with individual patients. The BREAST-Q can provide “tangible evidence” of patient satisfaction, improve communication, and help in establishing the expected results of cosmetic breast augmentation. Using the BREAST-Q in future studies and clinical practice will also be useful in providing “benchmarks” for patient satisfaction and quality of life-especially psychological outcomes.

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

O presidente da Sociedade Brasileira de Cirurgia Plástica alerta para o risco da invasão da área por profissionais não capacitados

por Eliane Lobato

SEM TREINO
Aboudib critica a existência de cursos de fim de semana
 que garantem títulos de especialista em medicina estética

A ferida abriu e não parece haver remédio capaz de estancar o sangue. Essa ideia simboliza o sentimento de médicos integrantes da Sociedade Brasileira de Cirurgia Plástica (SBCP). Eles denunciam, por meio do presidente da entidade, José Horácio Aboudib, a invasão de profissionais não especializados na atividade para a qual se preparam durante 11 anos – seis de faculdade, dois de residência geral e mais três de especialização. O exercício de profissionais não preparados especificamente em cirurgia plástica tem gerado má fama para a classe toda. Levantamento do Conselho Regional de Medicina de São Paulo (Cremesp) revela que, entre janeiro de 2001 e julho de 2008, foram analisados processos contra 289 médicos envolvidos em cirurgia plástica. Mas apenas 2,1% eram de fato cirurgiões especializados. Os demais foram procedimentos feitos por profissionais de outras áreas.

 
“Vi um folder anunciando um curso de cirurgia plástica
nas mamas feito em apenas um fim de semana”

Aboudib chama a Sociedade Brasileira de Medicina Estética de fraudadora e diz que a Sociedade Brasileira de Medicina e Cirurgia Estética é uma entidade mais cafajeste ainda. Ambas são entidades não referendadas pelo Conselho Federal de Medicina (CFM) e compostas por médicos que, segundo ele, “fizeram cursos de fim de semana” para ganhar títulos e invadir a área. “Só querem saber de grana”, afirma. Capixaba e residente no Rio de Janeiro, casado, três filhos, Aboudib é, também, coordenador de Cirurgia Plástica da Universidade Estadual do Rio de Janeiro. Ele deu a seguinte entrevista à ISTOÉ.

“Há profissionais que fazem lipoaspiração em consultório, 
sem anestesia e até sem esterilização adequada” 

ISTOÉ -

 Por que o sr. afirma que há uma invasão no campo da cirurgia plástica no Brasil? 

 JOSÉ HORÁCIO ABOUDIB -

Existe uma coisa que se denomina medicina estética, que não é nada porque essa especialidade não existe. Não é reconhecida pelo Conselho Federal de Medicina, pela Sociedade Brasileira de Medicina, pelo Ministério da Educação, pela Associação Médica Brasileira. Medicina estética é fraude do início ao fim. Mas existe uma Sociedade Brasileira de Medicina Estética, presidida pelo médico Aloizio Faria de Souza, que só pensa em ganhar dinheiro.  

ISTOÉ -

 Por que o sr. diz isso?  

 JOSÉ HORÁCIO ABOUDIB -

A dita sociedade oferece cursos de fim de semana, os quais habilitam médicos sem residência médica a atuar como cirurgiões plásticos. O resultado é o número escandaloso apurado pelo Conselho Regional de Medicina de São Paulo: 97% dos médicos que respondem a processos relacionados à cirurgia plástica não possuem títulos de especialistas na área. Apenas seis cirurgiões plásticos e um dermatologista estão entre os 289 médicos processados por problemas em procedimentos relacionados à cirurgia plástica entre 2001 e 2008. Mas a péssima fama recai sobre todos os cirurgiões. 

ISTOÉ -

 Qual a diferença entre o médico especializado em cirurgia plástica e o da medicina estética? 

JOSÉ HORÁCIO ABOUDIB -

Gigantesca: a formação do especialista, seja cirurgião plástico, seja dermatologista, requer, após a formatura na faculdade de medicina, residência médica de 60 horas semanais, o que dá 240 horas mensais, 2,8 mil horas por ano. E são dois anos de residência em cirurgia geral e mais três anos de especialização. No total de cinco anos, são 14,4 mil horas na formação e no treinamento de um cirurgião plástico. Na chamada medicina estética, fazem cursos de um ano. Se não é uma especialidade reconhecida pelo Conselho Federal de Medicina, como pode dar título? São fraudes em sequência. 

ISTOÉ -

 Quais?  

 JOSÉ HORÁCIO ABOUDIB -

A segunda fraude são as aulas dadas em um fim de semana por mês durante um ano. Vamos considerar que sejam oito horas de duração no sábado e o mesmo no domingo. Isso dá uma carga horária de 192 horas por ano. Depois disso, a pessoa recebe título de especialista e está apta a operar. 192 horas por ano contra as 14,4 mil exigidas pela SBCP.  

ISTOÉ -

 Quais os outros problemas? 

 JOSÉ HORÁCIO ABOUDIB -

A terceira fraude é o fato de enganarem os pacientes dizendo que são especialistas sem ser. Medicina estética só visa ganhar dinheiro. Mas, agora, surgiu outra entidade mais cafajeste ainda: intitula-se Sociedade Brasileira de Medicina e Cirurgia Estética, presidida por um cirurgião-geral chamado Edson Teixeira, que ficou famoso há uns 40 anos quando fez transplante de pâncreas em um ser humano, e o paciente morreu. É totalmente amoral, faz qualquer coisa para ganhar dinheiro.  

ISTOÉ -

 Por que essa entidade é pior?  

 JOSÉ HORÁCIO ABOUDIB -

Vi um folder deles anunciando um curso de mamoplastia (cirurgia plástica nas mamas) em apenas um fim de semana. Um colega médico ligou para lá para confirmar e a mulher que atendeu perguntou: “O sr. sabe dar ponto?”. Quando ele respondeu que sim, ela disse: “Então, o sr. faz o curso sábado e domingo e já pode marcar sua primeira operação de plástica de mama para a segunda-feira.” Ou seja, tem paciente correndo risco nas mãos de pessoas (des)preparadas assim. Mas eles ganham fortunas dando esses cursos. Essa turma só quer saber de grana, não é de medicina. O nosso diploma e o da dermatologia são referendados por entidades sérias. O deles não é referendado por nada. Não estão pensando em ensinar, em formar profissionais. Só estão pensando em enriquecer, em faturar com o ensino.
 

ISTOÉ -

 Quais os riscos que os pacientes correm?  

 JOSÉ HORÁCIO ABOUDIB -

De todo tipo. Infecções, resultados desastrosos, por exemplo. E inclusive a morte. Por isso cuidado: médicos despreparados estão exercendo a cirurgia plástica.
 

ISTOÉ -

 Há áreas preferidas por esses profissionais não especializados?  

 JOSÉ HORÁCIO ABOUDIB -

A chamada medicina estética só quer faturar, não importa a área. E não é só em cirurgia. Tem alguns que, na endocrinologia, repassam a receitinha de dieta que pegaram nos cursos.
 

ISTOÉ -

 Como o paciente pode saber se o médico é especialista?  

 JOSÉ HORÁCIO ABOUDIB -

Por meio do site da SBCP ou se ele exibir o título em quadros emoldurados e à vista no consultório.  

ISTOÉ -

 O que o Conselho Federal de Medicina pode fazer?  

 JOSÉ HORÁCIO ABOUDIB -

Em uma reunião recente em Brasília, um conselheiro sugeriu perdão aos “coitadinhos” que “somam 12 mil caras trabalhando na clandestinidade…” Eu disse: Mas eles começaram na clandestinidade! Se quer perdoar, então vamos abrir as cadeias também. Vamos acabar com as regras de segurança.” 

ISTOÉ -

 O CFM não vai fazer nada? 

 JOSÉ HORÁCIO ABOUDIB -

O conselho argumenta que não pode deixar de ser generalista para não jogar na ilegalidade um médico do Acre, por exemplo, que mora numa cidade que não tem especialistas e tem que fazer parto, cirurgia geral, cuidar de diabéticos. Minha sugestão é que se separe: que se diga na lei do CFM que os médicos que trabalham em cidades com menos de 30 mil ou 40 mil habitantes possam atuar em áreas afins e os outros não. 

ISTOÉ -

 Que procedimento cirúrgico já teve resultado mais dramático?  

 JOSÉ HORÁCIO ABOUDIB -

Certamente, o de lipoaspiração, que esses profissionais fazem em consultório, sem anestesia e até sem esterilização adequada. Fizemos um levantamento, que mostrei ao Conselho Federal de Medicina, com mais de dez casos de mortes e complicações graves atribuídas a cirurgiões plásticos – e nenhum era plástico. Todos os responsáveis eram da turma da medicina estética. Eles fazem essas porcarias e as notícias saem como se fossem cirurgiões plásticos.  

ISTOÉ -

 Há levantamento sobre os erros realmente cometidos por cirurgiões plásticos? 

 JOSÉ HORÁCIO ABOUDIB -

Estamos fazendo um estudo. Queremos saber se a lipoaspiração dá mais problema porque é mais feita ou se é porque é mais realizada em condições inadequadas. Chegamos ao número de 30 óbitos nos últimos anos relacionados a cirurgias plásticas feitas por especialistas, em um universo de mais de 100 complicações graves. Temos uma comissão estudando por que isso aconteceu.  

ISTOÉ -

 O conselho tem como punir? Alguém está sendo punido? 

 JOSÉ HORÁCIO ABOUDIB -

Tem, se comprovar negligência, imprudência ou imperícia. Mas há médicos condenados em 15 processos que continuam trabalhando. Fica por isso mesmo. Não pagam as indenizações. Mas, de modo geral, a chamada máfia de branco acabou. Na SBCP e nas regionais não se pode punir, mas podemos excluir o mau profissional. Temos, agora, um problema diferente: um vigarista que não é cirurgião plástico tem um programa na televisão chamado “Dr. Rey” (apresenta o programa “Sexo a 3”, da Rede TV!). Ele foi cassado na Califórnia e veio para o Brasil – só que, aqui, ele não é médico. Não revalidou seu diploma. 

ISTOÉ -

 Ele atua como médico?  

 JOSÉ HORÁCIO ABOUDIB -

Atua nesse programa de quinta categoria, vende cintas, fica apalpando mamas de mulheres, é assustador o baixo nível. Denunciamos ao Ministério Público, que foi atrás. E os três cirurgiões plásticos que foram ao programa dele receberam advertência pública da SBCP. E, se insistirem, serão excluídos. Não queremos essas pessoas na Sociedade. 
 

ISTOÉ -

 Outras especialidades, como dentistas, também estão invadindo a área, já que muitos aplicam botox? 

 JOSÉ HORÁCIO ABOUDIB -

Isso é proibido pelo próprio Conselho Nacional de Odontologia. Se o dentista for denunciado, não terá defesa. Agora, isso é diferente de um otorrino fazer plástica de nariz, um mastologista fazer plástica de mama, um oftalmologista fazer plástica de pálpebra, entre outros, se tiver treinamento de pelo menos um ano. O que não pode é fazer um cursinho de fim de semana e operar. 

ISTOÉ -

Como é em outros países?  

JOSÉ HORÁCIO ABOUDIB -

Só dá para comparar com os Estados Unidos, que têm padrão à altura do nosso. O cirurgião plástico brasileiro não tem igual, é hoje o melhor do mundo. A prova é que tem mais gente procurando treinamento aqui do que em qualquer outro país. E o nosso congresso é maior que o americano também. A Europa nem conta. Estão 20 anos atrás da gente. Mas o problema de invasão nos Estados Unidos é pior.  

ISTOÉ -

 Pior como? 

 JOSÉ HORÁCIO ABOUDIB -

Por exemplo: no processo de implante de cabelo, muitos médicos trabalhavam com enfermeiras que cortavam e separavam o folículo para o cirurgião implantar. Mas como é um trabalho exaustivo, algumas vezes eles passavam o implante para que elas o fizessem também. Resultado: elas filmaram tudo e entraram na Justiça pedindo o direito de ser titular no procedimento. Lá, também dentistas querem o direito de fazer cirurgia de face e tem fisioterapeuta que começou a fazer lipoaspiração.