Panfilov_CosmSurg_139141 03.01.2005 16:27 Uhr Seite 1 P Cosmetic Surgery Today a n f i l o v A frank overview of the latest techniques in aesthetic plastic surgery For millennia, men and women have turned to surgical and cosmetic C Dimitrije E. Panfilov, M.D. o aids in the pursuit of well-being through physical beauty. Indeed, many s of the procedures performed by today’s aesthetic plastic surgeons have m Foreword by their origins in places and cultures as remote as ancient Egypt and Rome. e Robert M. Goldwyn, M.D. Never before, however, has aesthetic plastic surgery been so safe, so t i affordable, and unfortunately, so fraught with risk and misinformation. c It can be overwhelming, if not impossible, to obtain accurate, unbiased S u information about this rapidly changing field. r g In Cosmetic Surgery Today, one of Europe’s leading plastic surgeons e shares valuable insider’s knowledge and offers advice gathered over r y decades in practice. T o Written with candor and compassion, Cosmetic Surgery Today presents d a clear descriptions of the latest techniques, including face lifting, nose y correction, liposuction, breast augmentation, reconstructive surgery, procedures specifically for male patients, hair transplantation, and many more. Before-and-after photos show clearly what is involved in each procedure. Cosmetic Surgery Today provides the background necessary for an intel- ligent, informed discussion about aesthetic surgery that will interest not only medical professionals from various fields, but also potential patients, journalists, stylists, make-up artists, and anyone interested in this much-discussed, but often poorly understood field. Packed with accessible, practical information, this unique resource is also a fascinating exploration of the true nature of beauty and well-being, and the vital role aesthetic surgery can play in achieving it. Rest ofWorld The Americas ISBN 3-13-139141-3 ISBN 3-13-139141-3 (GTV) ISBN 1-58890-334-6 ISBN 1-58890-334-6 (TNY) www.thieme.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 h 44 45 46 47 48 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ 1 2 3 4 5 6 7 8 About the author 9 10 Dimitrije E. Panfilov, M.D., a specialist in general surgery 11 and plastic surgery, is founder and head of the Nofretete 12 Private Clinic for Aesthetic and Plastic Surgery in Bonn, 13 Germany. He is the author of several books and the producer of films on aesthetic plastic surgery. Dr. Panfilov 14 is also recipient of numerous awards, including the 15 prestigious Sushruta Oration given by the Association of 16 Aesthetic Plastic Surgery of India. In 2005 he was appointed 17 Visiting Professor in Plastic Surgery at the University of Liege. 18 The only German member of the International Society of 19 Aesthetic Plastic Surgery, as well as the American Society 20 for Aesthetic Plastic Surgery, Dr. Panfilov has lectured and 21 conducted practical surgery courses around the world, 22 including the Master Class Lesson at the 2002 ISAPS World 23 Congress. Dr. Panfilov, wo received his doctorate in medicine 24 from the University of Belgrade, is also the founder of Global 25 Expert Service Aesthetic Plastic Surgery (GESAPS) and editor- 26 in-chief of its journal Aesthetic News. 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ 1 2 3 4 5 6 7 Cosmetic Surgery Today 8 9 10 11 Dimitrije E. Panfilov, M.D. 12 13 Private Clinic Nofretete 14 Bonn-Bad Godesberg 15 Germany 16 17 18 19 Translated by 20 Grahame Larkin, M.D. 21 22 159 illustrations 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 Thieme 48 Stuttgart · New York 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ 1 2 3 4 5 6 7 8 Library of Congress Cataloging-in-Publication Data Important note: Medicine is an ever-changing science under- 9 going continual development. Research and clinical experi- 10 Panfilov, Dimitrije E. ence are continually expanding our knowledge, in particular [Moderne Schönheitschirurgie. English] our knowledge of proper treatment and drug therapy. Insofar 11 Cosmetic surgery today / Dimitrije E. Panfilov ; translated by as this book mentions any dosage or application, readers may 12 Grahame Larkin. rest assured that the authors, editors, and publishers have 13 p. cm. made every effort to ensure that such references are in accord- 14 ISBN 3-13-139141-3 (alk. paper) – ISBN 1-58890-334-6 (alk. ance with the state of knowledge at the time of production paper) of the book. 15 1. Surgery, Plastic–Popular works. I. Title. Nevertheless, this does not involve, imply, or express any 16 RD119.P3613 2005 guarantee or responsibility on the part of the publishers in re- 17 617.9'52–dc22 spect to any dosage instructions and forms of applications 18 2004029700 stated in the book. Every user is requested to examine care- fully the manufacturers’ leaflets accompanying each drug and 19 to check, if necessary in consultation with a physician or spe- 20 cialist, whether the dosage schedules mentioned therein or 21 the contraindications stated by the manufacturers differ from 22 the statements made in the present book. Such examination is This book is an authorized translation of the German edition particularly important with drugs that are either rarely used or 23 published and copyrighted 2003 by Trias Verlag, Stuttgart, have been newly released on the market. Every dosage sched- 24 Germany. Title of the German edition: Moderne Schönheits- ule or every form of application used is entirely at the user’s 25 chirurgie. Fakten und Faszination, Möglichkeiten und Grenzen own risk and responsibility. The authors and publishers re- 26 quest every user to report to the publishers any discrepancies or inaccuracies noticed. If errors in this work are found after 27 publication, errata will be posted at www.thieme.com on the 28 Translator: Grahame Larkin, M.D., Erftstadt-Liblar, Germany product description page. 29 30 Some of the product names, patents, and registered designs re- 31 ferred to in this book are in fact registered trademarks or pro- Illustrator: Denis Panfilov prietary names even though specific reference to this fact is 32 not always made in the text. Therefore, the appearance of a 33 name without designation as proprietary is not to be con- 34 strued as a representation by the publisher that it is in the pub- 35 lic domain. This book, including all parts thereof, is legally protected by 36 copyright. Any use, exploitation, or commercialization outside 37 the narrow limits set by copyright legislation, without the 38 publisher’s consent, is illegal and liable to prosecution. This 39 applies in particular to photostat reproduction, copying, mimeographing, preparation of microfilms, and electronic 40 data processing and storage. 41 © 2005 Georg Thieme Verlag, 42 Rüdigerstrasse 14, 70469 Stuttgart, Germany http://www.thieme.de 43 Thieme New York, 333 Seventh Avenue, 44 New York, NY 10001 USA 45 http://www.thieme.com 46 Typesetting by Satzpunkt Ewert GmbH, Bayreuth 47 Printed in Germany by Druckhaus Götz GmbH, Ludwigsburg 48 ISBN 3-13-139141-3 (GTV) 49 ISBN 1-58890-334-6 (TNY) Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ 1 2 3 4 5 6 7 This book is dedicated to my teachers 8 who imparted their knowledge to me 9 and to my patients 10 who gave me their trust. 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 The lines by the Irish 32 poet Yeats are spoken 33 from within this sculp- 34 ture by the Mexican sculptor Bustamante: 35 “I’m looking for the 36 face I had before the 37 world was made.” 38 39 40 41 42 43 44 45 46 47 48 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ Contents 1 2 3 4 5 6 7 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . XI What if Something Goes Wrong? . . . . . . . . . . . . . . . . 37 8 9 Reasons for a Disappointing Result . . . . . . . . . . . . . . 38 10 Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XII 11 12 Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .XIII II Aesthetic Plastic Operations . . . . . . . . . . . . . . . 40 13 14 A Pleasing Face—Facial Expression 15 I General Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 and Physiognomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 16 17 Ageing—Its Causes, Traces, and Limitations . . . . . 43 What Do the Terms Plastic and 18 Aesthetic Mean? Definition of Terms . . . . . . . . . . . . 1 Anti-ageing: Vitality Means Attractiveness . . . . . . 45 19 20 A Brief History of Plastic Surgery . . . . . . . . . . . . . . . . 2 Lines and Wrinkles and Fourteen Ways 21 Ethical Aspects in Plastic Surgery . . . . . . . . . . . . . . . 6 to Get Rid of Them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 22 Classification of Wrinkles . . . . . . . . . . . . . . . . . . . . . . . . . 48 23 Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . 8 Removal of Wrinkles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 24 Smoothing Out Wrinkles from Without. . . . . . . . . 48 25 The Commonest Operations . . . . . . . . . . . . . . . . . . . . 9 Filling out Wrinkles from Within . . . . . . . . . . . . . . . 52 26 27 Adverse Reactions after Surgery . . . . . . . . . . . . . . . . 10 Face Lifting and Ten Further Procedures 28 The Ideal Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 for Face and Neck Lifting . . . . . . . . . . . . . . . . . . . . . . . . 56 29 Face Lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 30 Emotional Strain and its Relief . . . . . . . . . . . . . . . . . . 13 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 31 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 32 The Ideal Surgeon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 33 How to Find a Good Aesthetic Plastic Surgeon . . 16 Duration of Effect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 34 Face Styling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 35 The First Consultation . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Forehead Lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 36 The Classic Operation . . . . . . . . . . . . . . . . . . . . . . . . . . 61 37 Planning and Preparation for the Operation . . . . 22 Endoscopic Procedure . . . . . . . . . . . . . . . . . . . . . . . . . 61 38 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 39 The Surgeon’s Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 40 Radiofrequency Surgery as Refinement Eyebrow Lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 41 in Aesthetic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Temple Lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 42 Midface Lifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 43 Pain and its Alleviation . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Mini Face lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 44 Midi Face lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 45 Clinic Stay and Aftercare . . . . . . . . . . . . . . . . . . . . . . . . 32 Neck Muscle Repair (Platysmaplasty) . . . . . . . . . . . . . . 64 46 Very Fine Scars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Correction of a Double Chin . . . . . . . . . . . . . . . . . . . . . . . 65 47 Chin Augmentation (Mentoplasty) . . . . . . . . . . . . . . . . 65 48 What Will it Cost? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Cheekbone Augmentation . . . . . . . . . . . . . . . . . . . . . . . . 65 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ VIII Contents 1 For the “Tired Eye” Look—Eyelid Lifting . . . . . . . . 65 Skin Stretching Using the Expander Method . . . . . 91 2 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Hair Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 3 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 4 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 5 Combined Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 6 7 Nose Corrections (Rhinoplasty) . . . . . . . . . . . . . . . . . 68 Laser Depilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 8 The Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 “Golden Nose” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 9 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Harmonizing the Nose . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 10 11 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Operations of the Fatty Tissue . . . . . . . . . . . . . . . . . 96 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 12 Bodily Ideals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 13 “The Overweight May Live Shorter, Chin Correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 14 but They Eat Longer” . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 15 Harmonizing the Figure by Liposuction . . . . . . . . . . 102 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 16 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 17 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 18 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Profiloplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 19 Combined Procedures . . . . . . . . . . . . . . . . . . . . . . . . 108 Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 20 The Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 21 Ultrasound-Assisted Liposuction . . . . . . . . . . . . . . . . . 109 Lip Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 22 SAL, UAL, VAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 23 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Body Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 24 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 25 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Corrections of the Breast . . . . . . . . . . . . . . . . . . . . . . . 111 26 The Female Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Correction of Prominent Ears (Otoplasty) . . . . . . 82 27 Breast Tightening (Mastopexy) 28 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 and Breast Reduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 29 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 30 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 31 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 32 The Fairer and Stronger Sex . . . . . . . . . . . . . . . . . . . . . 84 Combined Procedures . . . . . . . . . . . . . . . . . . . . . . . . 121 33 Valuable Information Concerning Silicone . . . . . . . 121 34 The Man as a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Breast Augmentation . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 35 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Strictly Masculine Problems . . . . . . . . . . . . . . . . . . . . 88 36 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 37 Penis Enlargement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 38 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Combined Procedures . . . . . . . . . . . . . . . . . . . . . . . . 131 39 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Other Corrective Procedures of the Breast . . . . . . . 131 40 Penis Lengthening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Nipple Inversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 41 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Enlarged Male Breasts . . . . . . . . . . . . . . . . . . . . . . . . 131 42 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Breast Asymmetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 43 Penis Prostheses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 44 Operation and Aftercare . . . . . . . . . . . . . . . . . . . . . . 90 Abdominoplasty (Tummy Tuck) . . . . . . . . . . . . . . . 133 45 The Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 46 When that Head of Hair Starts to Recede . . . . . . . . 90 Aftercare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 47 Skin Excision (Scalp Reduction) . . . . . . . . . . . . . . . . . . . 90 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 48 Hair-Bearing Skin Flaps . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Combined Procedures . . . . . . . . . . . . . . . . . . . . . . . . 136 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“ Contents IX Corrections of the Arms and Legs . . . . . . . . . . . . . . 136 The First Dressing Change . . . . . . . . . . . . . . . . . . . . . . 157 1 2 Skin Tightening (Lifting) . . . . . . . . . . . . . . . . . . . . . . . . . 136 Upper Arms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 The Surgeon’s Energy and Fear . . . . . . . . . . . . . . . . . 159 3 4 Inner Aspects of the Thighs . . . . . . . . . . . . . . . . . . . 137 All Surgeons Want to Cure Their Patients . . . . . . 159 Procedures and Aftercare . . . . . . . . . . . . . . . . . . . . . 138 5 6 Corrections of the Legs . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Surgical Miracle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 7 Varicose Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Spider Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Beauty is the Promise of Happiness . . . . . . . . . . . . . 161 8 9 Too Thick or Too Thin Calves . . . . . . . . . . . . . . . . . 139 10 Buttock Enlargement . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 V The Complex Phenomenon of Beauty . . . . 164 11 12 The Seducer from the Savannah . . . . . . . . . . . . . . . . 164 III Plastic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 13 14 Body Language, Sexuality, and Semiotics . . . . . . 167 Reconstructive Plastic Surgery . . . . . . . . . . . . . . . . . 141 15 General Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Making the Invisible Beautiful— 16 Breast Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Cosmetics and Fashion . . . . . . . . . . . . . . . . . . . . . . . . . 172 17 Burn Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 18 Malignant Skin Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . 144 The Love Potion Amorine . . . . . . . . . . . . . . . . . . . . . . . 175 19 Hand Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 20 Ever-Present Eroticism . . . . . . . . . . . . . . . . . . . . . . . . . 177 Reconstructions of the Face . . . . . . . . . . . . . . . . . . . . . 147 21 Tattoos. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Mythology of Everyday Life . . . . . . . . . . . . . . . . . . . . . 178 22 23 Plastic Surgery of Congenital Malformations . . 148 Justice and Injustice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 24 25 The Power of the Media . . . . . . . . . . . . . . . . . . . . . . . . 182 26 IV The World and Values of the Surgeon . . . 151 27 The Satisfied and the Dissatisfied . . . . . . . . . . . . . . . 185 28 The Warmth of the Human Look . . . . . . . . . . . . . . . 151 29 Human Suffering and “Psychosurgery” . . . . . . . . 186 The Ward Round . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 30 Spirits and Gods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 31 The Night before the Operation . . . . . . . . . . . . . . . . 153 32 Goodness, Beauty, and Truth . . . . . . . . . . . . . . . . . . . 192 33 Surgical Hand and “Brain Washing” . . . . . . . . . . . 153 34 Some Spiritual Fragrant Flowers . . . . . . . . . . . . . . . 196 35 In the Temple of the “Religion of Surgery” . . . . . 154 36 Poetry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 37 A Little OP Music. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 38 Put on a Friendly Face . . . . . . . . . . . . . . . . . . . . . . . . . . 155 39 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 40 The Patient as a Partner . . . . . . . . . . . . . . . . . . . . . . . . 156 41 42 Smiles in the Patient’s Room . . . . . . . . . . . . . . . . . . . 156 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 43 44 45 46 47 48 49 Thieme, Frau Langner, Panfilov „Cosmetic Surgery“