COVID-19 has not only changed the way plastic surgery is practised but also adjusted our perception of beauty to fit this new reality, says Cypriot cosmetic and reconstructive plastic surgeon Demetris Stavrou, who regularly practices locally. However, he is optimistic that it will soon be on the rise again – with even less invasive technologies that preserve a more natural look.

How do you think the coronavirus pandemic has impacted on cosmetic surgery, if at all, particularly in view of the necessity to go under the knife for ‘vanity’ reasons? Do you think people have re-evaluated the way they look at health?

This pandemic has impacted every aspect of our lives, including plastic surgery. It has disrupted the industry in terms of innovation and revenue, and popularity has declined over the last few months. Not only has the way we practise plastic and cosmetic surgery changed but also our perception of beauty has been adjusted to fit our new reality. 

People have re-evaluated the way they look at plastic surgery in the sense that they seek more natural looks. Results are focused on balance over size for surgeries such as breast augmentation or lip fillers.

Is this sort of surgery still low on the uptake post-COVID-19?

During the partial lockdown, only essential surgeries were taking place, like breast reconstructions or trauma cases. Now that we are starting to return to normality, we see more and more people having the confidence to go under the knife. We have helped the public to feel safer by implementing strict safety guidelines for any procedure. I am very optimistic that, sooner rather than later, we will see plastic surgery on the rise again.

You carry out surgery both on patients who are going purely for aesthetics and those who are obliged to undergo reconstruction due to an illness. How does your approach differ, if at all, between the two scenarios?

The principles of surgery should apply to both cosmetic and reconstructive cases. Function is always above appearance. However, any reconstructive case has inherent characteristics of cosmesis and the result will always be better if we respect the fundamentals of beauty.

Once the battle against breast cancer, or even weight loss, has been won, your work helps patients achieve a sense of normality again. How important is this form of surgery – even psychologically?

Breast cancer reconstruction is essential to any woman’s well-being. It is a process that will reinstate the confidence of which the illness would have robbed them. The same goes for weight loss. Many would be very proud of their achievements, but at the same time, wary as their appearance would have changed so much and their skin would not have retracted as desired. Surgery is what can help them regain confidence.

What percentage of women actually go for breast reconstruction after cancer?

The vast majority – well above 90 per cent – go for immediate breast reconstruction. There is no reason, today, to avoid having this immediately after breast cancer surgery. A woman’s quality of life is as important as the treatment of any pathology.

Do many women have doubts about implants affecting their chances of detecting the disease? And how do you erase those fears?

Yes, it is a common question. Women who undergo breast augmentation can carry out all diagnostic tests, such as mammograms and ultrasounds, like any other women without implants. This is explained during their initial consultation. With the new 3D diagnostic machines we have, the detection of cancer is very high even with implants.

A woman’s quality of life is as important as the treatment of any pathology

How have techniques and results in ‘boob jobs’ changed and improved over the years? What is the greatest and latest innovation and are the horror stories a thing of the past?

Innovation and plastic surgery go hand in hand. Medical devices have been created to allow surgeons to never touch the implant with their hands but to actually insert it directly in the breast pocket. This has also allowed the surgeon to minimise the scar to a tiny two centimetres.

Many companies have invested in research and have incorporated nanotechnology in their devices to mimic biological surfaces, drastically reduce complications and be more biofriendly. All reputable companies invest in their product and are always on the lookout to improve and innovate. However, horror stories may still be happening in places where cost-cutting becomes more important than quality.

What are the possible downsides of breast surgery today?

Like any other surgery, it always comes with risks. But nowadays, it has become very safe. During a consultation, one assesses health status, motivation behind the decision to undergo surgery and other factors that are considered important. The importance of informed consent is highlighted.

Would you say that more and more younger patients are undergoing plastic surgery? If so, why do you think it is the case and do you think it is a good idea?

Patients’ ages vary from 18 to over 65. The biggest portion falls in the 30-55 age group rather than younger, but young adults are becoming more independent and are now seeking plastic surgery more. Every single case is taken on its own merits but, as a general rule, patients have to be of legal age to go ahead with a planned surgery.

Have you ever tried to put clients off due to their age?

Again, one needs to assess each case on its own merits. One cannot just refuse to go ahead with surgery just because the person is 18 or 19 years old. If the patients are mature enough to understand the implications of the surgery, the surgeon has no doubts about their ability to take a decision and they are of legal age, then age is not a limiting factor.

What is the market like in Malta as opposed to elsewhere and in Cyprus, where you come from? Has it grown since you have been here?

The market is very similar. There are less barriers to entry nowadays and it is a market that will keep growing.

Where are we heading for in terms of more modern and sophisticated techniques in this form of reconstructive, aesthetic and plastic surgery?

Less invasive techniques, which preserve a natural look, are the way forward. These require higher skills from the surgeon to preserve the integrity of the tissues and still achieve the desired result.

As a researcher in the field, what is your focus at the moment?

Providing minimally invasive solutions to patients with considerable results is my focus. We develop instruments and materials that will allow us to perform surgeries with minimal trauma to the tissues and minimal downtime for the patient.