UKRAINIAN PLASTIC SURGEONS GIVE WORLD HOPE
A new material for plastic surgery in the form of a gel appeared several years ago, almost simultaneously in Ukraine and Russia. Remarkably, in both cases it proved to have the same characteristics making it a truly unique discovery. In which of the two countries did it actually originate? In an information war lasting a number of years, the interested quarters in Russia have been attempting to discredit the Ukrainian gel. Strangely, they have been assisted by interested persons in Ukraine. Not long ago, the argument finally ended. The subject was discussed by the Fourth Ten Years of the Extensive Use of the Hydrophilic Polyacrylamide Interfal Gel in Plastic, Aesthetic [Cosmetic], Restorative, and Reconstructive Surgery International Scientific and Practical Conference. EU experts attending the conference stated there were positive findings on the Ukrainian gel and that from now it could be used in Europe. In fact, the conference’s leitmotif was that Ukraine has given the world hope, and this was repeatedly said without exaggeration.
The problem lies on the social and medical plane. In other words, after receiving a reliable means of solving a medical problem, the world can now hope to solve a complex social problem.
To understand it, one ought to remember the tragic consequences of past wars and local military conflicts: not just lost or ruined lives, but also crippled bodies and maimed faces. This fruit of ethnocentrism and ethnic cleansing has exposed millions of people across the world to mentally devastating factors, making their existence practically unbearable, dooming them to loneliness and despair.
In other words, restoring the volume and form of organs and tissues damaged by wounds, disease, or deforming surgery is a pressing issue in both plastic surgery and the social realm. A person’s physical and social deformity does not allow him to function adequately as a community member, mentally as well as socially. Meanwhile precisely such adequate functioning is the basis for the development of the personality and its freedom, supplying the basic human needs: work, family, and children.
Unfortunately, Ukrainian media actually reject the social status of plastic surgery and its public necessity. Instead, it is presented as a closed structure meant to cater to the rich, famous, and young ladies of easy virtue who regard their bodies and physical appearance primarily as a commodity (and not without reason). It is further portrayed as a structure working exclusively for self-sufficiency and enrichment. In this sense, we lag behind not only the European but also Asian countries. In Ukraine, plastic surgery has no official status, meaning that the profession does not officially exist; there is no legal framework to protect the plastic surgeon (considering our mentality, I might say that he feels even more vulnerable than the patient).
Until recently, high molecular compounds — biological tissues, seasonal bovine collagen and its analogues; synthetic tissues (silicone and other hydrophobic gels; by comparison, Ukrainian Interfal is hydrophilic), polyurethane, glycerin Teflon paste, hydrophilic cellulose hialuronate gels, etc. — were applied in world reconstructive surgery to make up for various soft tissue defects and those of certain organs. In internal prostheses metal and other non-organic implants have been used.
However, all of these have some counter-indications or another and involve significant risk for the patient. Finally, their usage was restricted and in some cases totally discarded. But this made the problem even more pressing.
Various modifications of silicone remain widespread, including Ukraine. Here the word silicone is associated with the dream of living like they do in the West. Few people, including plastic surgery patients, know that silicone has in most respects failed to meet the expectations of both patients and surgeons, as evidenced by many decades of experimentation and experience. Post-implant complications reduce the results of such surgery, yet such failure gave an impetus to the search for materials with programmed qualities. Safety is the main criterion and it remains on paper, meaning the safety ratio has never been 100% with any of the available materials.
Ukrainian Interfal is not perfect either, leaving a 4% risk margin, but this is by far lower risk than anything previously experienced. No one wants to take even such a small risk, of course, yet this does not exclude the necessity of using this gel. Moreover, there are ways to reduce even this small risk, as corroborated by the fourth international conference. It recognized Interfal as a new generation agent answering all the universally accepted requirements. It was developed by a small R&D business of the same name. All or almost all other such agents have no authorization for use in Ukraine.
Interfal is also approved in Estonia, Lithuania, Russia, Bulgaria, China, Belarus, Georgia, etc. It is patented in Ukraine, in all Western European countries, Russia, the United States, Brazil, China, and Australia. It is being tested in the Middle East. Ivan Kebuladze was the first to use it at his clinic, and the latter is now the experimental base used by experts from Denmark and Sweden studying the agent’s practical application so as to receive a Class C European Quality Certificate. And all this is against the background of our hysterical campaign against Interfal. To make the “horrible picture” even more horrifying those behind the campaign personified the gel, pointing to miserable Ukrainian women as victims of some evil genius, in this case Ivan Kebuladze, a man from the Caucasus. In the end what happened? The Ukrainian gel is certified according to the 1SO and EN standards, recommended for serial output, and allowed to be used in every EU country.
The main objective of plastic surgery is to rid man of suffering in the aftermath of disease or disaster. In other words, to improve one’s mental and physical condition. This is precisely what the creators of Interfal are after.
What makes this gel unique? It best supplies the needs and meets the general requirements of prosthetics, specifically:
1. It is elastic, has a high rupture strength, and is tough (gel-like consistency); the said qualities can be programmed depending on where this gel is used and for what purpose (injection or surgery), so the agent can completely imitate a given tissue.
2. It is shape-steady, so for the first time in world practice it can be implanted into soft tissue for life.
3. It is highly resistant to aggressive chemical and physical factors, which is extremely important in terms of storage and long-distance transportation (there are no such aggressive factors in the human body).
4. It is completely biologically compatible. In other words, the organism responds to the gel the way it does to its own tissue.
5. It is chemically inert and harmless to the organism.
6. It has a singular containing capacity, developing a tender connective tissue capsule linked to the implant, preventing the latter’s excessive mobility and causing no form-destructive contractures (e.g., stricture or contraction).
7. It sustains high temperature and pressure, when exposed to a thorough sterilization, without changing any of its physical or chemical properties, and it does not attract or develop bacteria. In other words, findings show that no bacteria known to man can use this gel as a nutrient medium, thus changing its structure and properties, fermenting hydrogel.
Biologically incompatible water-repellent gels have been widely used in the past. Interfal is a hydrogel, a hydrophilic gel that can be saturated with a variety of medications. Most importantly, it opens broad horizons for further studies aimed at its practical application. Even now Ukrainian surgeons saturate this gel and its implants with anesthetics or insulin in diabetic cases. The effect is beyond doubt.
It was thanks to Interfal’s unique physical-chemical and biological properties, particularly its biological compatibility, as well as to the voluntary efforts of Ukrainian plastic surgeons, that the Ukrainian gel has won such international acclaim (even though it was not pursued as an end in itself). Moreover, this has expanded its application on an unprecedented scale, including corrective surgery on the face (especially the lips), hips, shins, buttocks, chest, back, mammoplastics, internal prosthetics, corrective and cosmetic surgery on the upper and lower limbs. Another noteworthy fact is that prior to Interfal contour plastic surgery on the lower limbs was impossible. This can only inspire optimism. Ukraine leads the world not only in tanks, but also in this extremely humane field.
I wish I could end at this optimistic note, but the reality is different, and the problem has to be approached from the triple surgeon- material-patient point of view. Also an attempt has to be made to cut the knot of controversial interpretations of all post-implant complications with all the attendant consequences affecting the surgeon, gel, and patient.
EDITOR’S NOTE
Dear Reader, you are welcome on our pages with your views on the humanization of medicine, as these problems are topical the world over, and not only in plastic surgery.
