The Bolyai Workshop Foundation published an interview collection financed by the Hungarian Scientific Academy in 2014. The following interview with Dr. Pataki is one chapter of the well-written and meaningful book with the Hungarian title "Monetársak", which is about the most important terms and questions of today's society, such as beauty and money.
The plastic surgeon opens up new possibilities in the patient's life
– It is said that beauty comes from within. How does that fit that anyone can go to a plastic surgeon, puts a certain amount of money on the table, and ask the physician to "put them together"?
Dr. Greg Pataki: – It is not going that way. A plastic surgery consultation works by talking to the patient, who tells which physical endowments or deformities disturb their mental and physical harmony. They ask for our help to resolve this. Hardly moving fingers, sagging eyelids, or deformed breasts may pose a problem as well. Several solutions are outlined for the patient to select the most suitable one together. Nowadays, plastic surgery is not just the privilege of the rich. The range of patients is really wide; from mothers with more children through a poor little gypsy girl to a wealthy CEO. People should not approach this topic only from they see in the mass media and the public transformation of celebrities. Bad stereotypes are ingrained in the public consciousness from American movies that show plastic surgeons as tanned playboys, and their patients as Baywatch-girls with huge breasts.
Ignorance is the main reason for these beliefs because the plastic surgery has so many areas that it can be considered as the most diverse branch of medicine – including reconstructive surgery, aesthetic surgery, surgery of burned patients, hand surgery, and regenerative medicine. This field has a lot of innovative power generates enormous progress in medicine. Plastic surgery is one of the fastest growing disciplines of medicine: besides the development of tools and equipment, the area of wound healing and tissue regeneration is largely based on the growing experience of plastic surgeons. We achieved remarkable results, for example, in the field of tissue replacement, since we are able to reconstruct a breast from the body's own tissues after a malignant tumor. We have also seen that we will "produce" fully functioning tissues from the patient's own or cultured cells. The microsurgery, the development of genetic engineering will offer help against a lot of illness and injury. This profession enables the replacement of lost body parts, such as ears or nose. We can "repair" many things in order to restore the form and function as perfectly as possible.
– It sounds so incredible! Are there any limitations to development?
– There are boundaries, and there will be, too. We may form angel wings on the human back from skin-muscle flaps, but will not do that. Our task is not creating a new man, but to apply the possibilities of technological development on the human body, even if a disorder or injury disrupts the physical and mental harmony. Body dissatisfaction can cause various problems, and may damage the mental health. Plastic surgery can offer help in these situations as well, when appropriate.
– How can a plastic surgeon help?
– Maybe it is difficult to accept that I and thousands of my colleagues consider as a help if a woman acquires a better job or have a happier relationship after breast augmentation. Scientific fact: women who had an inferiority complex because of their previously shapeless and too small or too large breasts, have a dramatic increase of self-confidence after breast correction. This improvement is comparable to separating the fused fingers of a child to ensure better hand skills, as the patients consider themselves more beautiful, more valuable if they are satisfied with their looks.
We can help those women whose job require perfect body proportions, perfect look. And those, too, who are uncertain in their feminine existence because of a disadvantageous feature, so they can hardly find a partner and achieve success in other life areas. Many people think of themselves as more valuable if they find their own appearance more beautiful. This is generally a taboo, but as the ancient Greeks said: "Healthy body, healthy mind."
The somewhat pejorative term of "dog eat dog world" is perfectly true for the process of evolution: millions of years of "selection" led to the creation of today's humanity. "The more beautiful and smarter you are, the better your chances." People have always sought to improve their internal and external endowments, with increasing their knowledge, developing their skills, working out their body, and nursing and decorating their exterior. How apt is that the Greek word "plastikos", from which the term plastic surgery comes, means "training"!
– And how is the search for beauty in our genes?
– Research shows that a newborn baby just 14 hours after the birth looks longer at the photographs of pretty faces than less beautiful ones. During another series of research examining human beauty and its effects, 1 182 children voted to same-age peers who they think will be more successful at scholastic records. Lovely children with attractive features got 74%, meanwhile the less attractive group got only 26%.
– Why do we consider symmetry as beautiful?
– There are certain ratios which we found beautiful thousands of years ago, and we still see as pretty. The search for symmetry is in our DNA. If you remove asymmetric parts of a beautiful face, it becomes even more attractive. Symmetry suggests valuable features, such as developmental stability, resilience, and fertility. In nature, symmetry is the expression of calm, ergonomics, rationality, stability. A significant part of wildlife specimens build up their body following some kind of symmetry. The biosphere is the thesaurus of axes of symmetry, mirroring points, and planes. The dominance of symmetry is thought-provoking. A probable cause is the ease of movement for every symmetrical organism. The dominant groups of the human population always considered symmetry as harmonious and beautiful. Women's facial symmetry has always been more important because the men's face was covered with a beard for ten thousands of years.
– But the beauty ideal is constantly changing! Who would like the Venus de Milo now?
– Not quite so, because if you compare the death mask of Nofretete, the ancient Egyptian Queen and its artworks with Penelope Cruz's face, there are actually very slight differences in facial symmetry, proportions, and features. This means that the beauty ideal hardly changed since 3-4 thousand years. This applies for the natural ratios. Of course, there are some changes. Now we live in an era when women do their eyebrows with the arch rising from the inside to the line of the pupil, then coming down, meanwhile, Marilyn Monroe or Zsazsa Gabor always drew it as a semicircle. The beauty queens of recent years have this modern eyebrow shape almost without exception. The slight change can be explained by the media and the changing habits. Beauty ideals also differ according to continents: the breasts are quite pronounced in Europe, the buttocks in Africa, and the eyes and the nose in Asia.
– Can you determine, where are the most beautiful in the world?
– I think the most beautiful women live in the Carpathian basin or a few hundred kilometers away from it, so in Hungary, Ukraine, Croatia and Romania. This is mainly due to the enormous genetic diversity. This is the most various mix of different ethnic groups. You may often hear that Hungarian women are the most beautiful in the world.
One of the main causes is the nomadic lifestyle of our ancestors, and the armed raids to delay the formation of a Western community before St. Stephen's statehood. Later, the proportion of Tartas, Cuman, Slavic, German, and Turkish genes has increased. The exceptional beauty of Hungarian woman is due to this special genetic mix. The Asian genes mingled with the genes of the conquered territories (Sicily, Portugal). The genetic diversity brought its own rewards. It is surprising that even men living in distant continents also find Hungarian women the most attractive if they can choose among many. Photographers who immortalized the pictures of beautiful Hungarian women have called my attention to the fact that the most attractive women live in the cities of Kecskemét and Székesfehérvár. Maybe because there were important military roads, and our nation of adventurers became an accommodating nation in the center of Europe.
– Do you like beautiful women? What do you feel when you are the head of the jury on a beauty pageant?
– The beauty competitions are training places for me. I do not sit there as a man but as a connoisseur. Mostly like in a museum. I am looking at the proportions, and try to classify the beauty, and express it in numbers. I am searching for and learning the harmonic beauty.
– How can the most beautiful beauty be defined?
– A high degree of proportionality applies to the face and the body of girls, women and each person. This phenomenon is approaching the golden section, symbolized by the Greek letter phi, and mathematically described by Φ ≈ 1.618. This indicator is also present in nature (tree branches, roots, the outline of snails), and can be found in art. You know Leonardo da Vinci's famous drawing, the human figure with outstretched limbs in a circle. Leonardo showed how the phi applies to our body. The length of the fingers compared to the palm, the muscular part of the calf to the whole calf, the proportions of the face or the breasts are similar or identical to Fibonacci numbers. Plastic surgeons also apply this golden ratio and the symmetry mentioned above. As the head of the jury of beauty pageants, I need to talk about feminine beauty very often. I would like to convince everyone that a woman's beauty is an inexplicable supernatural secret, which is the sophisticated interplay of shapes and the aura, and it is present with an overwhelming force in every woman. Complicated to determine the most beautiful, the decision is often difficult for the jury.
– Is it possible to explain the mankind's constant search for beauty?
– The anthropologist would say: "The search of beauty has existed since ancient times. It is an evolutionary tendency." Dostojevski wrote that beauty and the art of manifesting it are inseparable from man, without which there is practically no pleasure on earth. People want, find and absorb the beauty unconditionally, just because it is beautiful. They worship it and do not ask what it is used for. According to the theological point of view, the answer may be that God created man in his own image so that the people "are inherently beautiful": they are searching for beauty as they are searching for themselves and God. Maybe the search for beauty is the same as our ancient desire for God. A plastic surgeon does not explain, that is the mission of the philosophers. We accept the fact and try to serve the demand with the best of our knowledge.
– How long the psychological results of plastic surgery last? How common is the addiction to surgeries?
– That is an extremely rare phenomenon. In most cases, the patients come in with a problem, and if we can find a solution, they will be satisfied with that in their whole life. The scalpel of plastic surgeons cuts through the barrier, which prevented the wholeness of their lives, opening up new opportunities for them. Cosmetic surgery is working, it is not with the devil, just one of the instruments – like cosmetics, hairdressing, and many more –, which are used to enhance women's beauty. Perhaps the media can inspire someone to search for surgeries obsessively. We usually dismiss these patients. Many of us have a small body image disturbance, but patients with severe body image problems must not be operated on because plastic surgery does not offer a solution for them. In normal cases, the indications are normally set up by the patient, and we accept that after consideration. Plastic surgery is the crossroad of medicine and healing, and the beautifying services. This is nothing to be ashamed of. What is more, we must strive to heal and reshape with perfectionism, and provide this service on the highest possible level.
– You have celebrity patients as well. Some people in this circle are present in the magazines with their repeated surgical interventions. Have you ever had such a patient?
– I do not remember that I had any famous patient who has gone over the top, but if it happens, I will definitely discourage them from multiple operations. We should not perform a surgery that does not make sense. I do only that I know will benefit the patient.
– In Hungary, there are two terms for "patient": one of them is "beteg", which literally means a person with an illness, and the other is "páciens", which do not contain any indications of their health status. What is correct when it comes to plastic surgery?
– It is better to use the word "páciens", because it indeed often happens that we perform surgery on healthy people, as one of the special features of plastic surgery.
– Plastic surgeons are psychologists working with a scalpel?
– I would not say that, even if we experience spectacular psychological changes after a plastic surgery which solved a previous deformity. Thanks to their restored appearance, our patients can participate in social life confidently, opening up new possibilities that were never seen before.
A scalpel is a surgical tool which leads to quick, immediate results. Only the healing process, the recovery time may be slightly delayed.
A psychologist will face a complex web of the emotions, beliefs, and thoughts hindering the patient's mental and physical health. This requires a different kind of tools to make a positive change and much more time. Another major difference is that the surgeon is active during the operation, meanwhile, the patient is mostly completely passive in deep anesthesia during their transformation. A psychological intervention always requires the patient's active cooperation. The two paradigms are essentially different. The surgeon removes the "wrong", perhaps to be either replaced by or transform into "right".
The psychologist encourages the patient to discover their own characteristics and symptoms perceived as "wrong", but have been created for an inherently good cause, and their survival is only possible because they have some purpose in a larger system. If the system changes, the symptoms will not be necessary anymore, so they disappear almost by themselves. Unwanted symptoms "peel off" like dead skin cells, which are no longer needed.
The nature of the relationship with the patient is also different in these two healing professions. Among the physician-patient relationships, the surgeon-patient relationship is the most intimate, as the patient gives the surgeon a temporary almightiness for the sake of their own safety, otherwise they would not dare to go under the knife.
In order to communicate effectively, we have to understand the psychological processes occurring in the doctor-patient relationship. This requires personal talent, which can be developed with training, but develops by itself during practice if we pay attention to the new elements and possible problems. Discreet interview technique is very important. Imagine that someone dreamt about nicer looking appearance for decades, or have some kind of deformation, which causes decreased self-esteem, and makes them very reserved. Exploring these problems is the task of the plastic surgeon. Sometimes the patients do not dare to talk about that why they came to us during the first conversation. This is normal, and it is our duty to build up a relationship of confidence, in which they can reveal all the problems. As a fact, we often reveal more of the problem than during a conversation with a psychologist. And this is quite understandable since the patient is waiting for the solution can be provided with surgery, while they only expect no more than sympathy from the psychologist, who is in a special position as well.
– Compared to other professions, how important is trust in plastic surgery?
– Trust is the prerequisite for any healing profession. This applies exponentially to plastic surgery. People do not entrust their car to someone they do not trust, let alone themselves, their faces or their breasts! Many feel anxiety or fear in the presence of a doctor, which is due to their previous bad experiences because of the deficiencies of the health care system. In ideal cases, the presence of a doctor provides a sense of security and does not cause anxiety; especially in a hospital ward. A peaceful environment, a stable background is the base of the good co-operation. We consider this extremely important in our clinic.
– What is the proportion of female and male patients in your private clinic?
– Approximately 80:20. Aesthetic interventions are becoming increasingly popular among men in Hungary as well. More and more men turn to plastic surgeons.
– How can you explain this?
– With changing attitudes and deeper understanding of people, and with the increasingly evolving methods and devices. For example, previously there was no solution for the treatment of feminized male breasts, although it can be very embarrassing for a man. Another explanation can be that the patients talk about their positive experiences, which is passed on by the media.
According to an American survey from 1972, 85% percent of men were satisfied with his body, while in 2001 only 57%. This is certainly also due to the media in the USA. During that time the muscle mass of the G.I. Joe figure doubled! And as a new phenomenon, the arrival of a newborn baby worn out so much the fathers physically that need a specific plastic surgery package. This is called Daddy Makeover. So besides the Mommy Makeover postnatal recovery operations, Daddy Makeover also came to existence, which mostly includes liposuction, tummy tuck, and facial aesthetic treatment. But in Hungary, we rather recommend "new daddies" more sleep, controlled caloric intake, and more sport. This is the first step. By the way, rhinoplasty is the most popular aesthetic surgery among men in the USA, followed by the liposuction close behind. In Hungary, we have no specific statistical data.
– Which age group is the most frequent in your practice, and what are the most popular interventions among them?
– The youngest child was a few months old and the oldest patient was 98 years old. People turn to us with any kind of problems from head to toe. We do everything in our private clinic from breast reconstruction to the removal of moles and ingrown toenails. The most common age group are women between 25 and 45. The most popular surgeries are breast surgery and liposuction. Plastic surgery is not just the privilege of the rich. Some frustrating factors may be present since childhood, since the early development of self-concept. If someone firmly believes that they can become complete only if they get rid of something that makes them unhappy, or simply want a body part to be more shapely and make them happy, change is possible, and in many cases, it is a must. This is not a "rich entertainment" and not unattainable. I had a postman and a dolly driver in my practice, who collected the money with years of conscious saving to pay the surgery, and they are happy since then.
– Plastic surgery is a success story, and plastic surgeons are special people?
– I think plastic surgery is a success story, because – if applied accordingly – it can contribute to the patients' quality of life to such an extent that other professions cannot. We change the form and the function together, at the same time. This changes a cleft lip patient's life, and changes a mother's life as well, after repairing their "dog ears" and stomach muscles. On the other hand, we are not the great "magicians". No one, no plastic surgeon should believe such a thing of himself. Our profession is just like this: it has the potential to change others body rapidly and in a markedly good direction.
– What determines the price of the surgery? What about the clinics with cheap plastic surgery costs and intrusive advertising?
– Those, who ask only about the price and go to the cheapest place, almost surely can expect the most frugal medical service. But the most expensive does not mean the best either since paid advertisements and media appearances can be calculated into the price as well. Here I can proudly tell you that we have not spent a penny on advertising so far. Anyway, the calculation is based on a complicated system. Components include the quality of the equipment and the materials, the qualifications of the team, the clinical background, the tools available in the operating room, the type of anesthesia, the duration of hospital stay, the quality of medical attendance. The price also depends on the regular foreign training, study tours, and congresses of the plastic surgeon, and the expensive professional books and journals. If you always want to use one of the best (if not the best) technique in this rapidly changing world, you have to more courses every year that cost thousands of dollars. Otherwise, we would still use thick cannula for liposuction, and could not perform lipofilling for tissue regeneration.
Those who are interested in aesthetic interventions can find various companies on the web, online forums, and in other advertisements that do not publish the name of contributing plastic surgeons. It may happen that the patient is greeted by an "aesthetic consultant" without any medical qualifications and professional experience, which is compensated with intrusive sales skills – and the anonymous plastic surgeon will meet the patient only after the declared intention and the advance payment.
These businesses, which are not led by plastic surgeons, conduct unspeakable practices both professionally and ethically. No coincidence that the majority of the cheapest (and later deemed as unsuitable) implants was used at some of these places. Manipulating with cheap prices is, therefore, dangerous, too, because this does not fit into the expected use of the best technology and materials. Brash business tactics, coupons, and "the other breast for half price" or "free hair removal with breast augmentation" are unethical. They are disrespecting both the patient and the profession, so has been banned by the plastic surgery societies in many countries. Unfortunately, still not in Hungary. But most patients become suspicious when they see the environment and lack of professionalism during the consultation.
– How did the famous patients find you? Do they pay for the surgery?
– We have famous patients as well, but unlike in many other places, all of them pay the regular price for the surgery. They come based on recommendations, just like the vast majority.
– What was last request that you did not want to fulfill?
– One of my colleagues raised unrealistic expectations regarding the post-surgery recovery, so I did not perform the operation. Besides this, there was a patient with body image issues and very beautiful, slim calves, but she wanted to make them thicker.
– What about the complications? Are they common?
– They are very rare because we usually operate on the integuments of the human body, not on the internal organs in the chest or the abdomen. In an appropriate hospital environment, you can reduce the risk of complications with tissue saving techniques, modern devices, and medication.
– What is the secret of perfect results in plastic surgery? What factors affect the result of a breast augmentation? What could be the secret to long-term patient satisfaction in the practice?
– I would emphasize five things.
1. Individual approach. Everyone has individual endowments and body image to be analyzed in detail. Openness necessary toward the patient's personality. Proper trustfulness in the communication is also important, so the patient will be able to formulate their request and expectations regarding breast shape and size. Every patient must have realistic expectations, and this will require detailed discussion. For example, we have to choose the most suitable implants from more than 1,000 different sizes. Part of the individual treatment is to arrange realistic expectations for the final result.
2. Quality above all else. We always use the best quality products available, whether instrumentation or implants. Only the best material should be implanted into the human body, there are no compromises. This includes the rigorous work schedule expected in the operating room (which results in maximum sterility), and the control, selection, and training of staff members. You cannot make mistakes in this business because there are serious consequences.
3. Creativity. Breast augmentation – and plastic surgery in general – requires great creativity, a good eye, and artistic abilities. We must train ourselves. This type of surgery with many others are on the verge between science and art. Less is often more since perfectly shaped breasts seem bigger than actually bigger ones with inappropriate scale and shape.
4. Technique. Many questions arise about the "perfect" breast augmentation. What kind of implants should be used? Which size? Which shape? Where on the chest, and compared to each other? Obviously, there are more risky points.
5. Innovation. Plastic surgery is one of the most innovative branches of medicine. We always adhere to age (with using an ultrasonic scalpel, for example), and even create new developments, which, if they are good, will be appreciated by the foreign medical journals.
– What is the reason if a patient is dissatisfied?
– There are many possible reasons, but often the lack of what has been said above can be detected. Sticking to the topic of breast augmentation, there are more places where patients are discouraged from anatomical implants with false information, even when that would be the best solution for them. Unrealistic expectations can also lead to dissatisfaction, regarding both the post-operative period and the expected outcome of the surgery. Thank God, dissatisfaction is very rare among our patients.
– In how many places are you practicing now?
– I perform surgeries requiring general anesthesia mainly at the Semmelweis University Clinic and Teaching Hospital, have pediatric plastic surgery consulting and operations at the St. John's Hospital in Budapest, lead my private clinic, and in addition, I have some operations in Germany as well.
– How do you work in Germany?
– Nowadays, I go only occasionally. I used to work there for nine years, and some of my patients insist that I must operate on them if necessary.
– You are one of the few plastic surgeons who are engaged in all branches of the profession, operating on people from head to toe, both for aesthetic and reconstructive purposes. How can these be united? In which one are you the best?
– Indeed, I perform almost the entire range of aesthetic and reconstructive surgeries, but I also operate on patients with burn injuries and perform hand surgeries. Besides this, I am also among the few performing pediatric plastic surgery. I am interested in all body areas from the hairy (or hairless) scalp to the toes. This is why I like the profession. I love every aspect of plastic surgery. According to the statistical data, most of my operations are breast and face cosmetic surgeries, but it makes me feel good that I was able to stay a plastic surgeon who not only does breast augmentation and liposuction, but much more than that.
– In the St. John's Hospital you were the one who restarted the pediatric plastic surgery. How did you manage to do this?
– My previous boss, head physician Dr. Pelenyi invited me to go back to the hospital. He asked me to re-organize the children's plastic surgery, which stopped functioning for a while by then. I started to do it, and soon every Thursday became filled with surgeries, and the consulting hours are scheduled to Fridays. I do the management of the pediatric plastic surgery as a part-time job, a charitable work – because the money can be earned this way it is not measurable to the fulfillment we get from healing children. We are able to make a lot of indigent child's life easier with the treatment of birth defects, distortions resulting from burns, scars, cleft lips and hand injuries from the age of few months up to 18 years.
– You also offer medical help in Bangladesh, and in those Hungarian-populated areas that are beyond the border. How does these charitable activities fit in your practice?
– The two are complementary. I do not see a big difference between a child's happiness, who can fit into the community easier after a scar removal, and a woman's transformation whose breasts were sagging or became asymmetrical after breastfeeding, so she could not look in the mirror, but wanted to be her own self again. In the latter case, the surgery is performed for aesthetic purposes, but actually, can be considered as reconstructive. In both cases, patients find themselves in the harmony of body and soul, which is the primary role of plastic surgery. This profession is unified, cannot be broken down into various professional disciplines. There are two main branches of plastic surgery: aesthetics and restoration. Laymen may think that believe that the two are completely separated. How nice is when the doctor cures children in the St. John's Hospital, but how inappropriate to perform a breast augmentation on wealthy women later! This is absolutely untrue. Firstly, plastic surgery is now available to almost everyone, and on the other hand, the two areas cannot be separated, since there are clearly no "black" or "white" health complaints.
When restoring an injured child's nose, we do our best to make it functioning, even with adjusting the lip movement, but will also strive to make it beautiful and be in proportion to fit their face. During an abdominoplasty, we not only take care of the aesthetically pleasing results but have to restore the functioning of the surrounding muscles. This is a very hot topic since health policy makers and financial experts would like to define the term of "medical interventions only for aesthetic reasons" to make them subject to VAT – even though the issue is much more complicated. Aesthetic restoration exists; but in real life, there are no purely cosmetic interventions, just in the tabloids.
– It is well known that you founded the first Hungarian plastic surgery charity mission. Why did you choose Bangladesh?
– It just happened this way. I always wanted to establish a mission in a remote corner of the earth. I saw the Brazilian and Southeast Asian misery, and as a medical student, I felt that I will be a doctor to help the poor and the miserable ones.
Our beautiful profession can do this if someone can bring it there, where the destiny leads. And it led me to Bangladesh. This is one of the poorest countries in the world, so we can help a hundred times more from our saved money and the donations for the foundation. [Editor's note: more information about the Action For Defenceless People Foundation on cselekves.org.]
Twenty times more people live in Bangladesh than in Hungary, and there are many underserved patients. I went with a small team to one of our missions, and we could achieve very significant results: two weeks of work under my leadership with two other plastic surgeons was enough for 142 reconstructive surgery operations. We do not go to Switzerland, where people already receive the highest quality of care, which is mostly true in Hungary as well in the case of plastic surgery. Bangladesh has broad masses of patients underserved, so we have to be there. During the missions, many local doctors join us and learn from us. We educate them to multiply the value of professional knowledge. Our work actually means a few water droplets – if not in the ocean, but in a big cup –, as much more indigent people live in Bangladesh as well than we can personally help.
– What kinds of health complaints do you face during the missions?
– Mainly congenital and acquired deformities, including burns, scars resulting from accidents, abnormal scars, shrunken limbs, and the consequences of these are typical. Among malformations, we often perform cleft lip or syndactyly operations. We also offer help in various tumor removal procedures.
– How do you help those Hungarians who live beyond the border?
– Our most important mission in Bangladesh now, but I am a member of several transborder charitable organizations. In the recent years, I participated in the health screening of young Csango people, and we organize free surgeries for problems like a hernia through a foundation. Without our help, native environment of medical care could not be guaranteed for these indigent children.
– You are a member of several organizations and also founded a few. Which one is most proud of?
– I am a member of several professional organizations, was the founder of the European Plastic Surgery Research Society and several Hungarian and foreign charitable organizations. Maybe I am the proudest of the Hungarian Residents Association, which I founded with nine of my classmates at the medical university. The goal of this organization is to improve medical training and renew the whole Hungarian health care system since the start of 1999. Once I cannot do the management tasks anymore, it has been taken over by people who were able to formulate the problems of health care and present them to health care policy makers in a way that was never seen before. The Association's current fight against gratuity serves the same purpose. I think a process has probably been started that may lead to modernization, purification, moving away from the previous corrupt regime.
<– What can lead to this goal?
– The so-called "Disaster medicine" is still going on, because there are such anomalies in the distribution of workforce on the various professions and branches that make the principle of equal opportunities impossible in health care. So much depends on luck and on the particular situation. The health sector would require a radical moral change. Let's start with us, doctors, who should serve according to the Hippocratic Oath and meet the social expectations.
We need more leaders trained abroad, who were trained in a different atmosphere. Doctors who socialized abroad would present a good example in a new position which they surely occupy because of their experience, not as a result of their politic views or personal connections. Financial recognition would also be important since the salary of these well-educated people is unprecedentedly low compared to their huge responsibility. The strenuous work of health care professionals should not be awarded alms. After my days in public health care it is always refreshing to work in the private health care, but unfortunately, not everyone can afford that, and the main direction would be a well-functioning public health care.
– Some say it is very difficult to find a good plastic surgeon in Hungary, and many believe that the industry is lagging behind compared to abroad. Do you agree?
– Not at all. Regarding the first part of the question: aesthetic surgeries and interventions (for example breast augmentation, facelift or tummy tuck) are performed by excellent plastic surgeon colleagues across the country, in well-equipped operating rooms of private clinics or plastic surgery wards. As far as the second part of the question is concerned: Hungarian plastic surgery is very famous around the world and has a serious impact on the profession internationally. There are several types of surgery named after Hungarian colleagues.
– PIP breast implants were revoked in 2010, because their filling material was not the required medical grade silicone, and they began to leak. How common are such cases?
– These implants were produced by a French company, against which criminal proceedings are in progress. We know that they used cheaper materials, partially industrial silicone instead of the required quality for the implants that were later implanted in the human body by plastic surgeons. To our knowledge, this kind of "scandal" has occurred only once.
Plastic surgeons must pay extra attention to the quality of products and materials. I have never been implanted PIP implants. I like France as a travel destination, but I would not buy technology products from there at the moment. I order only such implants that have been approved by the strictest quality assurance authority in the world, the Food and Drug Administration (FDA) of the USA. There are no proper financial reasons to use cheap, low-quality products. Nevertheless, we have to say that the plastic surgeons are not at fault, since the PIP implants came from a dealer with valid permission, and the colleagues did not know what they implant exactly. On the other hand, these were very cheap products, so it should have been suspicious. Unfortunately, the number of PIP implants per capita is the highest in Hungary: more than 5 000 women affected, indicating a serious problem. This international scandal is a dark spot in the medical history.
– What quality standards are present in today's plastic surgery?
– We have to meet the highest quality standards and the requirements imposed by our own professional perfectionism. There is a growing number of modern methods, and the patients' expectations are growing accordingly. The specialty of our profession is that the result will be visible for many years. The aim of plastic surgery is to achieve a harmonious natural appearance. We need to provide the highest levels of personalized care for our patients during aesthetic treatments and surgeries, using the gentlest techniques to achieve the best results.
The interventions we carry out significantly improve the quality of life through restoring the harmony of body and soul. Even if sometimes it looks like a miracle, we do not do wonders.
Hungarian interview by Renata Hrecska
Translated by Alexandra Valeria Sandor
Another interview with Dr. Pataki in English: