Dr. med. Eduarda Jurševiča Estētiskās medicīnas klīnika
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A new specialist, Dr. Pavel Zhibenko, has been receiving patients at the Lipex clinic since October. Dr. Zhibenko specializes in the diagnosis and treatment of vein and artery diseases, especially in the lower extremities:

- consults patients with chronic venous insufficiency;

- conducts diagnostics and duplex scanning of the veins;

- develops a treatment plan, selects compression hosiery;

- conducts conservative and surgical treatment of veins (sclerotherapy, miniflebectomy and endovenous surgery of varicose veins).

For additional information and setting an appointment for a consultation – ask at the reception or by call 67333322

A hectic rhythm of life, endless career plans and constant stress - the human body is under a lot of pressure. This is probably why more and more couples are faced with a very painful situation - infertility. Sometimes it takes months to find the root of the problem. It takes effort, time and, of course, faith that everything will work out in the end. Anton Babushkin, a gynecologist and specialist at the Lipex clinic, tells about why sometimes couples “fail” to conceive and what can be done about it.

When to contact a specialist?

The diagnosis of "infertility" is made only if pregnancy does not occur within one year of unprotected regular sexual intercourse. But, if a woman is over 35 years old, it is worth actively looking for reasons and doing examinations after six months of unsuccessful attempts.

In Latvia there is a program according to which all women up to 37 years of age (included), after being diagnosed with infertility, can undergo examinations and an in vitro fertilization (IVF) procedure at the expense of the state budget.

Infertility today is far from uncommon - about 15% of couples face this problem. Of these, 10-15% are diagnosed with the so-called unexplained infertility, when it is impossible to find the cause of infertility using available diagnostic methods. In the remaining 85-90%, the causes of infertility are divided equally into male and female factors. And this is especially important: infertility is a diagnosis in which both a woman and a man must be examined!

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wadays, the concept of what does a "woman’s health" mean has undergone major changes. This is no longer means the absence of any disease – it means a high quality of life, subjective contentment with oneself, one's body and one's sensations. Perhaps that is why aesthetic gynecology has boldly entered the forefront of modern medicine. And although the line between aesthetics and "real" medical indications is often blurred, the most important thing is the woman's desire to feel as confident and healthy as possible. Anton Babushkin, a gynecologist at the Lipex clinic, explains what can aesthetic gynecology offer to women, says.

What problems can aesthetic gynecology solve?

Indications for aesthetic gynecology can be divided into several groups.

 

The first is the problems that concern the labia majora and labia minora. These could be birth defects, consequences of childbirth, trauma, age-related changes or severe weight loss.

Classic examples of problems that can be solved in one way or another by aesthetic gynecology:

  • Too large labia, which interfere with sex life and active lifestyle;
  • Too small labia majora;
  • Asymmetry of the labia majora or labia minora;
  • Laxity of the labia majora;
  • Hyperpigmentation;
  • Hypotrophy of the labia majora (their ptosis - prolapse),

The second group - problems associated with the vagina and perineum. Here the main reference point is the patient's feelings. The list of problems may be as follows:

  • Decreased sensation during sexual intercourse (for example, a consequence of childbirth);
  • Feeling of dryness, tightness in the vagina (after menopause, childbirth) and as a result - pain and discomfort during sexual activity;
  • Consequences of episiotomy, tears during childbirth (for example, unsuccessful suture).

Additionally, it is possible solve problems related to the "classic" problems of gynecology:

  • Urinary incontinence;
  • Lichen sclerosus;
  • Problems with lubrication after radiation therapy.

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Pelvic prolapse and stress urinary incontinence are often examples of situations where patients silently live with daily discomfort, trying to "endure" the condition. In such cases, you should not hesitate, but turn to specialists for help. Gynecologist of the Lipex clinic Anton Babushkin explains how modern medicine can successfully solve both of these delicate problems.

What causes pelvic organ prolapse?

Pelvic organ prolapse, also called pelvic floor dysfunction, is a situation in which the bladder, rectum, intestine, uterus, cervix or vaginal stump (part of the vagina that remains in the case of removal of the uterus) “protrudes” outward through the vagina due to a decrease in the support of muscles, fascia (a kind of muscle “covers”) and ligaments of the pelvic floor.

There are many causes for such problems, but the main one is an increased intra-abdominal pressure, for example, during childbirth, if the patient is overweight, has a chronic cough (bronchial asthma, smoking) or if the patient is involved in weightlifting. In all these cases, the muscles of the abdomen are excessively strained, which, in turn, puts pressure on all the organs of the small pelvis and stretches the muscles and ligaments that support these organs.

The decrease in the level of estrogen - a female hormone, for example, after menopause – also plays an important role. This affects the decrease in the synthesis of collagen and elastin - fibers that also help maintain the pelvic organs in an anatomically correct position.

Plus, heavy, long and / or numerous births predispose to prolapses, stretching the walls of the vagina and injuring the pelvic floor.

When we talk about urinary incontinence, it is important to emphasize that stress-induced urinary incontinence develops due to a weakened pelvic floor — when, with a little physical exertion — coughing, sneezing, bouncing, laughing — situations in which the patient’s intra-abdominal pressure increases, which means that the patient’s intravesical pressure rises, urine is released (leaked). This is the only of three types of incontinence (stress, imperative and mixed), that is associated exclusively with a disorder of the normal anatomy of the pelvis.

In case of the imperative or the so-called overactive bladder syndrome, the problem is an acute, strong, uncontrolled need to urinate (including at night), because of which the patient does not have enough time to run to the toilet. With this type of incontinence, the root of the problem is not in a weakened pelvic floor, but in a self-willed contraction of the bladder, in the problems of its innervation. In the case of mixed incontinence, the problem is complex: it is caused by both innervation and the problems of anatomical structures.

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Getting rid of excess volume in the hips and at the waist, reducing cellulite and tightening the skin in just eight weeks. This is impossible to do with only proper nutrition, lifestyle and constant physical activity. But if you add the weekly VelaShape procedure, reaching this goal will be more realistic. In our clinic there is a new device for treating cellulite and reducing body volume - VelaShape III. The third-generation device, unlike its predecessors, is safer and more efficient.

What is VelaShape III?

VelaShape III is a safe and reliable device that is used for medical and aesthetic purposes *. It combines ELOS technology (electro-optical synergy - a combination of infrared light and bipolar radio frequency waves) with mechanical manipulations on the skin using soft vacuum.

Before the start of the procedure, a special cream with milk, caffeine, aloe and vitamins is applied to the areas of treatment, then the skin is heated due to infrared and radio frequency radiation, subcutaneous fat is “pushed down” and the dermis is smoothed. The mechanical action with the vacuum effect improves blood circulation, promotes the release of lymph and activates the metabolic breakdown of fat from fat cells.

“The usual temperature for the procedure is 43-47 degrees Celsius. The patient feels the warmth, but without any discomfort. The device has a sensor that monitors the temperature in order to avoid burns and discomfort. The effect of the vacuum is very light, leaving almost no trace,” says certified dermatologist Ekaterina Vedenina.

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Endometriosis is a truly insidious disease. Not only is the essence of the disease in the unexplained formation of the uterine endometrium in places where it should not form, but also the symptoms are so non-specific that it may take several years before an accurate diagnosis is made. Why can a painful menstruation be a good reason for meeting with a specialist, explains a gynecologist and a specialist of the Lipex clinic Anton Babushkin.

WHAT IS ENDOMETRIOSIS?

Endometriosis is a pathological situation in which the cells of the endometrium - the internal mucous layer lining the uterus – starts growing outside the uterus and are transformed into pathological endometriotic tissue. The main problem here is that the endometrium, like the ovaries, changes depending on the day of the menstrual cycle: it gradually grows in thickness and is expelled monthly, causing bloody discharge - menstruation. If this process fails, endometriosis may develop.

There are three main types of endometriosis.

 

  • The first is typical or superficial, when endometriotic tissue appears on the peritoneum - a thin membrane that lines the abdominal cavity, enveloping almost all internal organs.
  • The second variant of endometriosis is cystic. In this case, the affected organ is the ovaries, in which the so-called endometriomas or endometroid cysts form (see the article “Cysts - from small to large”).
  • In the third case, when the endometrium grows under the peritoneum into nearby organs - the intestines, bladder, postoperative scars – is the deep infiltrative endometriosis.
  • Separately, very rare types of endometriosis can be distinguished - when the lungs or, for example, the brain are affected.

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22.06. Lipex clinic works full-time as usual.
23.06. - 24.06. we are on vacation
We resume work on Thursday, 25.06.

The calendar and the weather outside confirm that the summer has arrived - skirts have become shorter, and the pants have been replaced by shorts. We begin to pay attention to our legs, noticing unpleasant star-like spots and bulging veins. And if during the warm season the legs constantly swell, it's time to consult a phlebologist. These are only some of the symptoms of venous insufficiency.

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Starting with June 3, the Latvian government has allowed to provide all planned outpatient and inpatient medical services in full. As before, or clinic takes all necessary precautions due to the Covid-19 pandemic.

Precautions include the separation of outpatient and inpatient flows, limiting the number of patients that can be in the clinic at the same time, and providing disinfection and personal protective equipment on each floor and at the entrance of the clinic. After each visit of the patients, the offices and operating rooms are disinfected.

!We ask patients to arrive at the clinic at precisely the time specified by the doctor. The need for the Covid-19 test and computed tomography of the lungs will be decided by the attending physician before carrying out the planned treatment.

For detailed information and to sign up for a procedure or a consultation with doctors, please contact the reception of the clinic by calling 67333322 or (+371) 67579208.

Since Wednesday, May 13, following the order No. 59 issued by the Ministry of Health “On restricting the provision of health services during the emergency”, the clinic has expanded the list of medical services provided. They, as before, are provided strictly in accordance with the epidemiological precautionary measures.

 

From May 20, the elective surgeries that do not require the use of general anesthesia (endotracheal anesthesia or laryngeal mask) will also resume.

Patients at the clinic are provided with personal protective equipment at the entrance of the clinic and each of its floors, and disinfection measures are provided for equipment and premises after each patient visit.

For elective surgery or invasive procedures, the patient should:

 

  • take the COVID-19 test no later than 48 hours before receiving the service. State-sponsored COVID-19 tests can be done with a doctor’s referral.
  • conduct a mandatory x-ray test (it can be done in the clinic).

 

We ask all visitors to observe the following precautions:

  • attend the consultation strictly at the indicated time;
  • wash your hands regularly and use the hand sanitizer, which is available at the entrance to the premises;
  • maintain a distance of at least 2 meters from other visitors;
  • do not come to the clinic if:

 

- you have symptoms of an acute respiratory disease;

- during the last 14 days you have been abroad;

- You have been in close contact with a COVID-19 patient.

 

To attend an in-person consultation with a specialist, we ask you to contact the administrator of the clinic in advance by calling (+371) 67333322.

 

Starting from April 27, a limited number of specialists of the LIPEX clinic will resume their work in the conditions of intense hygienic and anti-epidemic regime.

Due to the COVID-19 pandemic, the LIPEX Clinic provides routine healthcare services, which are carried out under strict precautionary measures in accordance with the amendments to Order No. 59 of the Ministry of Health “On limiting the provision of healthcare services during an emergency”, adopted on April 17.

We also ask all visitors to follow security measures:

  • arrive for the visit at the exact time;
  • wash your hands regularly and use hand sanitizers available at the entrances of the premises.
  • keep a safe distance between others - at least 2 m;
  • do not enter the premises if:

o you have symptoms of acute respiratory infections

o you have been abroad in the last 14 days

o you have been in close contact with a COVID-19 patient.

To check for the availability of specialist consultations, please contact the administration of the clinic in advance by phone (+371) 67333322.

Make an appointment in advance before you come – call before you arrive!

Dear patients! The staff of our clinic wish you and your loved ones happy Easter! May joy and peace reign in your hearts, and thoughts be sincere and kind. And above all - we wish you all good health.

According to the decision of the Cabinet of Ministers, in order to protect patients and doctors from a possible infection with the COVID-19 virus, until the end of the state of emergency caused by the current epidemiological situation, the work of day hospitals, scheduled operations and the provision of paid medical services in both public and private medical facilities are suspended.

If you have any questions contact your doctor or the reception of the clinic by calling (+371) 67333322  (9:00-13:00).

We will definitely inform you of the time when the admittance of patients will be resumed!

Take care of yourself and your loved ones - stay home!

What is a myoma?

Myoma has many names - fibromyoma, leiomyoma or uterine fibroid, and is the most common pelvic tumor in women. Although myoma is a completely benign tumor, it can cause great trouble if its treatment is not given proper attention.

The uterus consists of several layers. The thickest layer of the uterus, which consists exclusively of muscle tissue, is called "myometrium." This is the layer that is affected in the context of myomas - the tumor begins to develop from the muscles of the uterus. The muscle layer is the middle layer between the mucous membrane that is “growing” inward, into the uterine cavity - the endometrium - and the external layer that is “growing outward”, towards the bladder and colon.

  • Why do myomas form?
  • What are the symptoms?
  • How to diagnose a myoma?
  • How to treat myomas?
  • Is surgery the main treatment method?

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Due to the spread of the COVID-19 virus and the emergency situation declared in Latvia, from March 13 to an unspecified date, we have introduced additional safety measures and restrictions to protect the health of our patients and the staff of the clinic.

  • Patients who have arrived for surgery or consultation can only be accompanied until the entrance of the clinic.
  • Inpatient visitations are temporarily prohibited.
  • Before and after visiting the doctors of the clinic, please, use the disinfector located in the lobby, next to the reception

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Breast augmentation or reconstruction using implants is one of the most popular types of plastic surgery. Trends began to change when some celebrities defiantly began to remove implants to restore their natural look. Fashion or necessity? The doctor of medical sciences and plastic surgeon Eduard Yurshevich reassures: one should not be subjected to general hysteria. And he explains in which cases the removal of implants is justified, and in which cases it is not.

  1. The terrible phrase "capsular contracture." Do I need to remove the implants?
  2. How often does seroma form after the surgery and is it necessary to remove the implants in this case?
  3. If my breast implants were inserted 10-15 years ago, do I need to change them?
  4. Do I need to remove the implants during pregnancy and the lactation period?
  5. If I want to change the shape of my breasts before or after childbirth (insert / remove implants), when is the best time to do so?
  6. What is an EN-BLOC surgery? Is the implant always removed along with the capsule?
  7. What happens to the breast shape after implant removal?
  8. Is it possible to remove the old implants and immediately put in new, more modern ones?
  9. How quickly does a woman's body recover after the removal of implants?
  10. I do not want to remove the implants: how often do I need to check my health?

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The gynecology specialist of the LIPEX clinic Anton Babushkin reassures: endometrial polyps and cervix polyps are not only treatable, but also there is a great probability that they will disappear forever. But you need the right tactics to achieve it.

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On February 10, the founder of the LIPEX clinic, plastic surgeon Eduard Yurshevich, was a guest of the journalist Abik Elkin on the broadcast “Direct Speech” on Radio Baltkom.

Here are just a few excerpts from the interview:

"In 2019, we began to pay more attention to the FUE method for hair transplantation. We perfected this procedure to the smallest detail so that our patients can get the desired result without scars and unnecessary anxiety."

"There is now a new diode laser In the arsenal of our doctors, one with more accurate medical characteristics to provide better results for each and every one of our patients. Unwanted hair can be removed at any time of the year."

"In our clinic, we have performed unique surgeries:

- the patient's breast was reconstructed from her own adipose tissue simultaneously with the correction of the breast shape and the collection of adipose tissue. Given the scale of the operation, this is a unique surgery to be performed in a private clinic.

- The penis, lost by a patient due to an illness was completely reconstructed. We created a new penis from the patient’s own tissue. After the second stage of reconstruction, not only the appearance of the organ will be restored, but also its full functionality."

"A little about who comes to see plastic surgeons:
It is a myth that plastic surgery is a privilege of the rich and famous. Our clients are ordinary people with unusual stories who want to improve not only their appearance, but also the quality of their life. "

 “The trends in aesthetic surgery today are not only to make the patient’s face look younger, but also to preserve the unique features of the face. This is the approach we use when performing an endoscopic face-lift and eyebrow lift - an operation that is one of the “calling cards” of our clinic.”

“We provide a comprehensive approach to improving the health and appearance of our patients. Our philosophy is not only the provision of world-class surgical services, but also an extensive list of different types of diagnostics and treatment options.”

Full interview with a doctor

The “Youth and beauty” code in Paris

Our doctors have returned from the prestigious IMCAS World Congress.

Our doctors - dermatologists Ekaterina Vedenina, Evgenia Velenteychik and surgeon Vyacheslav Simonov visited Paris to attend the international congress of aesthetic medicine doctors - IMCAS World Congress. And now they share their impressions.

In recent years IMCAS World Congress has addressed the theme of “Youth & Age” in the field of dermatology, plastic surgery and aesthetic medicine. 345 scientific sessions presented by 800 world-renowned specialists, new surgical approaches, the Cadaver seminar, the latest news in the cosmetics industry – this is the knowledge that was available to the participants of the congress.

The participants shared experiences, their views and approaches, characteristics of each area of ​​dermatology and aesthetic medicine, talked about the peculiarities of work in their respective regions.

“I must admit that there are no groundbreaking technologies in the field of plastic and aesthetic surgery right now. Such congresses are a way to gain experience only for young doctors, but for professionals, such as our doctors, they are a kind of a readjustment of watches, the opportunity to once again make sure that our level of professionalism is high, that we have developed unique methods and technologies that are still up-to-date and in demand,” said the head of the Lipex clinic Evelina Yurshevich.

The first IMCAS congress in Paris, that took place in 1994, was addressed to plastic surgeons and dermatologists. The goal of IMCAS is to bridge the gap in knowledge in the fields of plastic reconstructive surgery and dermatology, thereby creating a synergistic and mutually reinforcing “interface” between these two areas.

IMCAS today is one of the most high-profile international courses on Anti-aging medicine. The annual IMCAS World Congress is held in Paris in winter and hosts over 10,000 participants from 105 countries.

“Piezotome”, or “Piezo”, for short, is not new in itself. It is actively used in maxillofacial surgery to work with dense tissues and bones. Relatively recently, this technique has been implemented in rhinoplasty. For plastic surgeries of the nose, the manufacturing company has made special nozzles, thanks to which manipulations that, for example, lower the hump or reduce the width of the "pyramid" of the nose, have become more gentle.

Due to the uncontrollability during use, the traditional osteotome (chisel) and electric drills, though rarely, can lead to unpleasant complications. When working with a chisel, the icebreaker effect could sometimes occur – that is, accidentally an adverse fracture of the nasal bones may occur. In turn, electric drills can damage the soft tissues (including skin), leave metal dust, which in some cases can lead to the formation of granulomas.

With the “Piezo” knife, these adverse scenarios are excluded. Ultrasound only works with the bones of the nose. The Piezo machine acts only on hard tissues: it sculpts bone tissue without affecting soft tissues, blood vessels and nerves. In addition, due to the constant supply of water by the device, the doctor can clearly see the surgical field, which improves the quality of work.

 “It is very convenient to work with this device. It is not always necessary to do an osteotomy, that is, to purposefully break the bones to narrow the "pyramid" of the nose. You can engage in sculpture - to thin the bone and create a beautiful bone "pyramid",” - says Dr. Tatyana Bogdanova.

The Piezo machine has another advantage – the bruises and swelling on the face are minimized. Instead of a cast, a light bandage can be used to mobilize the nose. This means that the recovery period after surgery is shorter. Patients can return to their usual lives sooner.

We suggest choosing one of these five procedures that will restore elasticity and radiance, will relieve you of the wrinkles, and, in short, help you to become the Queen. Besides – it is also a good gift for a friend, your mom or beloved daughter.

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LIPEX clinic`s doctors - plastic surgeon dr.med. Eduard Yurshevich and maxilo-facial surgeon Vadim Klimets conducted demonstrative face-lift operations in Moscow

Plastic surgeon Eduard Yurshevich conducted demonstrative face-lift operations in Moscow On November 29-30, a plastic surgeon with more than 25 years of experience in the field of aesthetic face surgery, the owner of the Lipex plastic surgery clinic, Eduard Yurshevich, visited Moscow, where he performed a demonstrative endoscopic forehead lift surgery for his colleagues.

This is one of the most popular aesthetic face surgeries.

The course "Aesthetic face surgery" for plastic surgeons was based on the practice of the I.M. Sechenov First Moscow State Medical University and was organized by the medical training centre "Praxi Medica".

The participant doctors discussed the latest surgical methods in blepharoplasty, facelift surgery, endoscopic forehead lift and other problems regarding aesthetic face surgery. The training was conducted on biological material with demonstrative surgeries and their detailed analysis.

A course in the “hands-on” format was conducted for beginners and experienced surgeons alike, with whom Dr. Yurshevich, in addition to demonstrative surgeries, shared his knowledge in the field of modern and proven methods of rejuvenating the upper (frontal) part, the middle part and the lower third of the face.

For doctors it was a unique opportunity to gain to gain personal knowledge by watching the hands of an experienced surgeon in the field of aesthetic face surgeries with the opportunity to communicate freely.


“The course is focused on self-development in the main aesthetic surgeries by using biological material and showing the techniques of the surgeries. I trained my colleagues by performing reliable and working methods of facelift and blepharoplasty, which the doctors can use in their everyday practice,” says Dr. E. Yurshevich.

Instant skin rejuvenation is most often associated with beauty injections. However, there is a method to achieve a better effect, without pain and rehabilitation – the PRX-T33 peeling for revitalization and instant lifting. After the procedure you can go into the world rejuvenated and beautiful on the very same day. Do it in the morning and shine in the evening!

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On November 29-30, a plastic surgeon with more than 25 years of experience in the field of aesthetic face surgery, the owner of the Lipex plastic surgery clinic in Riga, dr.med. Eduard Yurshevich and maxilo-facial surgeon Vadim Klimets, visited Moscow, where Eduard Yurshevich performed a demonstrative forehead endoscopic lift surgery for his colleagues. This is one of the most popular aesthetic face surgeries.

The course "Aesthetic face surgery" for plastic surgeons was based on the practice of the I.M. Sechenov First Moscow State Medical University and was organized by the medical training centre "Praxi Medica". The participant doctors discussed the latest surgical methods in blepharoplasty, facelift surgery, endoscopic forehead lift and other problems regarding aesthetic face surgery. The training was conducted on biological material with demonstrative surgeries and their detailed analysis.

A course in the “hands-on” format was conducted for beginners and experienced surgeons alike, with whom Dr. Yurshevich and Dr. Klimets, in addition to demonstrative surgeries, shared their knowledge in the field of modern and proven methods of rejuvenating the upper (frontal) part, the middle part and the lower third of the face.

For doctors it was a unique opportunity to gain to gain personal knowledge by watching the hands of an experienced surgeon in the field of aesthetic face surgeries with the opportunity to communicate freely. “The course is focused on self-development in the main aesthetic surgeries by using biological material and showing the techniques of the surgeries. I trained my colleagues by performing reliable and working methods of facelift and blepharoplasty, which the doctors can use in their everyday practice,” says Dr. E. Yurshevich.

At the end of October, surgeons and otolaryngologists of the LIPEX clinic - Dr. Tatyana Bogdanova and Dr. Andrey Lifshitz - visited the Seventh International Live Surgery course for plastic surgery professionals “Advanced aesthetic rhinoplasty and face contouring 2019” that took place in St. Petersburg.

The event was attended by 650 specialists from 63 countries. According to the organizers, the Live Surgery course in St. Petersburg has become a truly landmark event for surgeons for whom rhinoplasty is a professional area of interest. Over four days, 60 world-class lecturers demonstrated and discussed their practical experience, as well as shared clinical knowledge.

More than 40 hours of exciting science: the round tables, key lectures, video sections and discussion panels have become more than a unique lecture material. For example, the section “What have I learned by performing rhinoplasty for 30 years” was one of the most anticipated among the participants. The lecturers were internationally recognized experts - Dean Toriumi, Bahman Guyuron, Rollin Daniel, Eugene Kern and Yves Saban, who openly shared their invaluable experience and made history with the participants in the course.

As noted by otolaryngologist Tatyana Bogdanova, specialists whose professional careers span many years, as well as actively working colleagues who are developing new methods and technologies, have all gathered in St. Petersburg. “We develop new techniques, analyse them, test them. But decades must pass in order to draw conclusions on how well they work. It is very important to gather and share your experience with others. During the congress, two directions of the development of modern rhinoplasty were examined. One is closed rhinoplasty (performed through endonasal access - incisions inside the nose), the other, which has been widely used for many years, and which I have been a supporter of, is open rhinoplasty (implies the presence of marginal incisions along the edge of the large wing cartilage, as well as along the columella). Nowadays we are experiencing a revival of closed rhinoplasty and I am closely watching how this method develops,” the doctor explains.

At the same time, real-time operations were broadcast from two operating rooms. Two world-famous doctors showed new features in rhinoplasty live. Doctors could watch the broadcast and ask questions during the operation through moderators. The third broadcast was conducted from the anatomical hall, where, as part of the cadaver course, another doctor shared the intricacies of the operations performed in the halls.

The doctors who attended the Live Surgery course also participated in discussions that allowed them to exchange experiences with other professionals, learn more about the features of the techniques used and share opinions on current trends. All this knowledge is already applied at our LIPEX clinic to ensure the well-being of our patients and to achieve excellent results.

Photos – www.aasurgery.ru

Tinnitus, dizziness and deafness? Three operations that solve these problems.

There are many causes of hearing loss, dizziness, and tinnitus. Some of them are autoimmune or genetic diseases. If you neglect the problems with your ears for a longer time, it can lead to a total loss of hearing. Otolaryngologist Andrei Lifshitz talks about three microsurgical operations that allow people to regain their hearing.

What are the most common complaints of the patients?

Most often they notice that their hearing is worse than it used to be. Hearing loss is often accompanied by tinnitus. If the noises resemble the waves of the sea, it may mean there is an earwax plug or a perforation of the eardrum (people say "ruptured eardrum"). If the noise is high and squeaking, then the problem could be in the inner ear. Of course, we do not rely solely on this data; we always carry out an additional examination. But noise in the ears is a symptom that can also indicate hearing loss. Dizziness may also be present.

Therefore, in any case, the first thing to do in case of tinnitus, problems with the vestibular apparatus and hearing loss is to consult an ENT specialist.

How is the diagnosis made?

Hearing loss can be caused by various reasons, so initially I examine the patient. On visual inspection, some changes are noticeable, such as perforation of the eardrum or discharge from the ear. This may indicate inflammation, or cholesteatoma (tumour-like formations that contain aggressively proliferating skin cells that grow into the middle ear).

Cholesteatomas are dangerous - they destroy the bone tissue, including the auditory ossicles that are responsible for hearing and are located in the middle ear.

On the spot the doctor can perform audiometry (a hearing test) and tympanometry (it tests the mobility of the eardrum, pressure in the middle ear). If necessary - acoustic reflexometry (also a hearing test) as well. Combining the results of the tests, one can determine what the problem is and how to treat it. Because sometimes the ears hurt due to nasal diseases – a curved septum, which leads to chronic inflammation in the nose and nasopharynx, and, as a result, causes problems in the Eustachian tube.

Polyps of the nose, adenoids, etc. can also be to blame.

Additionally, the doctor may prescribe magnetic resonance imaging (MRI) and computed tomography (CT). Next, we can discuss the treatment plan.

For example, a patient comes in and claims that his hearing has gone bad. We investigate the ear and see the perforation of the eardrum. We perform a hearing test to see if it is enough to restore the membrane or are there any other problems. We offer a treatment plan.

We can fix many of the problems of the outer and middle ear surgically, and in a minimally invasive way. I will tell you about three operations that can cure ear pathologies and restore hearing.

1. Surgery on a perforated eardrum

This is not the most difficult surgery, but it can be done within an hour under general anaesthesia. It is quite a jeweller’s work - the eardrum on average is only 8-10 millimetres in diameter, so all the manipulations are carried out under a microscope. First, we take the material for the “patch” (most often it is the fascia – connective tissue over the muscles, or perichondria, or, if the opening in the membrane is large, the ear cartilage itself. Then the edges of the perforation site are refreshed so that the patch could connect to it. Then the middle ear is opened, the eardrum is raised, and an implant flap is inserted under it.

How fast does the patient recover?

After the operation, a special swab is inserted into the external ear canal, which is easy to extract, it does not stick to the ear, but allows fluids to pass through. You need to wear the swab for two weeks and instil an antibacterial agent through it.

When does the hearing return?

Ideally, the flap fully adheres after a month, which can usually be seen during an examination. But unfortunately, in 4 - 10% of cases, a second operation is required.

The patient remains in the hospital under the supervision of a doctor for a day. And the very next day returns to normal life. Due to the swab, the hearing will be slightly reduced at first. You need to be prepared for the fact that the maximum improvement in hearing will come into effect only after six months.

2. Microsurgery in case of cholesteatoma

Cholesteatoma is a formation that contains aggressively proliferating skin cells that grow into the middle ear. It usually affects the eardrum and auditory ossicles (malleus, anvil and stapes). The disease develops slowly and is asymptomatic at first. One of the first signs is liquid seeping from the ears. If you ignore the disease, you can lose your hearing completely, it can cause paralysis in the face and even an abscess of the brain.

The main goal of the operation is to remove the entire cholesteatoma. If there is even a tiny piece left, the formation can grow anew.

The gold standard for detecting cholesteatoma is computed tomography. According to its results, it becomes clear which part of the ear is damaged. The scope of the operation depends on where the destruction of the bone structure is visible; where there are cavities filled with soft tissues instead of bones; whether the bones of the middle ear are deformed.

At what age does the disease usually develop?

Most often we see the disease in young people. Rarely among older people, if they have it, they have usually already been operated before. A while back, the disease was common in children. Now for children with chronic secretory otitis media, a special tube, an ear shunt is inserted into the eardrum, which, when inflammation occurs, the Eustachian tube swells and ventilation is difficult, drains the fluid from the middle ear and helps to get air into it. And the hearing of the child is restored. Previously, there were no such technologies, which at first led to the development of chronic inflammation (longer than three months), and then to cholesteatoma.

How fast is recovery after the cholesteatoma surgery?

This is the most difficult operation, because very often in addition to removing the cholesteatoma, you need to restore the chain of three tiny bones (hammer, anvil and stapes). Previously, everything was done in two stages – in the beginning, the cholesteatoma was removed, then the bones were restored. Now this is often done in one operation, which is also performed under a microscope.

There are several options. If the ear bones have collapsed, then prostheses are placed, if two of the three are preserved, then they are interposed, replacing the missing segment with the bone of the patient himself. During the last stage, the eardrum is restored, as it is usually also affected.

How quickly is the hearing restored to the patient?

It is important to realize that after the illness, the hearing will no longer be ideal, but it will certainly be an improvement. In this operation, the main task is to stop the spread of infection and cure the pathology, as unoperated cholesteatoma can lead to death.

3. Microsurgery for otosclerosis

Otosclerosis is a disease associated with pathological bone remodulation. Usually, the growth is found on the very last ear bone, the stapes, in the place where it comes into contact with the inner ear. In case of otosclerosis, the stapes is fixed with bone tissue, becomes immobile, which causes hearing loss. By the way, women suffer more from this pathology. Although it is often congenital, it often manifests only after childbirth.

There is another link that points to this disease – it is more likely that the person will suffer from otosclerosis if the person has been infected with measles in the past.

How is the operation performed?

The operation is performed under a microscope, the doctor pulls out a part of the fixed bone, makes a hole in the base of the stape, inserts the prosthesis and fixes it on the anvil. Unlike the other two cases, hearing is restored instantly.

Unfortunately, the treatment is often symptomatic, and it helps to improve hearing only temporarily. But there are cases when the progression of the disease after surgery slows down. And sometimes it stops altogether. The operation can be done under general anaesthesia or under local anaesthesia. It all depends on the wishes of the patient and the experience of the doctor. But you should know that under local anaesthesia it is more difficult to carry out the operation: the patient may experience dizziness during the manipulations.

How is the post-operative period?

After this operation, you need to stay in the clinic for a day. But after going home, the patient can return to their usual life in a few days. It should be noted that all three operations are initially medical, aimed at eliminating pathologies of the middle ear. Therefore, auditory functions are restored in different ways. If a person has lived without hearing for a long time and has not done anything about it, then there is a chance that their hearing centre has atrophied. And in this case hearing is harder to restore. Therefore, it is better to consult a doctor as soon as you notice the first changes.

Dear colleagues!.

We invite you to take part in a dissection course “Aesthetic face surgery” on November 29-30, dedicated to blepharoplasty, facelift, endoscopic forehead lift and other problems of aesthetic face surgery. The course will be conducted on biological material (cadaver) with show and tell operations and their detailed analysis.

The show and tell operations will be conducted by one of the leaders in aesthetic face surgery, a plastic surgeon with more than 25 years of experience in the field of aesthetic face surgery, and the owner of the Riga “Lipex” plastic surgery clinic Eduard Yurshevich.

The course, which will be conducted in a “hands-on” format, will be interesting for both beginner and experienced plastic surgeons who want to learn modern and proven methods of rejuvenating the periorbital region, the middle and the lower third parts of the face, as well as master a popular operation: endoscopic forehead lift, which will be performed by Dr. Eduard Yurshevich.

VIDEO INVITATION

This is a unique opportunity to gain personal knowledge by watching the hands of an experienced surgeon in the field of aesthetic face surgeries with the opportunity to communicate freely. “The course is focused on self-development in basic aesthetic operations by using biological material (cadaver) and showing the techniques of the operations. The objective of the course is to inspire and show the working methods of facelift procedures and blepharoplasty, which the attendees will be able to use in everyday practice. Participation in the course will provide a unique opportunity not only to study the anatomy in detail, but also to learn about the areas of the face that could endanger the patient and to find out all the secrets behind a successful operation, while enjoying open communication,” says Dr. E. Yurshevich.

The dissection course, based on the practice of the I.M. Sechenov First Moscow State Medical University, is organized by the medical training centre "Praxi Medica".

At the end of the course, the participants will receive state-issued certificates.

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Lai arī plastiskā un rekonstruktīvā ķirurģija tiek uzskatīta par vienu no galvenajiem medicīnas tūrisma virzieniem Latvijā, 80% «komforta medicīnas» pacientu ir vietējie iedzīvotāji un tikai 20% ir ārzemnieki, intervijā aģentūrai LETA pastāstīja Baltijas valstīs lielākās skaistuma klīnikas «Lipex» īpašnieks Eduards Jurševičs.

Pēc viņa teiktā, klīnikā apkalpo 1000 līdz 1200 pacientu no ārzemēm, lielākoties no Īrijas, Lielbritānijas, Vācijas Francijas, Norvēģijas un Zviedrijas. Tomēr daudz pacientu ir arī no Igaunijas un Krievijas. Klīniku apmeklē arī cilvēki no Baltkrievijas, Ukrainas, Kazahstānas, Uzbekistānas un pat Taizemes.

«Tomēr apmēram 80% klientu ir vietējie iedzīvotāju un tikai 20% ir atbraucēji, tā sauktie medicīnas tūristi,» saka Jurševičs. Pakalpojumu cena ārzemniekiem neatšķiras, jo katra operāciju veida standarti ir vienoti, tāpat kā medicīnisko manipulāciju izmaksas.

«Vai būtu godīgi par vienu un to pašu pakalpojumu ņemt no cilvēkiem atšķirīgu naudu tikai tāpēc, ka viņi ir no citām valstīm?» jautā klīnikas īpašnieks. «Un turklāt nav tik lielas atšķirības mūsu ienākumos, ja atskaita visas obligātās izmaksas. Procentuāli amerikāņi vai zviedri ir par mums nedaudz bagātāki. Un operāciju cenas viņiem ir apmēram tādas pašas kā mums,» viņš piebilda.

Latvijā vispopulārākās operācijas estētiskās ķirurģijas jomā ir sejas atjaunošana un krūšu formas izmainīšana - palielināšana, samazināšana, korekcija.

«Nedaudz vairāk par 90% ir sievietes vecumā no 45 līdz 55 gadiem - visdažādāko sabiedrības slāņu pārstāves, no pensionārēm līdz lielām valsts vadītājām,» norāda Jurševičs.

Pēc viņa teiktā, sejas savilkšana, neskaitot plakstiņus, izmaksā no 2500 eiro līdz 4000 eiro. Pilna sejas atjaunošana izmaksā līdz 8000 eiro. Krūšu korekcija maksā sākot ar 2000 eiro. Ir tomēr arī nelielas operācijas, kuru izmaksas nepārsniedz 1500 eiro.

Autors: Leta     Avots: tvnet

Latvijā šobrīd strādā apmēram 20 sertificēti plastiskie ķirurgi. Katru gadu viņu rindas papildina viens vai divi jauni speciālisti un parasti viņi paliek Latvijā un strādā Mikroķirurģijas centrā, intervijā pastāstīja Baltijas valstīs lielākās skaistuma klīnikas «Lipex» īpašnieks Eduards Jurševičs.

«Latvijā ir piecas dažāda lieluma klīnikas. Katrai ir savs «jājamzirdziņš«. Piemēram, mēs biežāk operējam seju, bet maz taisām rekonstruktīvās mikroķirurģijas operācijas, jo mums ir viens mikroķirurgs, bet Mikroķirurģijas centrā - 19 speciālisti. Pilnīgi cits potenciāls. Lielākā daļa kolēģu specializējās «uz krūtīm», jo ne visi uzreiz var operēt seju, vajadzīgi ilgi mācību un prakses gadi, lai cilvēki tev noticētu un uzticētos,» stāsta Jurševičs.

Runājot par plastisko ķirurģiju kā vienu no pieprasītākajiem medicīnas tūrisma virzieniem, viņš piebilda, ka noteicošais ir ne valsts vai pat cena, bet ārsts - viņa vārds un reputācija. Tādēļ cilvēki no sākuma meklē speciālistu, interesējas par viņa darba kvalitāti, viņa iepriekšējo pacientu atsauksmēm un, ja viņus tas pārliecina, dodas uz operāciju, viņš skaidro.

Pēc viņa teiktā, cena var būt noteicošais faktors citās sfērās - rekonstruktīvajā ķirurģijā, kardioķirurģijā. Bet sejas plastiskā ķirurģija ir gabalprece.

Atbildot uz jautājumu, kāpēc Latvijā parādījies tik daudz sieviešu ar «uzpampušo lūpu» efektu, viņš norādīja, ka šodien tā ir ļoti liela medicīniska problēma, jo papildu lūpu gelam tiek lietoti gandrīz visi kosmētikas līdzekļi, bet plastiskajam ķirurgam pēc nākas likvidēt sekas.

«Mēs par to pat esam uzrakstījuši lielu rakstu profesionālā žurnālā un nolasījām lekciju kosmetologiem Baltijas konferencē, lai viņi saprastu, ko dara,» stāsta Jurševičs.

«Protams, skaistums mūsu sfērā ir ne tikai medicīna, bet arī bizness,» turpina ārsts. «Tomēr jāatrod līdzsvars starp šīm divām kategorijām. Ir lietas, kuras var darīt un ir lietas, kuras darīt nedrīkst,» viņš piebilst.

To present gifts to friends, relatives and close people is a tradition, which will never be cancelled. A gift is a sign of consideration, kindness and care of the person whom it is intended to. The majority of the people feel a lot of pleasure when they give presents. The world of gifts is huge and it is always hard to take bearings in it. An ideal gift should be pertinent, desired, and useful; it must bring satisfaction and positive emotions. To get the Gift Card of our clinic means to make a well-grounded choice in favor of health, youth and beauty! This is an optimal decision, a competent investment of means and a guarantee of your gift's success!
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