In Almaty, a surgeon was taken into custody two years after fatal liposuction
The investigative court of Almaty took into custody the surgeon and head of the private clinic “Moscow de Luxe” Roman Alferov, as well as the anesthesiologist of the clinic “Author’s Medicine” Alexey Sek. They are suspects in the case of the death of a 42-year-old patient after liposuction in December 2017.
“The Specialized Interdistrict Investigative Court authorized the detention of Alferov and Sek for a period of one month,” the press service of the Almaty City Court reported.
The third suspect, on-duty doctor Elmira Tilenshieva, was released on bail in the amount of 300 MCI (757,500 tenge).
All three, according to investigators, participated in the operation of a woman born in 1975, who subsequently died.
Surgeon Roman Alferov / Photo from the clinic’s website
Roman Alferov and Alexey Sek are suspected of improper performance of professional duties. The head of the clinic was also charged with dishonesty in his duties. They face imprisonment for up to 5 years.
“According to the investigative department of the police department, the investigation will be completed in the near future and the materials of the criminal case will be sent to court,” the press service of the Almaty Police Department reported.
Almost a year after the patient’s death, in October 2020, the Almaty Department of Public Health (DOPH) began inspecting two private clinics, “Moscow de Luxe” and “Author’s Medicine”, at the direction of the police.
In the spring of 2020, the Department of Public Health appealed to the civil court with a request to suspend the specialist certificate and admission to clinical practice in the specialty “plastic surgery” of Roman Alferov until the criminal case is resolved on the merits. But the court left the claim without consideration, since such claims are considered in an administrative or investigative court.
Then the DOOH appealed to the economic court with a demand to invalidate the permits and licenses and revoke them from Moscow de Luxe and Author's Medicine, but the DOHO specialists did not come to the hearing. The court considered the failure to appear disrespectful and left the claim without consideration.
In the “Author's Medicine” clinic in 2020, Ukrainian citizen Dana Agamuradova died after liposuction. But the clinic continues to operate. Surgeon Dmitry Pisarev was found guilty of the girl’s death, but he escaped punishment due to the fact that the investigation lasted a long time and the deadline for bringing him to justice had passed.
Dmitry Pisarev is now in custody. Before the start of the main trial in the case of the death of Dana Agamuradova, in September 2020, he performed breast surgery on a young flight attendant, who fell into a coma and died.
Plastic surgeon Stanislav Zhirkov
Any branch of medicine today can boast of innovations. Plastic surgery is no exception. Thanks to new and classic techniques, everyone can turn their own ideas of beauty into reality. The main assistant in this matter is the plastic surgeon. We talked about the concept of beauty, free operations and differences in the region with a specialist originally from Yakutsk, a doctor of the highest category, a plastic surgeon, “Excellence in Healthcare of the Russian Federation” Stanislav Nikolaevich Zhirkov.
Corr.: Stanislav Nikolaevich, hello! Tell me, what does the concept of “beauty” mean to you as a doctor in your specialty?
Stanislav Zhirkov: Hello! In my opinion, beauty is the harmony of the external and internal world of a person. This is not only an attractive appearance, it is also a noble heart. Beauty is present in everything that surrounds a person - this is both nature and our environment. What is so beautiful about being a plastic surgeon is the ability to help patients live a full life. To do this, we carry out various reconstructive interventions and eliminate defects.
Corr.: It is believed that plastic surgery is all about patients’ money, “commerce”.
Stanislav Zhirkov: If we are talking about aesthetic operations, then yes, these are paid services. If we are talking about reconstructive interventions, then very often this is carried out free of charge, in specialized government institutions. The most complex reconstructive operations are performed free of charge at various clinical institutes. Plastic surgeons often conduct charity events.
The beauty of being a plastic surgeon is the ability to help patients live full lives.
Today, Natalya Manturova, the chief plastic surgeon of the Ministry of Health of the Russian Federation, is actively working to include a number of plastic surgeries in the compulsory medical insurance system, so that the state pays for them instead of the patient.
Corr.: What operations are in great demand?
Stanislav Zhirkov: Of course, this is facial plastic surgery. Blepharoplasty is very popular, and patients of various nationalities apply. Eyelid correction is popular due to the relative simplicity of the intervention and the significant result - the look becomes open, more youthful. Next comes mammoplasty. To say that they often turn only because of their own desire to increase their size would be wrong, since many patients are women who have undergone mastectomy (removal of the mammary gland) due to breast cancer, with unsuccessful results of primary mammoplasty. Well, the top list of popular operations is completed by liposuction and abdominoplasty.
Sometimes the correction of certain complex deformities requires the help of other specialists - oncologists, maxillofacial surgeons, etc. Then we work together to provide the patient with the maximum amount of care.
Corr.: What is the indication for aesthetic surgery? Only the patient's desire? Is correction of appearance always justified?
Stanislav Zhirkov: It is undoubtedly dominant, but if there are no certain signs, then I do not undertake the operation. If a patient expresses a desire to have blepharoplasty, I see that he has drooping eyelids, I undertake the operation to eliminate these age-related changes. It happens that I tell patients “too early” and send them to a cosmetologist.
Surgery is always justified if there are medical indications. When it comes to the patient's wishes alone, the situation is more complicated. Sometimes a person may expect unrealistic results from a surgeon, so it is important to explain what maximum effect can be expected. Don’t forget about possible complications - even though we doctors make every effort to reduce this risk to zero, no one is safe from them anyway.
Corr.: How can you understand that you need to go to a plastic surgeon?
Stanislav Zhirkov: You know, most of our patients come to us consciously, this is not a momentary decision - “let me go and fix my appearance.” No, usually certain defects or deformations cause discomfort to a person for a long time - be it physical difficulties or psychological complexes. Today, patients come for consultation knowing exactly what result they want to see after surgery.
It is important to explain to the patient what the maximum effect from the operation can be expected.
Corr.: What can you say about plastic surgery in Yakutia?
Stanislav Zhirkov: The industry is developing everywhere, in the region or the capital. We also have competent doctors who know how to do their work efficiently, we have some technical innovations and equipment. But I note that the demand for plastic surgery here is not as high as, for example, in Moscow.
Corr.: Stanislav Nikolaevich, how can one preserve youth and beauty while living in the North?
Stanislav Zhirkov: Of course, a healthy lifestyle. Good sleep, proper nutrition, moderate exercise, no bad habits. If you follow these rules, then youth and beauty will remain with you for a long time.
One metropolitan surgeon performs 800 plastic surgeries a year
Kazakhstan is experiencing a real BOOM in plastic surgery. Since 2015, the number of people wanting to change their appearance has almost doubled. Believe it or not, people from the hinterlands also want to have beautiful eyes and an ideal figure. 800 people a year pass through the scalpel of just one metropolitan doctor. “Blepharoplasty” is especially popular among Kazakhstanis, that is, many of our fellow countrymen abandon Asian eyelids in favor of European ones. Representatives of the fair sex mostly undergo breast enlargement operations - this is not a cheap pleasure. Surgeons say that women who want to improve their appearance with the help of implants, prices starting from a million tenge, are not afraid. Even in a crisis. This type of medical services is becoming so profitable that young specialists, after studying, travel abroad to train as a plastic surgeon. Botagoz Sarkulova about artificial beauty.
Everyday life of the capital's surgeon Vladimir Khegai. According to him, there is now a boom in plastic surgery in our country. The number of his patients has almost doubled over the past year. Today he performs up to five operations a day. Mostly the age of patients is from 18 to 65 years.
Vladimir Khegai, plastic surgeon in Astana:
The most common person women want to be like is Angelina Jolie. They come and show her eyes. Or Valeria's eyes often show too. Of course Asian women can't have eyelids like that.
The operation we are currently attending is the second most popular. Mamoplasty. In this case, it is breast augmentation. The patient who is currently on the operating table is 29 years old. She is a mother of two children and after giving birth she was no longer satisfied with her shape. In just an hour she will become the owner of size two.
The palm goes to blepharoplasty. This is a change in the shape of the eyelids. Such operations are in great demand among young girls and boys who want to correct the “Asian eyelid” and get a “European” eye shape. The top five also include tummy tuck, correction of the shape of the nose and ears, as well as liposuction. At the same time, the path to ideality through a scalpel is not cheap. So, in Astana or Almaty, a “European” eye shape will cost an average of 300 thousand tenge. The cost of breast augmentation surgery is on average one million tenge. You can make your waist thinner with liposuction, in other words, “pump out the fat,” for 300-400 thousand tenge. By the way, in the southern capital the demand for plastic is growing at an even more impressive pace. Including among men
Roman Alferov, plastic surgeon in Almaty:
Still, women, including men, do not regret, they are looking for means to improve their external characteristics. Therefore, over the past three years, the number of patients has increased by a factor of five.
Vladimir Khegai, plastic surgeon in Astana:
Some even come from other countries. This is normal now. Because for them the prices we have now are pennies. Migration of patients is a normal thing. They all think that at home it’s worse, somewhere else it’s better. They think the opposite.
Roman Alferov, plastic surgeon in Almaty:
Just recently I came from St. Petersburg, recently a girl came from Australia. But they all come from here. +00.06.41 At the price at which they could perform the operation in Europe or America, they will fly here, see their loved ones, perform the operation and fly away.
Almaty resident Alisa Brzhstavitskaya is an Instagram “star”. Her life is followed on a social network by an audience of 25 thousand, to whom the girl told about three plastic surgeries she had undergone. Now subscribers are waiting for live broadcasts from the operating room: Alice is preparing for her fourth operation. This time abdominoplasty. She will have excess skin removed from her abdomen.
Alisa Brzhstavitskaya, resident of Almaty:
I have a long history of losing weight. I somehow lost more than 75 kg after pregnancy and childbirth. Then, unfortunately, the weight returned. The operation that I am planning, abdominoplasty...the situation there is such that after pregnancy and childbirth my abdominal muscles separated. And I need this operation not to cut off unnecessary skin, but to stitch the muscles.
Alice does not agree that plastic surgery is the path of least resistance. The risks are too high. But even knowing about them, the girl is thinking about a fifth operation. Wants to have a breast reduction.
Alisa Brzhstavitskaya, resident of Almaty:
Specifically in my case, there is a risk of fat embolism. Pulmonary embolism. This is when a piece of fat enters the heart and instant death occurs. The upcoming operation that I will have also has its own nuances. For example, if more skin is cut off than necessary, tissue necrosis may occur. I'm not going to do more than I planned. You won't see me with lips like these and eyes like these.
The rapid development of plastic surgery has led to the fact that in neighboring Russia there is huge competition for this specialty in medical universities. Since 2009, it has been officially entered into the register of medical specialties. The country's leading universities immediately opened departments of plastic surgery. Kazakhstan is in no hurry to do this yet
Erbol Bekmukhambetov, rector of West Kazakhstan State Medical University named after. M. Ospanova:
Plastic surgery today is not included in the guaranteed volume of free medical care for the population of the Republic of Kazakhstan, therefore all this care is provided only in commercial clinics, on a commercial basis. Therefore, training in plastic surgery...if there is demand, there will be supply.
Lyazzat Asenova, Dean of the Faculty of Continuing Professional Development, Karaganda State Medical University:
For plastic surgery, our demand is sporadic. Training is carried out according to the requests of doctors. In 2020, we had no demand at all. There were no applications from medical organizations or individuals. This year only 5 people volunteered.
The low interest is most likely due to the fact that domestic doctors prefer to retrain abroad. The specialists mentioned above did the same. At the same time, Alferov predicts that there will be more and more people who want to change their specialty every year, because the services of plastic surgeons are well paid and are always in demand. Doctors also note that despite the increased interest, Kazakhstanis maintain a sober approach to altering their appearance. There are no people who want to get on the front page of the media due to their resemblance to a Barbie doll.
Botagoz SARKULOVA
Another plastic surgeon was arrested in Almaty. Patient Roman Alferova died two years ago after liposuction. A resuscitator from a private clinic was detained along with him. The doctor on duty is also involved in the case. The team of doctors is suspected of improper performance of professional duties. Doctors face up to five years in prison. Let me remind you that just a month ago another plastic surgeon was detained in the city
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Dmitry Pisarev.
His patient died after breast surgery. On the building where the clinic is located, where the woman came to get a beautiful figure, an inconspicuous sign was lost among the others. Perhaps soon it will be removed altogether. The leader and practicing surgeon Roman Alferov was arrested. Two years ago he performed an operation that should not have happened.
Gulmira Baralkhieva, lawyer:
– The patient, let's say, was middle-aged. It was necessary to check whether she had cardiovascular, gastric, or endocrine diseases. All this needed to be checked, but these requirements were not fulfilled by Alferov. On the same day when she arrived, he carried out ordinary tests, and the operation was immediately performed.
The next day the patient died. As experts later established, the woman lost a lot of blood during the operation. She had too much fat removed. In addition, the procedure for the deceased was generally contraindicated.
Gulmira Baralkhieva, lawyer:
– After the operation, she was transferred to the intensive care unit, where the resuscitator Sek Alexey Nikolaevich and the doctor on duty Elmira Tilenshieva did not properly provide her with sufficient attention or supervision and did not provide medical assistance in a timely manner. That the person after the operation, it was during the day, spent the night, there was no post-operative care for her.
Now three doctors from one clinic have the status of suspects. But Alferov and Sek will be in a pre-trial detention center for the duration of the investigation. The doctor on duty was released on bail.
Abay Zharylkasyn, press service officer of the Almaty City Court:
– These persons are suspected by the pre-trial investigation agency of committing a crime under Art. 317 part 3 “Improper performance by a medical employee of his duties, resulting in the death of a person through negligence.”
The lawyer for the family of the deceased assures: Alferov carried out the procedures in an unequipped operating room. By the way, another plastic surgeon, Dmitry Pisarev, practiced there. Three years ago he unsuccessfully performed liposuction on a Ukrainian citizen. The woman died. And a month ago he was arrested for the death of a flight attendant who was undergoing breast surgery.
