Interview with Dr. Dean Ad-El

“The creative process is very similar to the arts and demands constant ingenuity.” [Dr. Dean Hell El]

Dr. Dean Ad-El is a leading expert in the field of plastic surgery at “Herzliya Medical Center” private hospital.

His professional career began at “Hadassah” medical center in Jerusalem, continued training in New York, at the Memorial Sloan Kettering Cancer Center.

Dr. Dean Ad-El specializes in plastic and aesthetic procedures, including breast reconstruction after mastectomy and other cosmetic procedures after resection of organs as a result of cancers.

Why did you decide to specialize in plastic surgery?

Plastic surgery, from my point of view, is the most creative surgery.

People are very different and, therefore, any procedure requires a special approach, which entails an extraordinary process, and in each case – unique results. In contrast, for example, general surgery, when the anatomy does not differ from patient to patient.

The creative process in the field of plastic surgery is very similar to the arts and requires constant inventiveness. I compare my work with that of an artist. In fact, I draw and create music.

You reconstruct damaged organs. You give back to people, if I may say so, a normative appearance. How do you explain the fact that so many people

with normal appearance tend to change it?
I am convinced that a plastic surgeon is required to be a good psychologist and clearly define how the client’s request corresponds to an objective perception of their appearance, or if the reason of disagreement with oneself is at a deeper level than changing the appearance itself. There are patients who are looking for a solution to their failures only in the change of their appearance, not realizing the real problem. These patients will never be satisfied with any process or the result of the procedure.

Give an example of justified complaints on the implementation of a cosmetic procedure?

For example, when a woman before giving birth of three children, had beautiful breasts and as a result lost what had been a part of her feminine identity; this is quite legitimate that she desires to recapture her former beauty. Or, when a man with a high degree of obesity, losing 40 – 50 pounds, it is natural that he wants to get rid of the excess skin through cosmetic surgery.

What reason is not acceptable for the cosmetic procedure, in your opinion?

I had a patient who was sure that if she will enlarge her breasts, for sure it will save her marriage. This was clearly a distorted view of reality. A balanced personality does not set itself the objectives. Cosmetic Surgery is a surgical procedure with all the ensuing consequences. A person in debilitating stress or an emotional dissonance will not be satisfied with the result. So I refused the patient and advised him to seek a solution with other specialists.

And if the patient insists?

I’m not going to perform the surgery because as a professional I’m interested in the fact that the patient will be satisfied with the result. This is the only criteria that determine success, and if such a goal is not reached, then it’s my failure as a specialist.

When you’re in a social gathering and meet people. Do you find yourself noticing disproportionate features or other defects of people?

Of course, this comes with the profession, but I do not give my opinion. I clearly see the signs of aging, I can accurately determine the patient’s weight, the size of a woman breast and I know how I improve their looks. These are skills that I have acquired in the course of intense professional activity, which covers all existing types of aesthetic medicine – facelifts, correction of asymmetry of the mammary glands, increases and decreases of breasts, liposuction, tummy tuck, nose surgery and all procedures related to the rejuvenation of the body and face.

What is the most requested cosmetic procedure in Israel?

Breast augmentation, of course.

What are the preliminary steps before surgery for breast augmentation?
First of all, the plastic surgeon consults with the patient, during which they both come to a complete understanding and awareness of the expectations of the outcome of the surgical procedure. We discuss the future appearance of the breast, its size and, of course, the process of the operation and possible complications. Before you assign an operation you must make sure that the breasts are healthy. Depending on the age of the women you conduct either ultrasound or ultrasound and mammography and standard blood tests. If the survey matches those of the norm, then we move on to the next stage – choosing the type and size of the implant.

What cosmetic surgery was proven effective?

Proof of the efficacy of cosmetic procedure consists of two parameters: a high success rate, of the operation and a high percentage of satisfaction of the patient. Such parameters are effective for breast augmentation surgery and breast reduction, nose correction surgery, facelift, etc… Men are much more difficult to withstand pain, to wait for the result and endure the recovery period.

Have there been developments in the techniques in cosmetic surgery in recent years regarding excess body weight?

Certainly. But above all, it is necessary to divide patients into two groups: patients with a degree of obesity and those with a body mass index within the normal range. Patients with a diagnosis of “obesity” in the first place, I suggest or contact a dietitian or a bariatric surgeon who specializes in surgery to reduce the size of the stomach in order to further reduce weight. After achieving the desired weight, the patient comes to me, to remove excess skin tissue. These treatments are very successful and are performed in large quantities. Patients with a normal index weight come to me with a request for the correction of certain parts of the body. With these patients, we can offer the latest non-invasive non-surgical intervention. Israeli high-tech companies created for this purpose, medical equipment that perfectly removes excess fatty tissue with a laser and infrared radiation. At this stage, I am leading research in this area and in the near future, there will be a technique that will replace liposuction and give people the opportunity to safely get rid of unwanted volumes. But I want to remind you that the above methods are useful only for those who have a body mass index which corresponds to the testimony of the norm.

What is your opinion about thread facelift?

The purpose of using these threads is that it is less invasive. The result lasts up to six months. Not quite an impressive method … So at this point, there is no substitute for facelift surgery.

What can you say about the machine IPL-Laser, used to remove pigmentation?
Technology is wonderful, I am well acquainted with it. I was one of the first who introduced this device in practice. This technology not only neutralizes the pigment, but also improves the texture of the skin, but there is one “but”; it can only be carried out by qualified specialists with experience. IPL-Laser has proven itself as a very effective method of removing the first signs of aging, facial hair, dark spots, and freckles. For example, to achieve the desired result by removing pigment it requires 4-5 sessions and hair – from six to ten sessions.

What are patients from the former Soviet Union treated for?

Breast reconstruction and facelift.

Everyone has heard the expression “progressive aesthetic medicine.” In your opinion, what is behind these words?

In my opinion, this means that all the components that are the basis of this concept must comply with the epithet “progressive”: progressive equipment, progressive education of professionals, innovative products pharmacology and high-tech. Thus in mentioning all of the above, the effectiveness of progressive aesthetic medicine depends only on the professional level of the plastic surgeon.

Are you saying that none of the experts, except the plastic surgeon, is able to achieve effective results in the field of aesthetic medicine?

Absolutely, because the plastic surgeon is the only specialist that owns all existing techniques and methods of aesthetic medicine, starting with Botox injections, to complex surgical procedures. Only a plastic surgeon who deeply understands the process of aging and the biomechanics of the organs and cells of humans can select and execute the very same procedure that will affect the desired specific patient.

Unlike an aesthetic therapist who completed a special course in the field of aesthetic medicine, has anyone technique, for example, injections of hyaluronic acid. These therapists offer their technique to the patient, not taking into account the peculiarities of the age, the individual anatomy of the facial muscles, skin type and so on. Plastic surgeons have the opportunity to make an overall professional choice.

Tell us about breast reconstruction

First of all, I would like to point out that the breast is not just one of the organs of the female body. The chest is an important component of the psychology of women, affecting its identity. Therefore, a woman who had a mastectomy is experiencing serious emotional trauma associated with the loss of her femininity. I remember one of my patients, 52 years old, who after a bilateral mastectomy came to me for breast reconstruction. After waking up her first question was: “Doctor, when can I start a sexual relationship?”

This is a very large professional success when you can affect the self-esteem of women and revive her healthy attitude towards life.