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2019 08 26

Doctor Simonas Kaupas: i’m happy if the patient is happy

Simonas Kaupas

Nuotr. Plastinės ir rekonstrukcinės chirurgijos gydytojas Simonas Kaupas.

The Medical Diagnostic and Treatment Centre has received reinforcement. Simonas Kaupas, an orthopaedist, traumatologist and plastic and reconstructive surgeon who has acquired valuable experience in the largest hospitals in the country, has started working at its Centre for Plastic-Aesthetic Surgery and Dermatology.

“A great team is my priority,” said the young doctor of plastic and reconstructive surgery who has already earned the recognition of patients and colleagues.

The head of the Centre for Plastic-Aesthetic Surgery and Dermatology, Renaldas Vaičiūnas, is a great authority for Simonas Kaupas and he expects to share knowledge with him and other medics working there. He will also be able to give a lot to his new colleagues and patients because he has already been successfully performing the most complex replantations (reattaching limbs severed from the body, helping patients suffering from facial nerve paralysis, etc.) in some of the largest hospitals in the country for a number of years. Seeing that he also holds a licence of an orthopaedist and traumatologist, this experience comes in handy too.

The staff of Santaros Clinic elected him Doctor of the Year 2018. This recognition was awarded both for his professionalism and his human qualities, as Simonas Kaupas is as good at coming to an understanding with a patient as he is at operating.

How did an orthopaedist and traumatologist also become a doctor of plastic and reconstructive surgery?

While still a resident at the hospital, I used to be on duty at the Unit of Plastic and Reconstructive Surgery. It was there that I became interested in this field. After studying for an additional two years, I received a plastic surgery licence. I’ve been operating independently since 2013.

Which of your selected fields is the most interesting and closest to you?

It’s difficult to choose one because there are challenges in all of them. Both reconstructive and aesthetic surgery are interesting. I feel particularly gratified by various corrections carried out for women after childbirth – probably because I see a great joy it gives them – although I do not deprecate facial or breast surgery either.

After pregnancy, the stomach often bears changes and stretch marks. Breast plastic surgery is also necessary – after breastfeeding the breasts change too, and an operation can help restore their previous appearance. These patients are generally happy immediately after their operation because they see an obvious transformation: no more excess skin and stretch marks on the abdomen, or separated straight muscles imitating a hernia that might have caused functional or digestion disorders. The breasts are corrected according to the patient’s wishes: if these pertain to size, generally implants have to be suggested; if excess skin is bothering the patient after the breasts shrink, they simply need lifting and shaping.  

Why don’t you suggest large implants for your patients?

In Lithuania, they are not that popular; the attentions of our women generally don’t go beyond the anatomical frames. But there are cases when these are necessary. Let’s say after oncological diseases, when one breast has been removed and the other is quite large, say a size D. I’m not inclined to use large implants for patients who simply come for breast augmentation, because implants are foreign bodies. There are no recommendations as to how much the breasts could be augmented at any one time, but in many cases, we change it by two sizes – one size would not give a substantially visible effect.

Treatment of facial nerve paralysis is one of the rarer of your specialisations. Are the patients suffering from it aware that the problem can be solved surgically or by injections?

I happen to see people tormented by facial paralysis in the streets. The message that this can be corrected generally hasn’t reached them, but there’s a variety of ways to solve this problem. We can transplant muscles from the legs or exchange the facial nerves so that the person can learn to smile while occluding the teeth. Occasionally, injections help – in certain places, botulin toxin is injected. In this way, the muscles are relaxed, and the face is smoothed down.

It is possible that some patients, tired after oncological operations, no longer have the internal resources to go for treatment once more. Women also often apply for breast reconstruction some ten or fifteen years later, after they have recovered and are no longer afraid of a relapse. This notwithstanding, more and more operations are done nowadays where a breast is removed and then reconstructed – tissues are transplanted – in the same operation. The percentage of such operations is slowly increasing due to the education and activities of the Breast Cancer Society.

You are a constant participant and speaker at Lithuanian and foreign medical training and conferences. Is everything changing so quickly?

The basic things, the surgery and methods, essentially do not change, just the instruments and technologies. These need the following. Complex operations where, for example, abdominal plastic, breast operation and liposuction are performed simultaneously or the fat removed by suction is transplanted to the buttocks or breasts subject to the patient’s wishes, are gaining popularity. This methodology is also invoked in cases of asymmetry, when, for example, one breast is size C and the other size A. Using implants, the breasts can be made more or less uniform, however, they would age differently with the years. With fat transplantation, the augmentation of the smaller breast would take probably about two years, but all of them would eventually change similarly.

I remember a patient with asymmetrical breasts and how happy she was when she finally resolved to have the operation. For this young woman, it gave her self-confidence and even a somewhat changed her approach to life. She was finally able to wear a swimming suit on the beach without any embarrassment.

Does the experience you gained in emergency assistance help when performing aesthetic operations?

Yes. Surgery means unavoidable traumatisation of the soft tissues and in these so-called microsurgical operations, I am accustomed to handling tissues especially delicately. Aesthetic surgery is not omnipotent, but each time I feel very happy when we attain the desired result, if not immediately then over time. If the patient is happy, I am happy too.