Interview: Konstantin Sulamanidze for AMARTA

By Tea Adeishvili

...After the third attempt, he eventually managed to find time and agreed on an interview over the phone. We have not met before; I’m a woman in my 50s, without plastic surgery, but with its potential. He is a young and popular surgeon, the introducer of bold innovations in face and body aesthetic reconstruction, and the star of Instagram-TV and “Beauty Groups” - Konstantine Sulamanidze; Hereby, I know I will use this chance to make this meeting into an interview-consultation on how plastic surgery approaches change from era to era, the trends, what they used to be, what they are today and what to expect in following years.

Total Charm plastic reconstruction and aesthetic surgery clinic, located in one of the most iconic areas of Old Tbilisi. I arrived on time at 8 pm as appointed, after a brief delay, the doctor opened the door and sent off the patient: “So you have plenty of time; think a bit more before the operation...”

When he does not have surgery planned, he goes through around 30-40 consultations daily. Patients book appointments several months in advance; If he has an operation day, Dr. Kote can be found in the clinic from 9 am to 9 pm stuck in the operating rooms. Today was a consultation day.

“We agreed on an interview,” - I reminded, and we entered the room. Few “chests” are laid out on the desk, all different shapes but sizewise on the smaller side compared to what I’ve seen.

These are quite small; if you are getting a job done, you might as well...

The time of large breasts and unnatural volumes is over, the cult of large breasts has retired in its era, along with the boom of disproportionately inflated buttocks. Modern aesthetics have come to the conclusion that a person is most beautiful when they look like themselves, but if you still have some remarks in front of the mirror and correction is needed, then plastic surgeons will help you create a better version of yourself. This is a new stage in aesthetic medicine: the inner and outer worlds blend harmoniously together, you look like no one but yourself, and you fully maintain your charisma and individuality. This is a new aesthetic movement called body positivity and plastic positivity.

What exactly do the trends Bodypositive and Plasticpositive imply?

Will they stand the test of time, and what are the actual changes in plastic surgery with these new approaches?

Is it that patients no longer come for lip, breast, and buttock augmentation?

They come, but 10 to 20 years ago, everyone ran to the plastic surgeon and did various operations (nose, lip, eye, breast, buttock), they wanted to look like Angelina Jolie, Kim Kardashian, Beyoncé or J.Lo. Today there is a different attitude; Everyone wants to become a better version of themselves. This is to be individualistic, to be body-positive, and plastic-positive. This means that you accept yourself but want to be an upgraded version of yourself; you don’t want to be someone else, even the most beautiful and world-renowned star. Everyone has to accept themselves the way they are. Plastic surgery is somewhat of a luxury and not an urgent or emergency need, so you should think carefully before the surgery and consult different doctors. In plastic surgery, compared to previous years, the possibilities have increased, and the risks have decreased. Now there is less fear around changing radically and not adapting to the new body or features. The operation process is much easier, with less blood and less pain, and rehabilitation has also been simplified. It is as if the patient was coming from the past times, and I were to give more natural forms.

Modern trends go hand in hand with beautiful and natural forms; If we want to rejuvenate a person, we should not try to erase all wrinkles. A person should be left with characteristic wrinkles that preserve the original charisma.

As for plastic-positive... according to the latest data, 15 million people worldwide have plastic surgery annually. And this is only the data collected from the member clinics of the World Organization of Aesthetic Medicine. Our clinic, Total Charm, is among them. If we include the operations of unregistered centers, this total is at least five times the amount. Now imagine how many people walk the earth who have already gotten plastic surgery and have post-surgery results, including scars in some cases. Well, to remove the excess skin during the surgery, a cut is made, where the implant gets placed to tighten or fill some spots. This cut is sewn finely and beautifully but still leaves a scratch-like mark - this is considered body-positive today. I agree with this attitude. You shouldn’t be embarrassed, hide, and be ashamed of this stitch just because you took this step, lifted the breast that sagged from feeding your children, and your stomach skin loosened as you gave birth—but is not this your proud story? You struggled and stayed up many nights, but you still managed to find the time and strength to do the operation after all. The post-surgery scar is your power, and it doesn’t matter if someone notices the stitch, the main point is that you have the kind of breast you want to have, and your stomach is the same as before, or even better. I do not mean rough keloid scars. If the scar is unaesthetic, it’s reworked, of course. In the end, it remains something like a scratch on your improved body, and look at it from a lens of a winner - that’s what plastic-positivity is all about.

I listen to a modern doctor and realize completely new approaches to beauty. In my mind, I see images of friends and acquaintances who change more and more from time to time but still do not admit that they are frequent visitors to aesthetic clinics; But, what a blessing it is when after constant work, stress, looking after the family and exhausting often unbearable existence, you find energy and resources to regain or improve your beauty. It means you respect yourself, your partner, and your job, and you’re much happier with your beautiful body, more energetic and motivated - it’s not something to hide, but rather be proud of. It’s a luxury we sometimes desperately need to reclaim ourselves. The left mark will probably turn into a natural accessory over time. I’m trying to imagine my “scratches” where they will appear... That I will find out at the end of this interview...

Where does this trend come from, which is already forming a sort of subculture in social networks, a nearer representation of a person’s inner world turned into a natural look instead of a plastic doll look? Who or what is the inspiration behind all this?

I think plastic surgery, the fashion industry, social networks, the state of the world, a pandemic, or a war–are interconnected; They dictate changes. What’s popular in the fashion industry is transmitted on social networks; Based on this, we observe influencers’ appearance, photos, and their influence on subscribers, so one or two specific models no longer define style.

The main inspirer of the plastic-positive movement is plastic-negative, meaning some popular faces over 45 who express a negative attitude towards plastic interventions and categorically refuse it. For example, 48-year-old Julia Roberts says: “I have three children, and they need to know what emotion I’m expressing and what I feel when I have that emotion instantly.” The answer to this is plastic-positivity, that is, reaching a better version of yourself.

Don’t you lose clients over this narrative?

On the contrary, the number of patients increases yearly, not only with me but worldwide. The more time people spend on themselves, the more they try to correct.

Despite the depression, pandemic, and war?

It doesn’t change anything. During the pandemic, the reach-out increased actually. I would say that any crisis in the world - war, pandemic... starts or restarts the evolution of plastic surgery.

Why is that?

The first society of plastic surgery appeared after the First World War. Many affected people needed skin transplantation, restoration, and reconstruction. At this time, plastic surgery developed and became established as a specialty, primarily in Britain.

Two thousand years ago in India, there was a doctor, Sushruta Samhita, who performed the first rhinoplasty - nose restoration and the first reconstructions, but the great progress in plastic and aesthetic surgery still began after the First World War. Then, specialists from Britain and surgeons fleeing from the communists came together in New York, opened the first department of plastic surgery, and began to develop the field. Even the safety measures of automobiles were in accordance with the recommendations of plastic surgeons in America because they had to restore faces damaged by the glass in accidents, so as a result of collaboration with auto engineers, plastic surgeons also gave safety recommendations. Therefore, plastic surgery plays a huge role in history.

The second phase of plastic surgery development began more actively after the Second World War. Marilyn Monroe became the worldwide beauty standard, who already had various plastic surgeries (chin, nose). In this context, plastic surgery developed further, although methods were flawed and incorrect then. Monroe’s cult has lived much longer than the actress herself, and even today, her forms are in demand - narrow waist, wide bottom. The first breast augmentation with silicone implants, also known as mammoplasty, was performed in America in the 60s. The surgeons who invented silicone implants registered it as a reconstructive medium to fill in excised breasts. After it was recognized by the World Health Organization, it became widely used and continues to be so. Still, the leads in the direction of aesthetical rather than medical.

Plastic surgery covers reconstructive and aesthetic surgery. These trends have evolved quite a bit over the last 100 years, but I think the third big wave is happening right now. There is a boom in plastic surgery around the world. Only here, in this clinic, from 2021 to September 2022, 2,500 major operations were performed, of which I performed more than 1,100 (I mean operations performed under anesthesia, without it, we don’t consider them operations).

Doctor Konstantine Sulamanidze is 35 years old. In 2015, he was awarded the best specialist in the nominee of the Best Treatment 2015-2016, held under the AMEC international congress in the field of aesthetics in Paris. He completed his studies and practical work in Moscow, France, the Czech Republic, Spain, and Singapore; However, his crossing with plastic surgery happened before he was a student. He knew the interesting nuances related to rhinoplasty and dermato-cosmetology since childhood. Kote’s father, Professor Marlen Sulamanidze, is a maxillo-facial surgeon and has been working as a practicing doctor in plastic and aesthetic medicine for 40 years. Marlen Sulamanidze invented and put into aesthetic medicine practice a unique method of modern rejuvenation - Aptos toothed threads. Today, Aptos is actively used in 60 countries of the world and is recognized by the American FDA. Giorgi Sulamanidze, Konstantin’s older brother, is also a successful plastic surgeon in Europe and Georgia. In 2004, the Sulamanidze dynasty, which left Georgia in the 90s, returned to their homeland after the rich experience gained in Moscow, Prague, Germany, and various European countries. In the old historical district of Tbilisi, he opened an aesthetic beauty center, Total Charm clinic, which is one of the most trusted and favored places for Georgians (and not only) who are famous for valuing their appearance and self-care culture. Kote joined the Sulamandze family dynasty ten years later, as he was doing practical work in Europe.

In the 2000s, my father had a chance to attend an international conference in Europe, where he presented his creation - the Aptos threads, to the world-renowned plastic surgeon, Pierre Fournier, known as the father of liposuction. He was impressed with my father’s idea (Aptos threads), and I would say he opened all the doors of aesthetic medicine in the world for us; We were invited to various conferences, which came with ovations and recognition, and that’s how they heard about Aptos, even in Georgia. It was first implemented in Europe, and now we have Aptos manufacturing facilities in Tbilisi, Germany, and Singapore. This is a unique know-how, thanks to which rejuvenation of any area of the face and body has become much easier, painless, fast, and long-lasting.

Perhaps you were into what you grew up watching, or what led you to continue the professional journey of your father and brother?

I am the youngest in the family, they could not leave me at home with anyone, and since childhood, I was either with my dermatologist mother in the polyclinic or with my father in the operating room. From the age of 10-12, nose surgery was a casualty for me.

Were you even assisting your father?

No, not at that age, but as soon as I entered my first year of studies, I got to work as an assistant, paramedic, and nurse. I went through all the stages, I did everything, and I know all the nuances of the operating room, if I need to, I can take over all the functions.

Was Pierre Fournier your main mentor?

My father was my primary mentor; When I felt his gaze while working, I would tense up and ask him not to come in. Then he recommended and it was decided that I would study with different teachers, in different countries, with different methods; Therefore, after graduating from the university, I had to stay abroad for a long time, where I went to different clinics around the world to get practical experience. I visited 60 countries as an invited specialist, sometimes, I studied, and sometimes I taught.

In 2016 I decided I should have a large army of my patients. The most important thing for a doctor is the happy eyes of the patient, so I came down and started bold experiments. I used to show operations live on Instagram (with the patient’s consent, of course), and I still do, and thousands of people watch. Here, the potential patient of plastic surgery looks at the perfectly organized operating environment, bloodless, painless, with fewer cuts and injuries, which helps to overcome the fear—in the end, witnessing extraordinary results. Along the way, I started raffling off free surgeries, mainly of breast and nose, which are the most requested. I remember once 2000 women took part in a breast raffle. A girl on social welfare won and nothing could beat her happiness. Of course, I performed the operation for free. I always keep in touch with my patients.

Along with the development of medical tourism, due to the high quality and low prices of plastic and aesthetic surgery, many people from all over the world come to Georgia, who fulfill their dream of ideal shapes and strive for perfection in Tbilisi...

Patients come and do many areas of the face or body together so that we can spend 9-10 hours in the operating room. Recently, a patient who arrived from abroad underwent Liposuction, Lipofilling, and full-body Liposculpture all at once. We removed 5-6 liters of fat and injected it elsewhere, cutting off the excess skin. I worked with a gynecologist who did intimate plastic surgery. It was a complex operation that lasted 9 hours.

Patients often come from America, Israel, Europe, and Asia. To save time, they are trying to perform complex plastic surgery and undergo rehabilitation here, so soon, we are opening a small 15-room comfortable hotel next to our clinic, which will offer nursing services. If required, the nurse from the clinic will go over and take care of the patient in the hotel. Patients often travel with companions who will have the opportunity to visit the city.

In general, what are the universal trends, what works are done most often, and how do the ideals form?

The first go-to in the world is still breast, then liposuction, liposculpture, buttock, and waist sculpting. Then comes rhinoplasty, rejuvenation operations, then beauty procedures, and so on. Therefore, the body still holds the first place. There are several reasons for this. Most of all, having surgery on the face takes more courage.

Now the main thing is the proportions and charisma, isn’t it?

Ideals are constantly changing, before, the standard was Sandro Botticelli’s Venus, how ideal and beautiful are these forms no? I do not trust it! I think she had cellulite, stretch marks, excess weight, and a double chin.

But this ideal must have been created around someone resembling someone.

I think it’s an accumulation of various women.

You compare plastic surgery to marriage. What is the connection, and who are you marrying, yourself? Or, to a certain extent, to a doctor whose work remains on your body or face for the rest of your life?

These are the words of my teacher Pierre Fournier. Marriage because, first of all, it requires consent from both parties. Plastic surgery is optional, it is not a crucial matter, and just as the patient chooses me, I also have the right to choose whether or not I want to operate on this patient. No other doctor in any other field has the right to refuse a patient. Often the patient comes in and pays for the appointment, and you look at her breasts, which are already nice looking, and I say: “Why do you have to go through an operation and get a cut? Think carefully. Consult with other doctors as well.” Plastic surgery is a luxury and should be done when many aspects of the patient’s life are sorted. However, I have patients for whom this luxury was as necessary as water. An 18-year-old girl was brought by her parents in need of rhinoplasty. We agreed on the time, but they couldn’t meet the fee in full, then we heard that they sold the cow to get her daughter nose surgery. Of course, we did it regardless, and this girl is very satisfied now. I have a patient who had facial paresis due to a stroke, I corrected their face completely free of charge, and they are so happy. They call me on every holiday and, from time to time, even send me honey or wine from the village as a gift. In such circumstances, what luxury are we talking about?

Beauty is not only in the post-result of the operation, but beauty should be found even in the clinic. The relationship between the plastic surgeon and the patient also has its own aesthetics. The whole process should be pleasant from start to finish, and the result ought to be perfect; That is why this process is similar to a marriage, which should be fortunate.

My consultation with Doctor Konstantine Sulamanidze went successfully. “Before marriage,” he advises: “Think, you still have time...”