"Beautiful does not mean perfect": Adele Faizulina on modern aesthetics

      Aesthetic medicine is experiencing a real boom today: new techniques, drugs, and technologies are emerging faster than we can remember their names. Along with this, the dark side of progress thrives – a multitude of scary stories, myths, and misconceptions that migrate from social media into the minds of patients. Where is the line between safe rejuvenation and dangerous experimentation? Can we trust AI images, and is it worth chasing trends?

      In this interview with plastic surgeon, cosmetologist, and founder of the multidisciplinary medical center for cosmetology and health "FAR CLINIC," Adele Faizulina, we will discuss what truly lies behind the desire to change one's appearance, the main fears of patients, and how to distinguish a healthy trend from a dangerous race for an ideal.

      Adele, tell us how you came to medicine? Was the desire to become a doctor a childhood dream, or was something else determining your path?

      My journey began with my mother's decision: after the ninth grade, she enrolled me in the P.F. Borovsky Medical College, which at that time had international status. However, if we look deeper, it was a matter of genetics. My grandfather is the chief architect of the district in Tashkent, my grandmother is a professor, a doctor of sciences in the field of aesthetic education. Combine architecture (the ability to create form) and aesthetics (a sense of beauty) – and you get my profession. I create beauty by emphasizing individuality, not breaking it.

      Why did you choose dermatovenerology and plastic surgery, rather than another field?

      My path in aesthetics began long before university: while working as a cosmetologist-esthetician, I studied facial anatomy and the basics of care. But over time, I felt constrained within the framework of cosmetology – I wanted to understand the deep processes of tissues and solve problems comprehensively. Dermatovenerology gave me a fundamental understanding of skin diseases, while plastic surgery provided the tools for their radical correction. For me, it was a logical transition from "superficial care" to "deep restoration" of natural beauty.

      Are there surgeries that you consciously refuse to perform as a practicing surgeon, and what criteria do you use to make such decisions?

      I don't like the word "refusal," as it sounds like a verdict. My task is not to close the door but to offer the right route. Once, a patient came to me requesting botulinum therapy, hiding a severe facial deformation due to fibrosis and granulomas. The antibiotics prescribed to her previously only worsened her condition. I explained that injections would not help here. Instead, we performed surgical destruction of fibrous tissues and lipofilling (filling defects with her own fat tissue). As a result, we eliminated asymmetry and restored the person's previous quality of life.

      Tell us about a case where the result was not what all participants expected. What did it teach you?

      In my practice, I see two types of "discrepancies." The first: there is a result, but the patient does not notice it in the mirror. Only mandatory photo documentation "before/after" saves the situation. The second: the patient sees changes but does not accept them due to inflated expectations. This happens if we did not discuss the realities during the consultation. For example, a well-performed surgery can disappoint if an AI image lived in the person's mind.

      How do you manage patient expectations before surgery to avoid disappointment afterward?

      It's always a delicate adjustment, almost intuitive. During the consultation, I read not only the wishes but also how realistic they are. I show the boundaries: what depends on me and what depends on the patient's anatomy and age. My approach is not to promise "perfection," but to demonstrate the "maximum" we can achieve while maintaining naturalness. When a person sees an honest prognosis, disappointment does not occur.

      Do you have a special protocol for conversation?

      There is no universal template, and this makes the work alive. I build communication for a specific person: one needs a detailed description of the stages with scientific terms, another – visualization with photos, and a third – gentle correction of "star" desires. My protocol is born in the moment of dialogue. The main thing that remains unchanged is honesty about the possibilities of the surgery and forming a realistic picture of the future.

      What is the most common fear you hear from patients before surgery, and how do you alleviate it?

      If by the time of surgery the patient has fears, it means I have not done my job well somewhere. Fear is always a derivative of ignorance. When I provide the patient with a complete, transparent route and explain each step, fears dissipate, giving way to trust. During the surgery, we are already partners, not a doctor and a fearful patient. It is on this trust that the best result is built.

      What mistakes in plastic surgery do you consider the most dangerous – not only from a technical standpoint but also in terms of health impact?

      The most dangerous thing is not the technical error itself (we are all human), but the refusal of the doctor to acknowledge it and take responsibility. The individual reaction of the body is unpredictable, but a professional is distinguished by not abandoning the patient in trouble. My position is to take control of the situation and accompany the person until they say, "Thank you, doctor, I like it."

      Which mentor at the beginning of your career had the strongest influence on your approach to aesthetics and safety?

      I came to surgery already with a ready sense of proportions and harmony. But the real surgical school, safety techniques, and confidence in my hands are the merit of my mentor, Alexey Evgenievich Avdeev. He is a great professional who taught me to combine my aesthetic vision with the precision of intervention.

      Were there moments when you seriously thought about leaving plastic surgery?

      No. I have never had such thoughts.

      What turned out to be completely different in the profession than you imagined during your training?

      Perhaps I was one of those lucky ones whose reality matched expectations. Thanks to my experience working as a cosmetologist, I had a good understanding of facial anatomy and aesthetics. When I came to plastic surgery, it was not a shock but a logical expansion of my capabilities. There were no serious disappointments or surprises.

      Now many people are oriented towards filters and AI images. How does this change patient requests, and how do you work with it?

      Requests have not changed; the only thing that has changed is the tool for fantasies. Previously, people brought glossy photos with retouching; now they bring images generated by neural networks. My task is to "disassemble" this picture into components: skin quality – this is cosmetology, excess tissues – this is surgery. I explain what changes are physically achievable.

      Are there trends in plastic surgery and cosmetology that you consider potentially harmful?

      Trends themselves are not harmful. What makes them dangerous is the desire to be "like everyone else" at the expense of one's own anatomy. In my practice, I always assess safety and naturalness. If the procedure is suitable for the patient based on indications and does not disrupt the harmony of the face – why not?

      Where do you draw the line between what the patient "wants" and what is "possible" from a health perspective?

      If the risks and consequences are professionally explained to the patient, the "want/can" problem resolves itself. No one wants to harm themselves. When a person understands the long-term consequences, they choose safety.

      How much does your profession influence how you view people's appearances in everyday life? Is there professional hyper-observance?

      No. In everyday life, I look a person in the eyes and listen to what they say. I can switch the toggle: at the entrance to the clinic, I am a surgeon; at the exit, I am just Adele. A mother, a friend, a business partner. I do not scan the faces of passersby and do not look for what I would improve there.

      As a plastic surgeon, do you evaluate a person's appearance in terms of proportions and skin quality outside of work?

      No, I do not evaluate.

      How do your loved ones feel about the fact that your work is associated with high responsibility? Are there family rituals that help you switch off?

      My family is my island of love and my main support. I am surrounded by real men who, despite their age, give warmth and care. At home, I am not a surgeon but a woman. It is there that I restore my resources, feeling harmony and respect. This gives me the strength to take responsibility for other people's lives in the operating room.

      If you had to give up surgery for a year, what field would seem interesting to you?

      I would dedicate this time to teaching and sharing knowledge. I am interested in teaching, conducting master classes. I would like to help young doctors grow and instill clinical thinking in them. Leaving behind strong students is as important as performing good surgeries.

      Do you have a hobby that helps maintain precision of movements outside the operating room?

      Yes, it is table tennis – it develops reaction speed and coordination. And to restore my resources, I sing: it helps me emotionally unload. I also love traveling. Changing cultures and environments broadens my horizons, allowing me to look at familiar surgery from a new angle.

      What popular "natural" or "Instagram" products do you see in patients, and what is wrong with them?

      There doesn't necessarily have to be "something wrong" with them. Any component can be beneficial in the right concentration and based on indications. The problem is not with the product but with the inflated expectations created on social media. A mask will not eliminate ptosis, and a cream will not tighten the oval.

      How do social media and filters change patients' perceptions of their skin?

      I have a positive attitude towards filters. They are a tool that helps a person see the best version of themselves and want