The interview with Professor Hakan Agir focuses on key areas of modern reconstructive surgery: correction of congenital deformities in children, staged treatment of cleft lip and palate, as well as microsurgical techniques for tissue reconstruction after oncological, burn, and war-related injuries.
Professor Hakan Agir is a highly qualified plastic and reconstructive surgeon specializing in pediatric maxillofacial surgery, the treatment of congenital deformities, as well as complex oncological and reconstructive surgery of the head and neck. The doctor has extensive clinical experience in treating cleft lip and palate in children, as well as in performing staged reconstructive surgeries from an early age to achieve optimal functional and aesthetic outcomes. A separate area of his practice is microsurgery and tissue reconstruction after severe trauma, including war injuries and burns, where he applies modern surgical techniques such as skin grafting and flap surgery. Dr. Agir also treats oncological diseases of the head and neck, performing both tumor removal and complex reconstructive interventions.
The interview with the doctor was conducted by Maria Chabdaeva, head of Beauty by Experts Medical, a company specializing in medical travel to the world’s leading plastic surgeons.
Reconstructive and Pediatric Maxillofacial Surgery
- Good morning, Dr. Hakan Agir. I am very happy to finally meet you in Istanbul. And thank you very much on behalf of all our patients. I would like to ask you to tell us a little about yourself and your experience. What types of surgeries do you specialize in?
Thank you very much for coming. I am very pleased to see someone from Ukraine. And of course, it is a great honor for me to talk about what we do here and what surgeries we perform. I am a plastic and reconstructive surgeon, a pediatric plastic surgeon, a head and neck surgeon, and also an oncologic surgeon. My field of practice is quite broad. However, I mainly focus on pediatric plastic surgery, meaning the reconstruction of cleft lip (the so-called “hare lip”) and cleft palate in pediatric patients. In addition, I treat oncological diseases – skin cancer, oral cavity cancer, tongue cancer, and head and neck cancer. I perform not only tumor removal surgeries but also reconstructive procedures, which can be extremely complex. I also specialize in microsurgery. This field is not widely accessible for patients in Ukraine, Kazakhstan, or Eastern European countries. We perform such operations very successfully, and I continue to receive a large number of patients who require them.
- I have heard a lot about your successful experience in treating patients with cleft lip and palate. Could you please tell us at what age these surgeries are usually performed?
Regarding cleft lip and cleft palate, as well as many other congenital conditions such as birthmarks or other facial abnormalities, we prefer to perform the first surgeries at around 3 months of age. For other procedures, palatal correction is usually performed between nine and twelve months. However, in most cases, I operate earlier to achieve better results. I perform cleft lip repair at 3 to 4 months of age, and we achieve good aesthetic outcomes. These are the general age guidelines.
- Is one surgery enough, or might a second one be required?
That is a very good question. If there is both a cleft lip and palate, we first operate on the lip, and then in the second stage we reconstruct the palate. Therefore, two surgeries are required before the child turns one year old. After the age of six, around 7 or 8 years old, we perform additional procedures, including bone grafting and sometimes aesthetic corrections. These surgeries are performed later.
War Injuries and Reconstructive Surgery
- As you know, the situation in Ukraine is currently very difficult, and there are many injured patients and people with facial burns. What treatment methods can be offered in such cases? Do you perform skin grafting?
Of course. I personally have one and a half years of military surgical experience. I served as a military surgeon in the Middle East. So I know what it means to be in a war. I understand war injuries very well. There are different types of war injuries in both soldiers and civilians, and most of them are caused by explosions or shelling. Some of them are burns, as you mentioned. Burns are treated in two stages. The first stage is acute care, which includes wound cleaning, dressing changes, and coverage with skin grafts.
If the burns are very severe, which sometimes happens, flap surgery is required, which is much more complex, and you need highly experienced plastic surgeons like myself. In very severe cases, we perform reconstructive microsurgical procedures, which, as I mentioned, are very rarely performed in Ukraine. I know this because I have visited all major cities in Ukraine. Only in Kyiv are these operations performed for civilian patients.
Patients may have limb injuries and burns, as well as crush injuries caused by explosions. These are very severe traumas. Without a good plastic surgeon and modern plastic surgery techniques, such patients face the risk of amputation, which is of course very tragic.
In the coming years, I believe there will be a large number of patients – soldiers, civilians, children, and elderly people – with extensive wounds requiring skin grafting or flap reconstruction. So there will be a lot of work.
- Is this usually a multi-stage procedure, or can it be done in a single operation?
In normal conditions, if you have the equipment and skilled surgeons, these procedures can be done in a single stage. However, it depends on how complex the war injuries are.
Patients stay in the hospital longer because they often have additional injuries that require treatment, such as internal organ damage. Therefore, surgery is performed as a second or third stage, possibly after 2 or 3 weeks. Under normal conditions, recovery takes about one month. However, in wartime conditions, it is difficult to make predictions.
- In general reconstructive surgery for war injuries, how long does a patient usually need to stay in the hospital in Istanbul if there are no other injuries?
It depends on the circumstances. For minor surgeries, patients need to stay in the hospital for 7–10 days. In the most complex cases, especially microsurgical procedures, we can discharge the patient after 3–4 weeks, followed by another week of follow-up observation. After that, they can return to Ukraine or their home country.
- If patients have questions after returning to their home country, can they consult you?
Of course. This is something I always do. For many years, I have been visiting Ukraine and some other countries, such as Romania, and I maintain contact with my patients. This is my policy and my main principle – to stay in touch with patients and remain available at all times, not only during treatment of war injuries, but also after all reconstructive and plastic surgeries.
We must stay connected. After plastic surgery, patients should be followed for at least one year. That is why maintaining contact is very important to me. I regularly traveled to Ukraine before the war. Now I stay in contact and monitor patients via WhatsApp or other messaging apps.
Head and Neck Oncology and Surgical Experience
- If we talk about genetic deformities of the lower jaw, when should reconstructive surgery be performed? Should we wait until the jaw finishes growing, or can it be done at an early age?
If a child has any jaw or facial deformity, in the first few months we must evaluate the patient’s condition, examine them, perform investigations such as MRI and other tests, and then develop a treatment plan.
In most cases, we do not operate on the jaw bones or other bones before the age of six, unless there are specific indications such as breathing, feeding, or speech problems. In such cases, we perform surgery earlier.
- In oncological treatment, what types of surgeries do you perform? The head and neck area contains the carotid arteries, which are very delicate structures, aren’t they?
That is correct.
The head and neck region is very complex because it contains major blood vessels and nerves. If a patient ignores the disease for a long time, the tumor eventually grows and spreads to these structures. However, we still perform successful surgeries using modern approaches such as microsurgery. In addition, we use a team-based approach and have extensive experience. I personally received my training and accumulated many years of surgical experience abroad, which allows us to perform such operations.
We are able to remove tumors that were previously considered inoperable or unresectable in countries such as Ukraine, Bulgaria, and Romania. These surgeries are not difficult if great care is taken around nearby vessels and nerves. The survival rate after such procedures is relatively high.
- This is very good news for our Ukrainian and international patients. Thank you very much!
You are welcome. I hope I have answered all your questions.
- Yes, thank you very much!
Thank you as well.
I would like to add a few words personally. Since the aggression and invasion of Russia into Ukraine began, I have always said: “I will consult any patient from Ukraine free of charge. I will do everything I can for any patient affected by the war.” At this stage, I cannot travel to Ukraine as I used to. However, I remain in contact with my surgical colleagues and friends in Ukraine. I provide my opinions, and together we review complex cases. I continue to help. Anyone who wishes can contact me via social media or Instagram and describe what kind of free assistance they need. I will do everything in my power. Glory to Ukraine!
