Plastic surgery demystified

By Annie Shirley

Plastic surgery is a recognised surgical specialty that includes both reconstructive and constructive surgery. Reconstructive surgery is used to correct abnormal structures in the body or to improve body functions. Cosmetic surgery is performed solely for the enhancement of appearance. Ideally it is concerned with reshaping, restoring and otherwise functioning properly for the purpose of beauty.

Once considered as a pastime of the rich and vain celebrities, the demand for cosmetic surgery is becoming a new craze. Cheered on by television shows like "The Swan" and "Extreme Make Over" which rely solely on using plastic surgery to change what is considered a below average looking woman, into someone society considers to be beautiful and acceptable.

Dr Stanley Khainga and Dr Adan, plastic surgeons based at Kenyatta National Hospital are up to standard and can easily be compared to equivalent professionals in the UK.

"We even get clients from UK, tourists from other European countries and people from other African countries who come to Kenya, because the procedures are not only cheap but of high standard" says Dr Khainga.

The cosmetic procedures provided in Kenya include:

Breasts

This involves breast augmentation (enlargement), breast reduction and breast lifts. Breast enlargement is usually popular with women whose breasts have never developed, those who have lost breasts to cancer or women who have reduced breast size because of weight loss. It involves the surgical placing of implants. Although it is popular in countries like America, in Kenya breast reduction is a more commonly preferred procedure.

"Some women have breasts that weigh as much as four kilos, a condition referred to as gigantomastia. It causes back pain, neck pain, cardiovascular and respiratory problems," says doctor Adan.

Breast reduction is also common among men who suffer from gynecomastia, a condition where men develop breast tissue during puberty, rapid weight gain, while using steroids or during middle age.

Breast lift

"Is a procedure that corrects aging breasts that have lost elasticity and shape, dropping nipples, breasts which have suffered a toll after pregnancy and nursing, says Dr. Khainga."

It is a procedure very common with women who have finished giving birth and want to restore their body to its original glory.

Liposuction

This is another procedure that is very popular among Kenyan women especially. The procedure involves the removal of excess fat from the abdomen, outer and inner thighs, upper and lower arms, knees, necks and flanks to give them a specific symmetry.

Liposuction is a procedure that can be performed on almost every part of the body even the bottoms, hips and chin, anywhere as long as fat is stored there. The full effect of a liposuction procedure is often not seen for up to a year.

Tummy tuck (Abdominoplasty)

It is a procedure for people who have excess skin and fat around the abdomen and want to have it removed. It is used to strengthen the abdominal wall. Although the procedure is very useful in reducing a protruding abdomen and tightening the abdominal, it does leave a permanent scar.

"Many times, women who were pregnant and stretched their abdominal muscles and skin elect to have tummy tucks to give them tighter abdomen and skin," asserts Dr. Khainga.

Peter Biu Ngugi, a Nutritionist at Karen Hospital where cosmetic surgery is also available, warns that, "Many women do liposuction or tummy tucks believing that it is a permanent solution to their protruding stomachs and so after procedures do not exercise or eat healthy. Thus resulting in the protruding stomachs coming back. After surgery, one has to exercise and eat a healthy diet.

Skin treatments

The chemical peel

"The chemical peel is a procedure used for facial rejuvenating. It helps skin which has been ravaged by exposure to the sun, heat and other harmful elements that cause wrinkles," say Dr. Adan.

A chemical peel can make an individual look years younger because it smoothens the texture of the skin by removing the outer layers and encouraging the formation of new skin. It can also be used to treat acne.

Chemical peels should not be performed by just any Tom or Jane, but by or under the supervision of a board certified cosmetic surgeon or dermatologist.

Dermabrasion

It is a form of mechanical exfoliation on one’s skin in order to smooth out irregular surfaces.

"Those who have acne scars, or scars from trauma like burns are good candidates for this procedure," advices Dr Khainga.

Anti-aging procedures

Laser skin resurfacing

This procedure can be used to provide adequate reduction in wrinkles and stimulate collagen production, to the point that skin resumes its shape, luster and fullness.

Botox

It has been called a wonder drug by celebrities like Jane Fonda who faithfully used the product. "It is a procedure that is very successfully used in the treatment of wrinkles, frown lines and crow feet through an injection. It is usually injected into the muscle tissue surrounding a wrinkle via small needle and the discomfort is minimal," explains Dr Khainga.

"It is advisable to begin anti-aging procedure like dermabrasion or face lift earlier on when you start to notice wrinkles and sagging skin, don’t wait until very late."

Microdermabrasion is a technique also used to reduce the signs of aging and sun exposure such as crow’s feet, age spot and laugh lines. It is usually done over series of five or 10 treatments, with each visit stimulating a layer of new, healthy skin to achieve lasting results. The treatments take between 30 minutes and one hour. Some skin types respond to micro dermabrasion more than others, so qualified doctor must be consulted. It is done quickly with very few side effects and requires no anesthesia.

Face lift (Rhytidectomy)

It is also used for the removal of wrinkles and signs of aging from the face.

The facelift procedure involves making incisions in the hairline from just behind the ear into the scalp by the temples. Also, if the neck is being worked on, a small incision will be made just below the chin. Once the incisions have are made, the plastic surgeon will separate the skin from the fat and the muscle below. Sometimes, in order to provide you with a sleeker and tighter face, fat below the skin is trimmed or suctioned away. The surgeon will then tighten the muscle and the other tissues beneath the skin, re-drape the skin, and remove excess skin from the face. Stitches are used to close the incisions and your hair covers up any scaring that is left after the procedure.

Sex Organ surgery

Apparently plastic surgery can be used to help in one’s sex life.

"Plastic surgery has developed so much; it can now help men with erectile dysfunction. Erectile dysfunction usually occurs when there is not enough blood flowing in the area. Surgery can help increase circulation in the area by bringing another artery and thus helps in creating a firmer erection for better penetration," says Dr Adan.

"We also perform vaginal plast for women, a very popular procedure that helps tighten up the vagina. Usually after a woman has given birth expansion in the vagina occurs. Many women who opt for this procedure, say they do this for their husbands," say Khainga.

Other cosmetics procedures include neck lift, ear surgery, nose job, face surgery, thigh lift, forehead lift, eyelid surgery, brow lift, laser hair removal, chin surgery, buttock enlargement and collagen injections to make lips fuller. The cost for the different procedures range from Sh20,000 to Sh180,000 at Kenyatta Hospital.

"In future we hope to be able to do hair replacement for men with receding hair lines and maybe facial implant," says Khainga.

What to look for when picking a plastic surgeon

1. Always ensure that the doctor performing the procedure has a Kenya Medical and Dentist Practitioners’ board certificate.

2. Must be a member of Kenya Society of Cosmetics and Reconstructive Aesthetic Surgery, which will soon have a website to better inform the public

"Many times we get patients who went to quack’s (unqualified surgeons), to get some of these cosmetic procedures done and when it goes wrong they come to us to correct the procedure. An uniformed patient is not a good candidate for plastic surgery," warns Khainga.

Adan adds: "Patients should also not have unrealistic expectations. It is not possible for a 50-year-old to look 18 even with the help of plastic surgery."

Pre-preparation

Before any plastic surgery procedures, the doctor has to determine if you are of the right age, normally over 18 and if you are emotionally stable for the procedure. Most plastic and cosmetic surgeons will also ask a series of question upon initial meeting, for example if you are a smoker, the doctor will advice you to stop smoking for perhaps six weeks before the procedure. Smoking interferes with blood circulation thus affecting healing. If you have conditions like diabetes the doctor will give appropriate advise. Also if a patient is seeking plastic surgery as a means of disguising emotional distress they are not good candidates for the procedure.

During preparation one is also advised on what they should eat and what not to eat before and after procedure.

Future of plastic surgery in Kenya

They are hoping to start a branch at the university that teaches plastic surgery. Instead of doing your masters before specialising in plastic surgery which takes almost 15 years, students will be given the option of going straight into plastic surgery after completion of a degree in medicine.