Professor Khainga: A pioneer of plastic surgery

Prof. Stanley Ominde Khainga [Samson Wire, Standard]. Did you know that we can do face transplants in Kenya? Only about 50 face transplants have been done worldwide since the first one happened in the early 2000s. Unsurprisingly, replacing one person's face with another's is a very complex procedure that takes over 16 hours of surgery, involves nerve regeneration and a lot of surgical preparation. In a quiet, sunlit office at the Davinci Medical Group in Nairobi, Professor Stanley Khainga, surprises me with the news that it can be done here. "Have we already done it?" I ask. "We haven't but we can. We have the capacity," he says. In the grand scheme of things, maybe it is not that surprising after all. We have had several limb reattachments done here now, all of which have made the news, so maybe a face transplant is not that far out of the realm of possibilities. "You remember that boy who had an amputation of the hand? Sometime back? And another Egyptian who had an amputated leg? We are the ones who re-implanted it," he says. Another surprising tidbit is that Kenya is a hub for plastic surgery in Africa. People come from other countries like Turkey, which has had a boom in the plastic surgery field, to the UK, US and even UAE, to have surgery done here in Kenya. "In Africa, apart from South Africa, the next stop for plastic surgery is Kenya and then you go to Egypt. We are at par. What you get in South Africa, you will get in Kenya and you will get it in Egypt. You will get it in Dubai. So we are at par with the rest of the world," he says. Apparently, we could even have our own version of the show 'Botched' where people get botched surgeries corrected by expert plastic surgeons, "They even have surgeries in those countries and get complications, they come here we sort out those complications!" he says. Affordability is also a crucial factor and Dr. Khainga acknowledges that people from various parts of the world choose Kenya for plastic surgery due to its comparable standards and cost-effectiveness. "We have also had training in different types of the world. We keep on going to international conferences. We peer review ourselves with others. We see what they are doing and what we are doing. So we see where we are in comparison to the rest of the world. We are always on the move and we know where we are at any one moment," he says. Khainga is a seasoned consultant plastic reconstructive and aesthetic surgeon. He has been a professor of plastic surgery at the University of Nairobi (UON) since 2013 and was the second chairman of the Kenya Society of Plastic, Reconstructive & Aesthetic Surgeons. He is a man of few words but vast knowledge, a pioneer in the field of plastic surgery not only in Kenya but throughout the African continent. As he speaks in a low, measured voice, he shares his life's journey, his contributions to the field, and the evolving landscape of plastic surgery in Kenya. Prof Khainga during a procedure in theatre. [Samson Wire, Standard] Many people who grew up wanting to be doctors ended up achieving that dream, but Khainga was one of the few. "I went to Lang'ata Road Primary School. My father was a military officer. That's why generally, I did my school in the garrison primary schools," he explains, offering a glimpse into his upbringing and possibly explaining his straight-to-the-point demeanour. He applied for medicine and scored stellar grades at Kakamega High School which enabled him to qualify for the program, proceeding to UON, his academic journey eventually leading him to plastic surgery. He, however, almost became a neurosurgeon after his post-graduate in general surgery. "But then I realized that, at the time, the technology in neurosurgery had not developed to where it is. For me, the outcomes were a problem, so I decided that plastic surgery was the best thing because you see what there was before, the effect, and then the very good outcomes. It's almost instant," he says. "And then I realized that plastic surgery was not just about managing burns, cleft lip palates, scars and so on, it's bigger than that." After his undergraduate training at Nairobi University and completing general surgery, he went to South Africa to gain expertise in plastic reconstructive and aesthetic surgery. A trailblazer, Dr Khainga started the program at Nairobi University to train plastic surgeons in Kenya and several African countries. "By region, I mean, Tanzania, Uganda, Rwanda, Burundi, Zambia, and Zimbabwe. We have gone as far as training for West Africa. We have students from Cameroon, Sierra Leone, and Lesotho, so we train for Africa." He points to the establishment of the postgraduate program for plastic reconstructive and aesthetic surgery in Kenya as his life's most defining moment. "Because that program was never there. So I had to do hard work because I started working on the curriculum. From 2007, it was only actualized in 2012," he explains. The monumental effort is evident, as he describes the extended process of getting it approved by the university. Under Dr. Khainga's guidance, the field of plastic surgery has blossomed in Kenya. "Actually, at the moment, we are about 30, so you can see the growth," he says. His childhood dream of becoming a doctor has turned into a reality that exceeded his expectations. When he started out in plastic surgery, it was almost all reconstructive surgery. "Like skin grafts, management of burns, cleft lip palate and so on - what we commonly call operation smile," he says. "Cosmetic surgery was not in the public domain. It was mainly in the private sector. There was Dr. Landra, who used to work in Nairobi Hospital, who was the main one who was doing it there, so the public was not aware of aesthetic surgery. But when I came in, I must say I contributed to the transformation of plastic surgery to what it is now. Now they are aware of it," he says. Khainga explains that even reconstructive surgery then was basic, but they then went into advanced grafts because he also did microvascular surgery. "You could now transfer tissues completely with their blood supply and you would come and put them in the recipient and join them to the vessels there," he says. Today, they even do hair transplants at the Davinci clinic. Khainga explains that the plastic surgeon is the real general surgeon, because he operates from the head to the toe. "We operate with neurosurgeons, maxillofacial surgeons, ENT surgeons, cardiothoracic surgeons and general surgeons. And most of the work we do with orthopaedic surgeons because there's also another aspect of plastic surgery called microvascular surgery," he says. "And in cancer, you have to remove huge tissues when you are trying to cure that disease, but you end up leaving a huge defect. That defect has to be reconstructed. You join the vessels from the tissues you are using to reconstruct to the tissues where the defects are, so blood starts circulating immediately into the tissues you have transferred, so it becomes part and parcel of that organ." As for aesthetic surgery, liposuction is currently the most sought-after procedure. "We have done a lot of beautiful work - like you see what Kim Kardashian looks like? We have a lot of patients who look like that, who are either local or international," he says, describing the high demand for aesthetic procedures. In Kenya, patients can have breast reductions, breast augmentations, and more." Dr Nangole Wanjala(Left) and Prof Stanley Khainga, the lead senior doctors in the first-ever penis reattachment surgery in the country. [Standard] There are many types of procedures some people also wouldn't expect, like those done on some patients who also come to have their legs augmented (made bigger). Dr. Khainga attributes the increased interest in cosmetic surgery to social media, where people are exposed to filtered images and celebrity standards. "The advent of social media made people want to seek more cosmetic surgery because of the images that they see there," he explains. However, he emphasizes the importance of discussing realistic expectations with patients and helping them understand what can be achieved. Despite his many accomplishments, he remains modest and grounded, describing himself as "hardworking, honest, someone you can trust." "And when I start my job, I like finishing it. I have a lot of interest in my patients. I follow them up, and I like good outcomes," he says.

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