Beauty by the knife to come with new price tag

In February, Maiko, a motivational speaker, booked and paid for a tummy tuck with a beauty surgery clinic in Nairobi.

“In our job, appearance is everything, hence my decision to shed some of the fat accumulated during the Christmas festivities,” said Maiko.

In a recent phone interview, Maiko, 32, said he had done all necessary medical tests, paid Sh200,000 as down payment of the Sh600,000 fees and booked for an early April surgery.

“The clinic called me on March 27th; six days to my appointment, regretting the operation had been suspended indefinitely. They would inform me of a new date in due course,” said Maiko.

The clinic was responding to a Ministry of Health directive which on March 25th had suspended all elective surgeries following the outbreak of Covid-19.

“This is to request you to cancel all elective surgical procedures except childbirth cases,” wrote Director General of Health Patrick Amoth in a letter to all county health authorities.

The ministry soon followed the directive with national guidelines on how health services will be managed during the whole period of the Covid-19 pandemic.

“No elective procedures should be performed at all levels of care. Any resumption of elective surgeries will be authorised by the Ministry of Health,” said the guidelines.

It is estimated that due to Covid-19, some 28 million elective surgeries are postponed in a three-month period globally, with about 2,000 in Kenya.

A study published recently in the British Journal of Surgery says it will take almost one year (45 weeks) to clear this backlog.

These numbers include elective surgeries both in health-enhancing procedures such organ transplants, burn and joint repairs; to cosmetic also called aesthetic or beauty surgeries, the latter likely to receive the least reopening prioritisation.

Some of the aesthetic procedures offered locally include reversing facial wrinkles, dermal fillers, face and neck lift, eyelid surgery, and cheek augmentation.

Others include reshaping of the nose also called rhinoplasty, the now much popular hip, and buttock enlargement as well as tummy tuck mainly to remove the extra fat around the belly.

Also available in Kenya and mainly in Nairobi are procedures for breast reduction or augmentation. These include reshaping the breast which on the streets is also called boob job or breast lift.

Aesthetic surgical procedures are also offered locally for men with enlarged breasts, a conditional called gynecomastia if one can raise Sh400,000.

Some of the facilities offering elective surgery in Kenya include: Vitality Fountain Clinic, Valentis Clinic, Karen Hospital, Apple and Sense Clinic, Kenyatta National Hospital, Diani Beach Hospital, Aga Khan Hospital and Coast General Hospital.

Closely related to this and affected is the dentistry sector especially those offering cosmetic services such as teeth whitening and straightening and facial reconstruction.

The Kenya Dental Association had also advised its members to suspend all routine and elective dental visits pending advisories from the health ministry.

 “This virus will be with us for a long time. It will be a marathon which we must learn to live with for some time,” says Cabinet Secretary for Health Mutahi Kagwe.

Already, many private health facilities have reported financial distress including shutting down some branches, sending workers home and reducing staff salaries.

Reopen but with safety procedures

“We cannot put elective procedures on hold forever,” says a group of experts offering elective surgery from across the world.

The experts, including Tilman Stasch of Vitality Fountain Clinic, Nairobi, and the others from US, Belgium, Switzerland, Spain, and Germany have worked on some elaborate safety procedures which they propose be used for the early resumption of elective surgical procedures.

The proposed procedures are mainly to reduce the possibility of Covid-19 infections to clients and medical teams and suggest redundant layers of protection. This though comes at a significant cost expected to alter the cost of services to clients.

For example, the proposal published last month in the journal Aesthetic Plastic Surgery, suggests clients be treated as Covid-19 positive until proven otherwise through multiple tests, before, during and even after the operation.

The team suggests, the client be tested a week before the procedure, again 78 hours before the procedure and if negative, self-isolate for at least 48 hours before a final test on admission.

Clients and health workers will be required to be in high grade physical protective equipment (PPE) in all steps of the procedure including during consultations.

 Just to illustrate how expensive this may be, Kagwe recently said it is requiring 15 PPEs to perform one normal hospital delivery.

Health facilities, the surgeons suggest, may have to rebuild their surgical theatres to ensure zero flow of contaminated air and install specialised air filters.

But even with all these precautions the team warns clients there is no guarantee that they cannot be infected with Covid-19 during the process.

“This, the patient will have to understand and expressly accept. Such a patient will have to sign an acceptance document,” the experts propose.

This week New York City, US, reopened elective surgeries with stringent requirements including 14 days of isolation before the operation and a similar period after surgery.

Maiko, however, will have to wait including to negotiate a new price. “Meanwhile I am thinking of some intensive gym workouts which I am told could temporarily help flatten the tummy.”