Plastic surgery: Looking for a new you
Plastic surgery is more and more common in Nairobi as middle-class Kenyans seek the feel-good factor of a little nip and tuck
Humans have been altering their appearance for generations. We Africans are famous for doing extreme things to our bodies, such as branding, neck elongation and the wearing of brass plates in the lower lip. Cosmetic surgery is the modern frontier of an age-old practice, and Nairobi is queuing up for a nip and a tuck.
Plastic surgery is one of the fastest-growing areas of medicine in Kenya. In the past, wealthy Kenyans took trips abroad to get procedures done, but a few experienced Kenyan surgeons have travelled to the US and UK for training. Rumour has it they set out with the noble intention to treat cleft lips and perform skin grafts on burn victims and skin cancer patients, but they landed on a lucrative landmine.
Stanley Khainga, secretary general of the Kenya Society of Plastic, Reconstructive and Aesthetic Surgeons (KSPRAS), dismisses the rumour but says there is clearly money to be made in plastic surgery. Demand is on the rise, he says, as Kenyans become more exposed to what is available, incomes increase and there is a move towards greater individualism.
“Our mentality is shifting and we are more willing to pay ourselves first. So patients will come in and spend money on a procedure that will make them happy instead of sending all their earnings to relatives upcountry. My patients are not the wealthiest Kenyans, just people who want to look better and feel better.” His practice, like that of other plastic surgeons in Nairobi, combines cosmetic and reconstructive surgery. Later this year he and some colleagues will launch a burn clinic where burn victims can receive pro bono treatments.
Don Othoro is a Kenyan doctor based in London who runs Valentis Beauty, a company running five plastic surgery clinics in Nairobi. Outpatients rush to an upmarket spa for Othoro’s Botox injections, chemical peels and microderm fillers.
He believes that there is a huge distinction between attractiveness and beauty: attractiveness is measured by those around you, whereas beauty is determined by how you feel about yourself. “We all want to feel beautiful and these procedures are not about chasing age. A 60-year-old patient came in for cheek fillers and I told her that we will make her a fantastic looking 60-year-old, not a 45-year-old. I do not ‘fix’ age, there is nothing to fix.”
Asked why Kenyans are now more open to these procedures, Othoro says that they are no different from his British patients. “As we get older, we become invisible and this has a huge impact on our identity and self-worth. Patients come in with a desire to rectify what they think is unattractive and a deep desire to feel great about what they see in the mirror.”
According to Khainga, there are five plastic surgeons now operating in Nairobi. It is difficult to estimate the number of procedures because non-invasive treatments can also be performed by general practitioners and dermatologists. Visiting doctors like Othoro also make the numbers harder to calculate.
The most common surgeries in Kenya involve reduction in size. Breast reductions and lifts top the list. They cost anywhere from $750 to $2,300, depending on fees and how much fluid is removed. Second is abdominoplasty, known as a ‘tummy tuck’ in the parlance of the plastic playground, the removal of excess fat and skin from the middle and lower abdomen. Liposuction can cost anywhere from $1,000 to $3,000. Khainga is excited about a new machine that liquefies fat before it is harvested and then tightens skin as it vacuums the fluid out. Previously there was a higher probability that skin would become lumpy after liposuction. Blepharoplasty (eyelifts) are fourth on the list, costing around $1,000.
The Beauty Beneath
June is a 42-year-old pastor in Nairobi who suffered from painful skin. “My face hurt!” she says. “If I made the mistake of brushing up against any of my pimples … it hurt like bumping your toe against the corner of a coffee table. It looked bad, and I am a pastor. My face was distracting people from my words.”
June searched for all kinds of solutions, from antibiotics and salicylic acid to changing her diet and staying out of the sun. Nothing worked and she resorted to taking painkillers. Then she heard about chemical peels and went to see Don Othoro, but he refused to perform the treatment, saying that it needed careful monitoring. He lives in London and so would not be available for all the necessary check-ups.
Finally, she heard about the Obagi Nu-derm method – a series of four products designed specifically for black skin that gently peels and restores the skin over six months. June is in her fifth month and her forehead is clear and her cheeks have only a few pimples. She walks around with a tube of sun cream that she reapplies throughout the day and avoids the sun as much as possible.”Finally, I have my face back. Oh, and the Botox made my eyebrows arch so I have those too,” she beams.
Othoro charges about $250 for a Botox treatment, which needs to be repeated every three months. Microderm fillers cost around $600 and they need to be repeated every six to nine months, whereas the frequency of chemical peels depends on skin type and lifestyle.
Men are also going in for similar procedures, though male breast reduction is treated as a liposuction. Microderm fillers which fill out deeply etched lines of expression on brows and laugh lines around the mouth are also a favourite amongst men. Due to high demand, Khainga plans to start offering buttock implants.
He also performs a lot of fat grafts which involve harvesting fat from, say, the abdomen, putting it through a centrifuge to increase the concentration of stem cells and injecting them into various body parts that could use more fat like calves and ankles. These fat grafts are especially useful in covering up scars as the stem cells continue to regenerate.
While the industry in Kenya is growing, Khainga cautions that it is still very much in its infancy. He and his colleagues are currently developing a curriculum for plastic surgery to be taught as a specialisation to two surgical students per year at the University of Nairobi. It will be the first programme of its calibre in East Africa.
“Patients need to check out their doctors’ credentials and accreditations very carefully. Certification by The Kenya Medical and Dentistry Board is mandatory,” says Khainga. He also pointed out that due to its high melanin content, black skin heals and scars differently, so the doctor in charge of your care should have experience with black skin. For example, a patient who wants a facelift should be warned that the scars surrounding the ears will be more visible than for other patients.
Patients need to be psychologically prepared for the changes they are making to their appearance and they need to be clear on their reasons and motivations. “I will not operate on a woman who wants to please a lover,” Khainga says. “What happens when the next lover comes along and he wants different things?”
While most people view cosmetic surgery as elective, that is not always the case. “We have to lobby Health Insurance companies on behalf of our patients,” says Dr Khainga. “In countries like America, taking out more than 600ml of breast fluid is immediately covered by insurance because the effects of that weight on the patient’s spine, posture and general wellbeing are well documented. Some patients need eyelifts because their skin has drooped so much, it impairs their vision. We are learning and teaching a lot and it is all very exciting.” ?
While the growth of this brand of medicine in a country where most do not have access to basic health care is surprising, it reflects a shrinking planet and the growing availability of services. The patients of these doctors are not ostentatious Africans in search of a fad. They are hard-working middle-class men and women who want the best that life can give them and are willing to save up for years, if necessary. They recognise that feeling good about oneself permeates all areas of one’s life. As Africans make more money and have more options for their lives, they are not exempt from global trends, and plastic surgery is just one avenue that expresses that.