Under The Cover Of Plastic

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It’s a long, dark and narrow corridor. Heels click against the cold concrete floor, causing a loud echo. The echo slowly fades as if absorbed by the bright open room. And as the door creaks open this suave sophisticated woman walks in to see her doctor. Not just any doctor, but the doctor who just might change her life…forever.

Many women and men in the growing middle class across Kenya can now afford to part with 150,000 shillings upwards for aesthetic surgery—commonly referred to as cosmetic surgery, as Dr. Tanga Audi, a registered plastic surgeon in Kenya, is quick to point out: “A just concluded meeting of the International Plastic, Reconstructive & Aesthetic Surgeons, (IPRAS) in Montreal states that cosmetic surgery doesn’t exist.”

Dr. Audi blames this to the lack of medical schools internationally that offer courses on cosmetic surgery. The five broad areas of plastic surgery, he says, are correction of congenital deformities like clefted lips, small heads, burns, cancer, and aesthetics and for patients who have suffered severe injuries from road traffic accidents. “Aesthetics is purely to improve the look and not the function of the organ,” added Dr. Audi.

The retired Doctor began his practice in 1978, with some of his first native Kenyan clients being female politicians and diplomats who requested to have eyelifts to get rid of the bags underneath their eyes. “These women’s ages were always questioned by their peers because of the bags they had under their eyes. They wanted to look as vibrant as they [felt inside],”said Dr. Audi.

But according to Dr. Kahoro, another plastic surgeon, “Women are now educated and have more money; their own money. And those who have conditions that effect them to the point of lowering their self worth now can rectify their condition and boost their self worth.”

The most common procedure among Kenyan women according to the plastic surgeons we spoke to is, abdominoplasty— better known as tummy tucks and breast reduction. Most of the breast reduction cases have been as a result of medical problems such as chronic back and neck aches and bra straps digging into women’s shoulders causing extreme pain and discomfort.

And the most common procedure among Kenyan men was lip reduction— making lips thinner. Dr. Kahoro is quick to point out that not everybody who walks into her office for aesthetic surgery will have it. She sternly believes in managing patients expectations.

“I had a patient who told me she wanted implants in her buttocks because she wanted to look like Jennifer Lopez.” In that case it was a plain ‘No’. The doctor outlines that there is a clear vetting procedure that is based on psychoanalysis of the patient. This process enables the surgeon to vet whether the desire for the need of surgery is genuine or instigated by a third party like a spouse or mate.

Anne*, 40, has had various procedures. Her story –which began in 2008 – saw her through four different aesthetic procedures that cost her over one million shillings. Anne said that she was constantly taunted about her weight. Her own mother once commented on Anne’s well-endowed bosom; the mother stated that Anne might suffocate her child with her breasts while breastfeeding.

But she was never a plus-size woman; she gained weight after the birth of her third child. “That’s when things changed. My belly bulged and it was hanging. I did look bad.”

It was on an unusual occasion while waiting to purchase a car at a dealers store that a fellow customer, a gentleman, who had also undergone several aesthetic procedures, recommended aesthetic surgery to her. “I can also introduce you to someone who can do your thighs,” he said. Anne remembers being distinctly embarrassed, but soon she was standing at a cosmetic surgeon’s door.

“He was so kind, a buddy and a friend. He put me at ease,” Anne says of the doctor. Anne was concerned that she may have gone berserk to consider the process. She opted for plastic surgery primarily because she wanted “fast results.” Her previous efforts to lose weight thorough exercise had proved futile.

Dr. Pius Mutie, a sociologist with the University of Nairobi observes, “Women at this age (late 30’s and early 40’s) tend to feel that life is catching up with them. They are in a transition and in denial that they are ‘mamas’,” he says. “They feel the need to look young. Also, at this age there is an economic dimension. Women can afford it.”

Susan* also underwent the process after what she terms ‘emotional abuse’ from her husband. In 2007, she had an abdominoplasty and a breast lift. “My husband kept prodding at my weight,” she recollects. Susan lived in the UK and hoped to get the procedure done there, but it was unaffordable.

“When I came home it was cheaper to have it done here.” She parted with 500,000 shillings for the procedure. But it wasn’t all rosy after negative side effects for the procedure kicked in. She turned diabetic. Both Susan and Anne are particular about talking about it publicly. They both recommend conventional weight loss practices such as eating right and exercise to avoid the negative effects.

“I’d rather keep it a secret,” Susan said. Anne says she wants her children to grow up normal and appreciate themselves for who they are. She wouldn’t recommend plastic surgery to her close friends or family. “When you say you have undergone plastic surgery, everyone will begin to think that you are showing off how much money you have,” she said.

Anne does believe that most married woman become lax in taking care of their appearance. “The man (husband) wonders ‘where’s the girl I married?’ ’’ she pointed out. Anne has received financial, emotional and psychological support from her husband through all the procedures that she has been through.

She believes that every woman should get plastic surgery. “If you can afford it go for it, instead of so much torture, just fix it because it helps your body, soul and mind,” she enthused. Given the rising cases of briefcase surgeons (Surgeons who operate without an office and operate illegally without certification from the Medical practitioners and dentist board)

Dr Khainga describes a case of a Tanzanian client who had a tummy tuck done by an uncertified foreign doctor. The doctor was practicing illegally at a private hospital in the city. Unfortunately the lady lost skin and had an infection. She was referred to a certified plastic surgeon who performed corrective surgery.

The foreign doctor fled the country and this resulted in a malpractice suit against the Hospital he practiced in, the case is still pending in court. Dr. Khainga advises the public to conduct a proper due diligence before committing their lives and money in such procedures.

“Visit the Kenya Society of Plastic Reconstructive and Aesthetic Surgeons (KSPRS) website to get a list of all recognized and certified surgeons,” he says. “It is also important carry out a research on the various procedures and their side effects.” He believes this will help an individual vet the actual need of the procedure.

The general feeling of aesthetic surgery is varied. But one consistent statement from plastic surgeons - and from Susan and Anne - is that there is nothing morally wrong with it for as long as it makes you happy and does not become an obsession.

According to Dr. Mutie, “Culture is not static. People’s values keep on changing depending on the circumstances. Plastic surgery will remain a contested issue for there are many who oppose for moral reasons- that one should not change what nature or God gave you (unless after an accident). With time however, people change their attitudes particularly if more and more

people keep on going under the knife.”