Plastic and reconstructive doctors are seeing a rising demand for elective and cosmetic surgery in Covid-19 times, as wealthy Kenyans opt for laser eye correction, chin and breast augmentation, Botox injections, and dental fixtures.
Reason? Working from home has given people plenty of time to do cosmetic surgery and heal without asking for time off the office, while others are rethinking their images as seen on Zoom and Skype video calls.
Dr Michael Rebeiro who has a clinic at MP Shah Hospital in Nairobi says, in the thick of the coronavirus pandemic, one of his patients — a 75-year-old Caucasian woman — frantically said, “I’m scaring people during Zoom meetings. They think I’m gonna die on them. Please make me look like I can do my job.”
The doctor who trained at the College of Plastic Surgeons of South Africa says medical technology has now allowed people to slow down the aging process and shave a few years off their bodies.
“She came in and left feeling and looking youthful,” he says.
The same was happening at Dr Angela Muoki’s private clinic in Nairobi. Pre-Covid, Dr Muoki could do two cosmetic surgeries a week.
“With a slowdown on activities, people had more time to reinvent themselves,” she says.
The 32-year-old fell in love with plastic and reconstructive surgery during her internship at Meru Hospital, where she dealt with many cases of cuts, burns, and congenital deformities.
Dr Michael Rebeiro a consultant plastic and reconstructive surgeon on January 26, 2021. PHOTO | DIANA NGILA | NMG
A decrease in emergency, non-cosmetic cases during the pandemic meant that she had more time to do aesthetic surgery.
Her weekly cosmetic surgery customers grew from two to eight.
The most requested procedures were liposuction, breast lifts, and tummy tucks, in that order.
Besides having the time to scrutinise their appearance, patients had more expendable income, time to recover, and privacy.
“There’s no need to ask for time off to go to a hospital and no one will know,” Dr Muoki says, explaining why the Covid-19 period presents a perfect time to check into a hospital for cosmetic surgery.
19 surgeons
Over the years, the market for elective surgery and cosmetic procedures has grown, even in harsh economic times when luxury spending was expected to be low. The number of doctors has also increased.
Ten years ago, there were only 10 registered cosmetic surgeons in Kenya. Only one was female.
Now, Dr Muoki is among the 19 registered cosmetic surgeons, seeing customers in need of liposuction, breast and chin lifts, gluteal enhancements, vulva enhancement, nose reshaping, labiaplasty, lip fillers, hair transplants, among others.
The doctors attribute the high numbers of clients to better technology which was not available in Kenya previously, forcing people to seek such surgeries abroad, social acceptability, and growth in disposable incomes.
“There is also the patients’ desire for good aesthetic looks to boost their self-image,” says Dr Nangole Ferdinand, a senior lecturer in the Department of Surgery at the University of Nairobi, and a consultant plastic and reconstructive surgeon.
Dr Angela Muoki one of the three registered plastic and reconstructive surgeons in Kenya. PHOTO | SALATON NJAU | NMG
Social media has played a major role in cosmetic surgery. It has increased awareness of the possibilities of aesthetic surgery and many enter the consultation rooms with an idea of what they want to be done.
Do they come with a photograph of what their goal looks like? I inquire.
“Yes they do,” says Dr Muoki.
Kim Kardashian’s look, an American socialite, is the biggest conversation starter as the doctors seek to know what is driving a client’s decision for surgery, their goals, and their willingness to stay the course.
This is important because cosmetic surgery is not a walk in the park depending on the extent of work to be done. A lot may need to be done before.
“For example, I ask some patients to lose weight before the surgery,” Dr Rebeiro explains.
Then there is the recovery period, the minimum of which can be six months for some procedures. With over 14 years of experience, Dr Rebeiro believes that “a well done cosmetic surgery should have longevity.”
Latest trends
Most clients who visit Nairobi’s cosmetic surgery clinics are older, professional women.
However, the doctors say men are increasingly joining the band wagon as technology improves. The latest trend, high definition liposuction, has become popular with men as it creates a toned and naturally defined physique. Other new technologies are fat transfers for skin rejuvenation resulting in wrinkle-free skin, and for skin reconstruction for scars and wounds. Costs range between Sh250,000 to Sh800,000.
“Research has found that adipose tissue-derived stem cells have a capacity for self-renewal leading to better skin,” says Dr Muoki.
The choice to go the aesthetic surgery route is very personal and most clients prefer not to tell their significant others— spouses or otherwise.
According to Dr Muoki, this is notable in women, especially when their spouses are not paying for the procedures. To avoid judgment, they opt to have their mothers, sisters, or close friends accompany them to the clinic.
“However, patients whose spouses are involved in procedures report better outcomes due to smoother healing processes and in case of a complication, spouse support is essential,” she says.
For the same reasons, Dr Rebeiro encourages spouse involvement.
“When they both come for the initial consultation, they make better decisions,” he says, adding that it is an opportunity for the spouse to hear what the process involves, and ask questions.
His patients’ numbers doubled from two to four per week during the pandemic. About 60 percent were Kenyans, 30 percent Indians, and 10 percent Caucasian.
Conducting surgeries during Covid-19 has its risks but precautions are taken.
“Initially, we were hesitant especially because there were no test kits. Nonetheless, we developed a system,” Dr Muoki says.
This involved performing a surgery a week after the final visit.
“We discouraged social interactions and when the clients came in, we’d check their temperature. If it was within the normal range, we proceeded,” she adds.
Is there a right age to be nipped and tucked?
“Do it when something bothers you,” Dr Rebeiro says.
Non-surgical options are more effective for younger clients. As one gets older, they become more of surgical candidates.
Even so, he is careful when handling patients. Some patients have unrealistic expectations. These, he will diplomatically turn down or “refer up”.
Others may be suffering from Body Dysmorphic Disorder {a mental health disorder in which one cannot stop thinking about one or more perceived defects or flaws in appearance}. Hence, counselling is required before surgery, he says.
Dr Rebeiro who is married would not mind if his wife opted for cosmetic surgery.
“Most of my clients are average mothers who want to project the best version of themselves. We (men) can’t give birth even if we wanted. Is it fair for women to carry the baggage of our babies for the rest of their lives?” he says, showing photos of two anonymous women, ‘before’ and ‘after’ surgery who have consented for their images to be used for educational/reference purposes.
The changes are impressive.
Dr Muoki is keen on having a “mummy makeover surgery when the time comes.”
A mummy makeover, done after pregnancy and breastfeeding, to lift or reduce the breasts, tuck in the tummy, is one of the most common procedures done in Kenya.
Plastic and reconstructive surgery is not just about manipulating skin, fat tissues, and bones for aesthetic purposes. These doctors also improve the quality of life of patients who come in with cuts, burns, and deformities like cleft lip and cleft palate.
Dr Muoki says, for instance, breast reduction is also done for non-aesthetic purposes.
“I remember a patient with breasts so heavy that they dislocated her shoulder. When we did the reduction surgery, the change in her was tremendous,” she says.
As more doctors join in this field which is seen as more lucrative and better at work-life balance because of few emergency cases, it is not all glitz and glamour.
“Some surgeries take up to 10 hours,” Dr Nangole says.
It also takes twice the amount of time to qualify, averaging eight to 10 years to master the art of aesthetic surgery.
Dr Muoki, one of only three registered female plastic surgeons in the country adds that to increase the number of specialists, especially females, in the field, medical students must be exposed to plastic surgery, or seek out opportunities and shadow the few that are there.
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