It’s hardly a new phenomenon, and one that North Americans and Europeans have been openly indulging in for decades. With visions of tight tummies and forever-young faces, Kenya has not only joined the cosmetic surgery trend, but is now drawing surgery seekers from all over By Helen Kinuthia

What’s even more interesting, besides the people looking to get aesthetic or plastic surgery, is the increase in awareness of these medical services.

Whereas cosmetic surgery was once considered a vain undertaking, modern society has now become more accepting of numerous body enhancing procedures performed internationally. Women in Kenya, and even an increasing number of men, are having reconstructive and constructive surgery done within the country. Whether it’s to enhance beauty, rectify an abnormality or increase one’s self esteem, there are now individuals not only getting cosmetic surgery performed by professional surgeons in Kenya, but travelling to Kenya for just such procedures. What was once a Western phenomenon is now a full-blown medical industry in the country.

What’s even more interesting, besides the people looking to get aesthetic or plastic surgery, is the increase in awareness of these medical services. Even though the number of licensed medical practitioners performing cosmetic surgery in Kenya is low, it has done little to minimize the number of patients seeking various cosmetic procedures. The growing credibility of these surgeons combined with the increase in demand for cosmetic surgery is gradually creating a viable market in Kenya.

Beginnings

Reconstructive surgery for accident victims with major scarring and other medical disfigurements is not new to Kenya, and a simple procedure such as mole removal has been performed on patients for the last half century. Also notable and successful in reconstructive surgery is the Operation Smile Mission, which has been offering lip palate and cleft lip surgical treatment since 1987. These are necessary surgical procedures, ones that undoubtedly improve the lives of those who have them performed, and Kenyans have become widely accepting of it. But what of elected procedures, performed for vanity rather than necessity?

The Western world has been responsible for various changes that have driven the modernisation of Kenya’s growing civilisation. Kenyan women in the 1980s saw enhanced beauty as the simple process of applying some lipstick, pressed powder, nail polish and having well kept hair. Body size and image were never really an issue until television permeated every aspect of daily life. Suddenly, women began looking at themselves differently based on the slender celebrities they saw on TV. The African shape – a curvy woman or well-fed man meaning that their spouse is taking good care of them – became something that was undesired, and the light skinned, skinny with straight hair look was sought after.

In the early 1990s, however, there was a shift in style and beauty depiction and a sense of increased awareness was born. Innate beauty was slowly welcomed back, coupled with a sense of modernism and a new fashion. Prominent African women in the limelight like Winnie Mandela, Janet Museveni and Dr. Wandira Kagibwe introduced a natural, more refined look that appealed to a large majority.

Cosmetic Modus Operandi

Cosmetic surgery is now slowly gaining a foothold as a less taboo undertaking in Nairobi, especially among the middle and upper middle class women. Not only are women opting for cosmetic surgery for medical reasons such as breast reduction, where a smaller breast size alleviates the back pain associated with overly large breasts, but for self esteem reasons as well.

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A plastic surgeon performs a facelift procedure.

Janice, an acquaintance of a friend, could easily pass for an early 30-something professional. Actually, you would be forgiven for thinking that she is at best 28 years old. Her petite, toned physique suggests a commitment to a healthy lifestyle and a considerable amount of time at the gym. But looking closer, you will see the evidence of something else. Right above her right ear is a not-quite-healed scar, a tell-tale sign of a facelift that has left her face looking younger than her 53 years.

In Nairobi, a rising number of female professionals, who are in good jobs and earning a good income, are turning to cosmetic surgery to boost their self-image as well as combat the aging process or their changed body images especially after having children.

For Nancy*, a 38-year old lawyer, plastic surgery was a last resort. After having three children, her body wasn’t the same as it used to be. She had what she calls an “annoying pouch belly” and love handles.

No amount of diet or exercise seemed to bring the quick desired results she wanted, and so she turned to cosmetic surgery to bring back her pre-children body. A tummy tuck and liposuction later, she is very happy with the results.

What the Surgeons Say

Advancements in science and technology have made it possible for surgeons to operate on patients and leave minimal or no scarring at all. Additionally, some procedures do not take long to heal, therefore a patient can actually be back to work the same day. Dr. Mahindra Pancholi is a Harvard graduate and the Director of Avané Cosmetic Dermatology Clinic & Medical Spa, a private practice located in Nairobi that conducts minimally invasive cosmetic procedures.

Through laser technology, Dr. Pancholi has introduced a different style of cosmetic treatment that is low risk with very few side effects. With procedures that include skin resurfacing and rejuvenation, non-surgical nose jobs, non-surgical chin and cheek augmentations, hair implants, hair removal, facelift, eye-bag removal as well as lip volumising, his client base has expanded extensively. For Dr. Pancholi, at least 90 percent of his clients are female patients, though his male clientele is also picking up, he notes. His older patients, men and women in their early thirties to fifties, seek cosmetic treatments such as Botox injections, collagen fillers – especially for men – liquid facelifts and skin tightening.

What’s more, people from Tanzania, Uganda, Mozambique, Rwanda, Congo and Burundi seeking these medical procedures are travelling to Kenya to get them done. Dr. Pancholi has patients from all over Africa and clearly states, “Though patients differ and of course the results vary, the success rate of the outcome achieved from cosmetic laser surgery is at 95 percent.”

A Growing Industry

According to Dr. Stanley Khainga, individuals in their mid and late fifties are also coming in to have various cosmetic procedures done. Based at the Doctors Plaza at Aga Khan University Teaching Hospital, Dr. Khainga is a senior lecturer at the University of Nairobi, a consultant at Kenyatta National Hospital and Nairobi Hospital, and he is the chairman of the Kenya Society of Plastic, Reconstructive and Aesthetic Surgery (KSPRAS). A highly recognised consultant, plastic and reconstructive surgeon, Dr. Khainga notes the industry has grown significantly. Even though the early 90s saw the introduction of cosmetic surgery in Kenya, it was not until late 2000 that the industry picked up progressively. “I have at least 10 patients come in each month to inquire about various cosmetic surgery procedures,” says Dr. Khainga. “Out of the 10, at least four or five of the patients will have a procedure carried out.”

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There is even a British doctor who visits Kenya to administer Botox.

The media has played a major role in promoting this area of enhancing physical features. Television shows such as Nip/Tuck, Dr. 90210, and The Swan are but a few depicting the wonders of cosmetic surgery. This has created great awareness for this field and provided a way out for those in need, or desire, of change. Additionally, the Internet has created access to a world of information – images and facts on the many cosmetic procedures are readily accessible just a click away, thus the knowledge base is greater than ever before.

Dr. Pancholi and Dr. Khainga both agree that the most sought after procedures are Botox and facial fillers. Many women and men are opting for these facial injections that help minimize facial lines, wrinkles and other signs of aging.

Dr. Pancholi gets more than 150 Botox patients each month. What’s even more interesting, adds Dr. Khainga, is the accelerating growth of this particular cosmetic process. Plastic surgeons, as well as dermatologists, now provide these common cosmetic procedures in their offices.

There is even a British doctor who visits Kenya to administer Botox, and many Kenyans are such fans of the procedure that they line up loyally for the injections.

The middle class continues to elevate cosmetic surgery in Kenya, observes Dr. Khainga. “People are no longer afraid to look the way they want,” he says. “There is very little we cannot do to produce one’s desired image. Facelifts are just as prominent. Using a patient’s picture from a few years back, we can modify the facial features and make them look young again.”

What the Patients Say

Patients who have cosmetic surgery are not very open to the discussion, mainly because there is still a hesitance in accepting this medical treatment in the country.

Patients who have cosmetic surgery are not very open to the discussion, mainly because there is still a hesitance in accepting this medical treatment in the country.

This kind of lifestyle is considered predominantly Western, thus it will take time before Kenyans fully embrace it. Shisama*, a Kenyan lady in her early forties, has had a cosmetic laser procedure performed under her upper arms and in her belly area. A skin tightening procedure that utilizes targeted heat therapy, it is meant to stimulate cells and result in smoother, radiant skin.

Like many people who seek cosmetic treatment to correct a certain aspect, Shisama decided to get the procedure to minimize the amount of excessive skin on her arms and abdominal area. “I have a lot of loose skin, but I didn’t want surgery that was invasive because of the length of recovery and other complications that might be involved,” says Shisama.

Shisama has had a similar procedure performed in the UK, but she says that she prefers getting the cosmetic laser surgery done here in Kenya. “Personally, I feel it’s better to have it done at home because it’s much more comfortable, and this is an on-going treatment. It’s not practical to be away for such a procedure for so long.” She also finds it friendlier and more lenient to do the procedures in Kenya. “In the UK, if a procedure lasts one hour, it’s clear-cut. They stop after that one hour, regardless. In Kenya, if the procedure is not done after the specified time, they will continue even for an extra half hour to make sure it’s completed.”

So far she has received a lot of compliments from close friends as well as family, and she is happy with the results too. However, she will not discuss her treatment with just anybody. According to Shisama, “There is diffidence about cosmetic surgery in Kenya. I wouldn’t want anyone to know I do this. It’s something a lot of women my age are thinking of doing but it’s difficult to discuss with just anybody. I talk about it with my immediate friends and family but that’s about it.”

What to Look For

The outcome for most of the cosmetic procedures seems to be gratifying. “Complications are minimal because the procedures carried out are standard around the world,” says Dr. Khainga. “Plastic surgeons in Kenya, similar to the US and Europe, are well trained and highly qualified to perform these recognized procedures in the expected manner. Any complication that might occur is the same as it would be in developed countries, but such occurrences are minimal,” he reiterates.

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Surgeon holds out sizing options for breast augmentation.

Typically, the ratio of plastic surgeons to patients should be 1:100,000. In Kenya however, it is 1:6,000,000. This means that there is a huge gap that needs filling if patients are to receive the treatment they desire. The number of people seeking cosmetic surgery in Kenya is certainly not as high in comparison to that of patients in European countries or the US. Last year there were 1.6 million cosmetic surgery procedures carried out in the United States, not inclusive of the non-surgical procedures. All the same, as Kenyans become aware of the procedures being performed domestically by adept surgeons, they will be more persuaded to seek this treatment in the country.

Having noted this, the Kenya Society of Plastic, Reconstructive and Aesthetic Surgery (KSPRAS), a board comprised of plastic surgeons in Kenya, is introducing a Master of Medicine in Plastic and Reconstructive Surgery programme at the University of Nairobi to train plastic surgeons, which is aimed at advancing the number of skilled surgeons in the country.

There have been a number of surgeons who come into the country to provide this medical service, having noticed the increasing need for cosmetic surgery. On the other hand, many Kenyans still travel outside the country – often to India, South Africa and Europe – in search of reputable cosmetic surgeons.

Carol*, a 36-year-old Kenyan woman, has her sights set on a breast augmentation, but she wouldn’t think of having the procedure done in Kenya. After childbirth, breastfeeding and gaining weight, she is no longer pleased with the changes in her body. But when asked if she’d consider going to a cosmetic surgeon in her home country, she says, “No, not at all. I don’t trust the level of care I would get here and frankly I don’t trust the surgeons either.” Carol would opt instead to have the procedure performed “in Los Angeles, USA. Doctor 90210!” Much like Shisama, Carol would not share her surgery with just anyone. “Of course I would tell some of my friends if asked, but I would not volunteer the information.” As to whether Carol has friends who have had surgery here in Kenya, “I have my suspicions, but no one will come right out and say it.”

The downside to both solutions is the complications that can come about. Unfortunately, some of the procedures do not always draw sound results, and the task inadvertently falls on the plastic surgeons in Kenya to fix the mistakes made abroad. As with any surgery, plastic surgery does not come without risks, from sub-standard breast augmentations to too-tight facelifts. In bad cases, patients are left with defects that cannot be corrected.

There are also instances when cosmetic surgery becomes an addiction and way of life, as it has for the famous US ‘cat lady’ Jocelyn Wildenstein, who has reportedly spent over US $4 million in plastic surgery in an attempt to look more like the cats she admires.

Looking young has become such a priority that women in affluent areas in the US are known to have ‘Botox Parties,’ treating their friends to injections as they socialise. A New York man has recently made news for ‘leg lengthening,’ a painful procedure in which surgeons must break the leg bone in two and implant a rod between them to create height. A dangerous procedure costing US $85,000 and up, and the same one that was banned for cosmetic purposes in China in 2006 after a series of botched operations left 10 people physically disfigured that year. It’s important that anyone interested in cosmetic surgery get the right information. KSPRAS has a group of plastic surgeons who can be consulted to provide all the vital details to any procedure. A surgeon’s reputation is highly relevant to the kind of work he will perform. Therefore, before opting to seek treatment outside the country or from visiting surgeons, it is crucial that proper research is conducted to avoid complications later.

Shortcomings and Misgivings

The shortage of plastic surgeons in the country presents one of the major shortcomings. All the six certified and practicing plastic surgeons are based in Nairobi, which means other parts of the country do not have this service readily available to them.

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The surgical evolution of the infamous 'cat lady'.

Dr. Khainga also notes that the regulations governing this line of medicine are not as strong as they should be. “The medical board has very many clear roles it’s supposed to play in terms of registration and regulation in the practice of medicine within the country,” he says.

“One major law and regulation they should put in place is who is eligible for registration. There is no screening of documents to ensure that those surgeons coming in are qualified."

"There should be more control of who is allowed to come into the country to carry out various procedures,” he emphasises. Though there are designated teams of visiting plastic surgeons that work closely with KSPRAS, there are, unfortunately, those who come in unconstitutionally. These surgeons sometimes expose patients to treatments performed under."

"To ensure they observe all medical standards and no danger is brought upon patients, Dr. Khainga advises that “the medical board needs to work together with societies in different specialties of medicine – in this case the cosmetic surgery society – to get only those surgeons who are certified.”

This will help govern operations carried out by guest surgeons and ascertain that patients are fully protected.

Future Expectations

Though perhaps still in the shadow of South Africa’s advertised “Surgery and Safari” holidays – as well as kept in the shadows by those who choose to have surgery – Kenya has become a hub for tens of thousands from East Africa and beyond seeking various procedures. With a new master’s program to train cosmetic surgeons and an ever-increasing demand for physical improvements, Kenya will continue to embrace and drive forward this growing industry.

*Names have been changed

Average Costs

In Kenya (KSH)

Botox: 10,000 and up

Total Facelift: 250,000 – 350,000

Breast Augmentation: 100,000 – 250,000

Liposuction (single site): 50,000 – 200,000

Rhinoplasty: 250,000

 

In the US (KSH)

Botox: 34,000 and up

Total Facelift: 600,000 – 700,000

Breast Augmentation: 340,000 – 670,000

Liposuction (single site): 250,000 –450,000

Rhinoplasty: 250,000 – 600,000