Why cosmetic surgery is popular — Oladeji

When plastic surgery is mentioned in Nigeria, what readily comes to the mind is the aesthetic aspect, commonly called cosmetic surgery. The popularity of aesthetic surgery, no doubt, is because of recent quest of women to have perfect figures.

Dr. Femi Oladeji, a plastic surgeon with specialisation in aesthetic aspect of the field, noted that one of the wrong notions Nigerians have is that plastic surgery is young, but it is not.

“We have Nigerian emeritus professors, who are plastic surgeons and have trained professors who have retired. Again, there is a misconception that plastic surgery is all about esthetics, but esthetics is just a very small aspect of plastic surgery. May be because of the popularity occasioned by the media, celebrity and high society who patronise the esthetic part more.

“Having also worked in every part of Nigeria, as a plastic surgeon, anywhere you see a plastic surgeon today, the person works all days, at odd hours, which shows the volume of patients that patronise plastic surgeon.”

Providing more insight about the field, Oladeji, who is the Medical Director, LekkiHill Plastic Surgery, said when a person is born with any abnormality, it is usually the plastic surgeon that fixes it and this could be any part of the body from head to toe.

The deformity, he said, might be at infancy, childhood or at a later age of life. “Some people miss the opportunity to amend the deformity at early stage, because they did not know that such treatment is available. Now, as adult, carrying such things around is embarrassing. It could be traumas, somebody has an accident or anything traumatic, from fight, injuries from anything or disaster, as a result, they have structural or functional defect, it is the plastic surgeon that is called to fix it.

“Burns are also under the purview of a plastic surgeon. Burns are a whole spectrum of their own. And the surgical management requires covering up the wound, commonly with skin graft, taking skin from a part of the body. There are also some other agents, artificial and bio-engineer items, which can also be used to cover up.”

But is plastic surgery, especially the aesthetic aspect meant for the affluent only?

No, Oladeji argued. Though, he acknowledged that plastic surgeries are actually very costly, especially in a country like Nigeria, where institutional supports are not available or insurance does not cover some of these surgeries, he said, “it is the wealthy that actually patronise such services, even the reconstructive part. Because plastic and cosmetic surgery require specialised skill to be able to offer such services, it actually cost a lot and therefore to be able to access it, you may have to bear a lot of cost. That may be the reason, but it does not mean that only the affluent that patronise plastic or cosmetic surgeons.”

He continued, “somebody who has breast cancer may need surgery to remove that cancer. After such person has been treated and lucky to be alive, but wants the shape of the breast back, plastic surgeons are called to reconstruct a breast for such person. To do that is a lot of money, except in places where such are covered by insurance. Even in advance countries, some of these are not covered.”

The LekkiHill boss, however, said it is not all the cosmetic surgeries that are on the very high side, especially if the clients do not mind doing them in bits. “So, it is not just for the affluent, it may just be like buying anything in the society, for instance a shoe. It may just be that the affluent may buy the expensive ones. While aesthetic surgery is about beauty, plastic surgery is not all about the beauty. Cosmetic surgery even while you are offering aesthetic, a well-trained surgeon knows that function, structure before beauty.

“I want to make your hand more beautiful, but you need your hand to do work. While I am trying to reconstruct your nose to look finer, I should understand that your nose is not just for the beauty of your face, but a very key part of the face. It has a function and that function first. We do reshape nose to make it more pointed, fine, but we do not forget that it serves as a pathway for air to pass, a place for dirty air to filter. So, when a plastic surgeon works, he works with that sense. Aesthetic is only secondary, it comes after function.”

The profession looks very lucrative, which may give room for quacks to infiltrate the field. How can government check quackery in the sector?

Oladeji stated that Nigeria has fantastic laws, but citizens often find ways round all manner of laws. “Even the enforcers of the law are those aiding and abetting those breaking the law.”

The Medical and Dental Council of Nigeria Act has a lot in it. It is the simplest way to ensure there is no quackery. Also, every state ministry of health has been empowered to monitor, regulate, so if they do their work well, that may not be something difficult to ensure safety.

“But if we want to do a direct impact, where we see quackery being practiced, it is just for those agencies and government parastatals to collaborate with professional bodies. Take for instance, there is Association of Plastic and Reconstructive Surgeons in Nigeria, and members know one another. This is beside the laws that guide members as an association.

“The laws are there, but it is just implementing. The other thing is for government to collaborate with those doing the right thing and the associations to check quackery.”

Oladeji said he chose to specialise in aesthetic surgery, though he went through the gamut of plastic surgery training.

“Someone trained as a plastic surgeon had gone through detailed training in all the various aspects of the field. After graduation, you may choose to do more in certain areas. I have colleagues who are more passionate about burns, hands, congenital, microsurgeries, but I am more passionate about aesthetics.

“All of us, while we were trained in all of these, we got more skills in a specific area and that is what I did on aesthetic. I did additional training within and outside Nigeria to be able to carry out esthetic surgeries that Nigerians require, though I can do any aspect of plastic surgery. Also, people patronise me more for aesthetic procedure than for reconstructive procedure.”

He revealed that when it comes to aesthetic surgery, the commonest form is liposuction, which is, using malleable instruments to break and extra fat from any part of the body to argument or reconstruct another area of the body.

“It could be to design certain feature. After doing liposuction, you can decide to discard the fat or use it to argument and the commonest place people argument, especially ladies, is the buttocks and there are so many reasons people do that. The main goal is that they want to achieve certain level of confidence in their look.

“Some do it for size, shape or correct an abnormality they were born with or acquired along the line. People transfer fat to the face, hand, leg, and virtually every part of the body. We have done liposuction and transfer of fat to the face. I remember an adult lady who recently came here because she was born with some deformity of the absence of fat in the face. We used the fat we extracted from her body to contour back her face so that the side that was deformed could look like the other.

“People do aesthetic surgery on the eyes, ears, nose, or the leg. So, from head to toe, you could do aesthetic surgeries. And it is not just women, men also. Men have big breast and they want to remove it. Some women have so massive breast that is troublesome and they want it reduced. In all of this, as I said earlier, we put function first and then aesthetic. This is why you find out that certain things some people want to achieve are just no possible, because as a well-trained person, you know that function comes before beauty.”

But are there times he turned down a request to perform aesthetic surgery and why?

Oladeji said he does it regularly, because safety comes before beauty. “For instance, if somebody comes in here and has a physiological problem, carrying out a surgery on the person might lead to losing the person. So safety first, no surgery. If somebody has diabetes and there is no deliberate step to control the diabetes first, then there is no surgery.

“Sometimes, some of them do not know they have these issues until they get here and because we are following standard by checking all traits, that is when they discover that they are hypertensive. Somebody is so obese and feels it is just to go to LekkiHill. Obesity is a problem too. If it is an emergency, it is between life and death or between loss of a part of the body, then you can go ahead to do it.

“But cosmetic surgery is an elective surgery, which means everything has to be normal. The other side is people coming to ask for what is not achievable. Or if you go ahead, you may be putting their life at risk.”

He also said the process of the surgery could be terminated midway. “When someone has qualified for the surgery, there should be nothing that should stop the process, but a patient is in the theatre already, but what you want to achieve, you find out that if you go ahead, it will cause one injury to the patient or lead to a devastating thing, then you stop.”

Considering you said a lot of Nigerians do esthetic surgeries whether within or out, but many of them do not like talking about it, why is it so? Oladeji put the blame on societal condemnation. “If you see the volume of persons, who desire to go through the surgery. They want it and are happy doing it. Human beings are all about emotion and any work you do, if you eliminate the emotional part of it, you are already loosing people and business.

“Some Nigerians are reluctant in doing the surgery despite they have the fund to do it, simply because they feel they will be condemned. Though it is changing now, as people are aware that it is available within the country, aside if it is done safely, it is safe.

“When a negative incident happens, the whole news is spread. The truth is negative incident can happen any time; somebody can be walking on the road and get knocked down. There was a helicopter crash recently. Mishap can happen in any field, but there is always a way to know when to put a stop to something.”

He disclosed that a lot of Nigerians travel abroad to go for cosmetic surgery because they want to keep it secret.

“Nigerians, especially very high and top persons, prefer to go abroad for cosmetic surgery, because they feel nobody will know they have done it. At LekkiHill, we may not be able to control passage of people into our gate, but we take the privacy of clients seriously.

“What is more important to us is the happiness of our clients and not taking glory that we executed the job, so we take our clients privacy very seriously. What we prime is the excellent service we offer and the joy of our clients. We do not compromise that in any away.

“And every member of our staff, from the lowest cadre knows that the clinic belongs to our patients. We offer these services at the highest standard that it can be obtained, reason Nigerians have no reason going abroad for these surgeries.”