Dr Torngee Malu is a Consultant Plastic Surgeon at Renew Aesthetics, Abuja. He spoke to NKECHI ONYEDIKA-UGOEZE on the myths surrounding penile enlargement, the safety of Brazilian Butt Lift (BBL), breast enhancement and tummy tuck procedures, as well as the complications that can arise when cosmetic surgeries are not properly performed or managed.

What cosmetic surgery procedures are commonly sought by Nigerians, and which are particularly high-risk?
Every surgery carries risks; it depends largely on who performs it. Even routine procedures such as circumcision can be fatal if complications are not properly managed.

In cosmetic surgery, liposuction is probably the most common procedure, sometimes combined with fat transfer. Others include tummy tuck, breast reduction and augmentation, facelifts, brow lifts, facial rejuvenation and bariatric procedures.

Many Nigerians previously travelled abroad for these procedures, but in the past decade, cosmetic surgery has developed significantly in Nigeria. We now have well-trained plastic surgeons performing these procedures locally.

The problem is that non-specialists are also carrying them out. Complications can occur even in the hands of specialists, but trained surgeons understand the risks, know how to prevent them and can manage complications when they arise. These can range from swelling and pain to severe complications and death.

How common is penile enlargement in Nigeria? Can surgery or other procedures achieve a meaningful, permanent increase in penis size?
Penile enlargement is relatively uncommon in Nigeria. For trained plastic surgeons, it is a highly risky procedure with a high likelihood of failure.

The penis is a sensitive and highly functional organ. You cannot simply enlarge it like the breast or buttocks. Any attempt to introduce a foreign substance or implant can damage its function and cause serious complications.

Most plastic surgeons will not perform penile enlargement because the anatomy and physiology make it impractical and risky. Unfortunately, many people offering these procedures are not plastic surgeons and may not be able to recognise or manage complications.

What motivates some men to undergo high-risk procedures such as penile enlargement, particularly when the medical benefits may be limited and the procedures can result in serious complications?
It is largely societal pressure. Society creates ideas about what constitutes the “right” penis size, just as it does with breasts and buttocks. Men may feel pressure from spouses, friends or society to achieve a particular size.

Social media has also reinforced the belief that every aspect of the body can be changed. But the penis is different from other body parts because it has both anatomical and physiological functions.

Does penis size matter medically or sexually?
Not really. Size does not determine functionality. Sexual performance is subjective, but men should understand that the penis they are born with should not be subjected to unnecessary attempts at enlargement.

There are many drugs, herbs and products online claiming to increase penis size. They do not work and can be dangerous.

The penis becomes enlarged during an erection because specialised tissues fill with blood. Injecting fillers or other substances can interfere with that blood flow. Foreign materials can also enter blood vessels and potentially travel to the lungs, causing a life-threatening pulmonary embolism.

My advice to men is that if your penis is functioning normally, leave it alone. Do not allow societal pressure to push you into dangerous procedures.

Brazilian Butt Lift (BBL) remains popular despite reports of serious complications. What factors could make someone unsuitable for the procedure?
BBL is one of the most common procedures performed and can be safe when carried out by a trained plastic surgeon. It involves transferring a patient’s own fat from one part of the body to another and can improve body contour and confidence.

The problem is that people without specialist training are entering the field because they see commercial opportunities in BBL and liposuction. These procedures involve much more than simply removing and injecting fat. There is a science behind them that requires years of specialist training.

There is no single list of people who are automatically disqualified from BBL. Every patient should undergo an individual assessment. Someone with uncontrolled hypertension, diabetes, an untreated heart condition or other significant medical problems may face unacceptable risks.

I have cancelled surgeries because of a patient’s weight, poorly controlled blood pressure or mental state. The decision must be based on individual risk assessment.

How long do BBL results last? Can transferred fat be absorbed or require repeat procedures?
The transferred fat consists of the patient’s own living fat cells. Once successfully established in the new location, they can remain there permanently.

However, like other body fat, they can change with significant weight gain or loss.

Can a woman who has undergone a tummy tuck safely become pregnant?
Yes. A woman who has had a tummy tuck can become pregnant and carry a pregnancy. A tummy tuck primarily involves repairing the abdominal wall and removing excess skin; it does not affect the womb or conception.

Is there an established link between breast enhancement procedures and breast cancer?
There is no established link between breast enhancement procedures and breast cancer. Breast enhancement can involve implants, fat transfer or other techniques, and these procedures have their own potential risks that should be discussed with a qualified specialist.

What complications can make cosmetic procedures such as tummy tuck fatal, and how can the risks be reduced?
Every surgical procedure carries risks. Safety depends heavily on the surgeon, the medical team and the patient’s assessment.

Going abroad does not automatically make a procedure safer. Nigerian-trained specialists may have an advantage in understanding the characteristics and complications associated with Nigerian and African patients because they routinely treat them.

The key issue is not simply where the surgery is performed, but who performs it, the quality of the team and the ability to prevent and manage complications.

Is there anything inherently wrong with cosmetic surgery?
No. Cosmetic surgery has existed for centuries and has evolved with advances in medicine. It involves procedures intended to enhance or correct parts of the body for aesthetic reasons.

When performed by properly trained specialists, these procedures can be safe and can significantly improve a person’s confidence and quality of life.

Does Nigeria have the infrastructure and expertise to safely perform major cosmetic procedures?
Nigeria’s cosmetic surgery industry has developed largely in the private sector. However, personnel are more important than buildings and equipment. You can have a well-equipped facility, but without properly trained professionals, the infrastructure is of little value.

Nigeria now has specialists capable of performing cosmetic procedures to international standards. This has also helped reduce medical tourism. A significant proportion of our clients are Nigerians and Africans living abroad, as well as patients from Europe, America and Australia.

The fact that people now travel to Nigeria for cosmetic surgery demonstrates growing confidence in the country’s specialists.

What should Nigerians look for when choosing a cosmetic surgeon and facility? What are the red flags?
Patients should look for a properly trained, qualified and licensed specialist. In Nigeria, a plastic surgeon should have specialist qualifications such as Fellow of the National Postgraduate Medical College of Nigeria (FMCP) or Fellow of the West African College of Surgeons (FWACS) in plastic surgery.

Anyone offering major cosmetic surgery without recognised specialist training should be treated with caution. Patients should also verify the surgeon’s credentials, the facility’s standards and the availability of anaesthesia, emergency care and appropriate postoperative support.

The most important thing is to ensure that the person performing the procedure is a properly trained plastic surgeon.