Plastic surgeons in Pakistan are performing both reconstructive and cosmetic surgeries.

KARACHI: Recovering from two recent cosmetic surgeries, 25-year-old Anila, happily married with two kids, is beaming with confidence.

“My broad nose and thin upper lip had been a cause of discontent since my childhood. No one in my family had such facial features and I remember my mother often getting quite disturbed by my frequently asked questions about my big nose,” she recalls smilingly.

As Anila grew up, friends and acquaintances reinforced the sense of unhappiness that she had deep inside her. “When every second person you meet tells you that you would have looked more beautiful, if your nose had been a little thin; it makes you weak from the inside,” she says.

Born and raised in Dubai, Anila researched aggressively on cosmetic surgical options available on the Net for her nose job and lip enhancement and consulted a number of doctors in the UAE. But, she decided to have the surgery in Pakistan after she recently got settled in Karachi and, to her satisfaction, found the cost of the surgeries “very reasonable”.According to Anila, the plastic surgeon initially tried to persuade her not to go for the procedure and even discussed the issue with her husband who was actually behind the idea. But, she was adamant that she would go for the procedure and the surgeries were carried out after she and her husband convinced the surgeon that she had independently taken the decision to get the nose job and lip enhancement done.

“I am a risk-taker and have made up my mind even for a revised surgery if a need arises. Times have changed and cosmetic surgeries are no more considered a big deal in today's world,” she says, asserting that she has no regrets that she had to sell her gold bangles to pay for the surgery.

What Anila did may be surprising for many. But, those who are in the field of reconstructive and cosmetic surgeries for many years only see it as a trend that has definitely gained in popularity over recent years. And, clients, they say, now include even people of younger age group.

“Seventy-five per cent of my clients are women. They are generally 35 plus, but young and unmarried girls are also coming now, though the cost of a cosmetic surgery has increased over the years,” says Dr Tahir Sheikh, consultant plastic surgeon at the OMI Hospital and associate professor at the Ziauddin Medical University.

According to Prof Sheikh, generally plastic surgeons in Pakistan are performing both reconstructive and cosmetic surgeries. Cosmetic surgery, he says, is a 100 per cent safe procedure, if performed in trained hands.

The most frequently done cosmetic surgery procedures in Pakistan, according to some plastic surgeons, are liposuction, an operation that removes fat from many different sites on the human body; abdominoplasty or tummy tuck, a surgery to make the abdomen more firm and hair transplant.

“Their costs vary depending upon the hospital and the doctor,” said Dr M. Ashraf Ganatra, professor and chairman of the department of Plastic, Reconstructive and Aesthetic Surgery at the Dow University of Health Sciences and Civil Hospital, Karachi and also president of the Pakistan Association of Plastic Surgeons.

“Having said this,” he added, “people need to know about an expert's qualification as well. A fully qualified surgeon may ask for Rs60,000 to Rs150,000 for a hair transplant that an unqualified practitioner is willing to do in much lesser amount.

“Besides, many beauty parlours are also offering cosmetic procedures which don't require a surgery, for instance Botox (a drug made from a toxin), dermal fillers (materials injected underneath the skin to make it fuller) and laser, which I believe is criminal. So, people must exercise extra caution while opting for any procedure.”

Fat grafting

According to Prof Ganatra, a recent popular technique in cosmetic surgery is fat grafting that is currently being used for a number of procedures. The technique has been in vogue for many years, mainly for the treatment of a rare disease called Parry-Romberg syndrome, a gradual deterioration of facial tissues.

“In a fat graft, we remove a patient's own fat and re-implant it where needed. The fat is usually extracted from body parts like the abdomen, thighs or buttocks and injected into another area that requires plumping such as a patient's facial features. They improve the creased and sunken areas of the face and add fullness to the lips and cheeks,” Dr Ganatra said, adding that fat grafting was also being used for breast augmentation as a replacement to breast implants.

Fat grafting, he says, requires one to three sessions and has a permanent affect. Although breast implant surgery is not a common procedure in Pakistan, the technique of fat graft would be preferred by women who have certain apprehensions about implants.

Dr Ganatra believes that fat grafting would become the most sought-after procedure in cosmetic surgery within five years.

Commenting on the fat-graft technique, Dr Mirza Shehab Afzal Beg, associate professor and consultant plastic surgeon, Liaquat National Hospital, said that it wasn't an alternative to dermal fillers, which, he said, were still the best way to treat wrinkles and fine lines on the face.

“Fat grafts are not permanent either as approximately 40 per cent of the injected fat get absorbed. Fat absorption is high if movement of the muscles in the particular part of the body where the graft has been done is high, for instance lips. However, after the absorption of six months, whatever is left will stay forever,” he said.

Liposuction, he said, procedures had also become safer with advanced equipment.

Since people could make quick money, hence every doctor was doing it. “But, lack of training and qualification are bound to create problems for patients,” he said, adding that once fat cells were removed through liposuction, the affect was permanent, though the person could accumulate fat in other parts of the body.