The art of the nip and tuck


  • Health
  • Sunday, 05 Jan 2003

Tired of the old you? There’s always plastic surgery to give you a new outlook on life. HOOI YOU CHING nips in to the plastic surgeon’s practice and discovers the wonderful world of plastic.  

LET’S be honest. How many of us are entirely happy with the way we look? Staring at yourself in the mirror may prove to be a shuddering experience. Fragile egos crack when perceived imperfections – from sagging skin and bat ears to small breasts – echo back from the looking glass. Some say God created us in His Image. But that doesn’t mean we can’t improve on his handiwork. 

Beauty, in its modern reincarnation, lies not in the eyes of the beholder, but in the hands of a plastic surgeon. 

The plastic in plastic surgery is derived from the Greek word “plastikos”, which means to mould or to give form. Therefore, what a plastic surgeon does is to remould a shape or form that is absent or has been lost. 

While reconstructive surgery is usually performed on individuals with afflictions either caused by injuries, cancer or congenital defects, aesthetic surgery, or cosmetic surgery as it is more commonly known, is done to improve one’s cosmetic appearance. 

“Humans are generally asymmetrical. If you look into the mirror and transpose one half of your face on the other, you’ll get two different faces. In congenital problems, the differences are greater and much more perceptible. For example, a jawbone that has not developed properly, scalp bones that have formed prematurely which result in a distorted looking face, cleft lip and palate and so on. For these, reconstructive surgery is required,” says Dr Lal Kumar, a past president of the Malaysian Association of Plastic Surgeons.  

And what about the visible legacies of ageing and pregnancy? Thanks to cosmetic surgery, wrinkles and stretch marks are history. Well, at least until the next gravity pull, anyway.  

Dr Kumar explains that in cosmetic surgery, medical procedures are performed to highlight one’s physical dimensions, not change it so radically that you look completely different.  

“Plastic surgeons try to make you look better. We don’t change your features so dramatically that you resemble someone else. We simply highlight whatever features you have so that it’s more harmonious to your face. 

“In most cases, cosmetic surgery is necessary because every person has a definite idea of his/her self-image. If one’s self-image is not up to expectations, the person starts to feel insecure,” says Dr Kumar. 

Furthermore, it’s also a matter of convenience, especially for the ladies. When it comes to the Asian fixation for double eyelids, consultant plastic surgeon Dr Benjamin George Jr disagrees that Orientals go for such surgeries to look more Caucasian.  

“It’s more for aesthetic purposes. In fact, double eyelid surgery makes it easier for a woman to apply make-up such as eye shadow and mascara, as well as makes the eyes more attractive.  

“The idea is not to make Chinese eyelids look like a Malay’s, an Indian’s or a Caucasian’s. Surgical techniques should have aesthetically pleasing results. I believe most of my patients have a fair judgement of what to expect from their surgery.” 

Dr Kumar makes the same observation too, describing that most Chinese eyes are puffy by nature due to underlying fat. This in turn creates a curtain-like effect to the eyes. “Without the extra fold, the eyes lack character. Therefore, the extra crease accentuates the eye,” he says. 

So, whether it’s a washboard chest, flat nose, bat’s ears or fat in the wrong places, most patients feel liberated after going under the knife as Dr Kumar recollects.  

“I had one patient who removed her bra in front of her girlfriends just to show off her augmented assets!”  

In the past, only the rich and famous would patronise plastic surgery clinics. Today, it’s the average wage-earner, homemaker or the awkward teenager registering at the counter and asking for a surgery, says Dr George Jr. 

“For most of these women, it’s not a job requirement to look physically attractive as you might expect from models and actresses. Yet, they form the bulk of my consultations. After the procedures, they become more self-assured, more sociable and more contented with life. They feel transformed,” he says, adding that there are a small number of men who undergo cosmetic surgery too. 

Then there is the prickly question on most minds – how safe is the technique?  

Says Dr Kumar, any kind of surgery, whether it’s plastic surgery or otherwise, carries some danger. But he emphasises that the risk factor increases if patients seek unqualified plastic surgeons who lack specialist skills. Otherwise, complications are usually rare and minor. 

In Malaysia, there are only about 35 trained plastic surgeons who are also members of the Malaysian Association of Plastic Surgeons. Dr Kumar is wary of surgeons who perform cosmetic surgery on the side. “We have ENT surgeons who do breast augmentation. We call them the ear, nose and tits surgeons!  

“People should go to a trained plastic surgeon. If not, the consequences can be disastrous, even resulting in death. It’s a field that requires strict adherence to medical protocols. Plastic surgeons are aware of procedural limitations and the precautions to take. Unqualified surgeons who are overzealous during surgery are only putting their patients at risk. In Thailand, a person died after undergoing liposuction. The surgeon must’ve have sucked out more fat than was medically allowed. Similar botch cases have happened in Malaysia too.  

“Surgery involves two parties – the surgeon and the patient. Basically, the outcome depends on how competent the surgeon is and how well the patient heals. Individuals vary in terms of their physical reaction and recovery,” he says, adding that full-fledged plastic surgeons usually train as surgeons in the field for two to three years.  

Before planning a surgery, it is essential for surgeons to access a person’s health record. Medical problems like high blood pressure, blood-clotting problems or skin that scars badly may affect surgery, as do smoking and blood-thinning drugs like aspirin.  

It is important, he says, for surgeons to inform patients of the surgical techniques involved, the need for anaesthesia and anticipation of the healing process. “Generally, you can see improvements a week after surgery, but most plastic surgery takes two months before you get your final results.”  

Dr Kumar, who has 30 years experience in plastic surgery, is cagey about characters who expect perfection, not self-improvement from plastic surgery. “Over the years, you learn to identify these people. They come with unrealistic requests. They tend to be very anxious, armed with a sheet full of points and diagrams. You find that any amount of cosmetic surgery is beyond satisfying this person’s needs.  

With regards to patients who come into his surgery requesting liposuction as a solution to their weight problems, Dr Kumar stresses that liposuction doesn’t solve the problem of obesity. Instead, this form of plastic surgery is meant for body contouring.  

“When you go for liposuction, surgeons are not trying to reduce your obesity. They are simply removing fat deposits from specific areas of your body, maybe because there are more fat cells in the area.  

“Did you know that genes control the distribution of fat cells in the body? We are all genetically programmed to have specific number of fat cells in specific locations. It is not that the fat cells there are bigger.”  

Based on this fact, Dr Kumar makes an interesting observation about different cultures and their dress sense.  

“For example, Sikh women have big hips. For this, the salwar kameez hides the bulge perfectly. The Japanese are fatter at the torso, that’s why the kimono wraps the body the way it’s meant to. African women usually have oversized buttocks, and wearing oversized skirts tend to diminish their figures,” he says. Now, there is a science to clothing, even if we’re ultimately more interested in what lies underneath.  

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