A few weeks ago, the public was left in shock when a young woman lost her life following a plastic surgery procedure.
It was very sad to see a young family go through such loss, robbing such young babies of a mother.
In the ensuing public discussions on mainstream and social media, the expertise of the surgeon was questioned, as was the post-operative care and management of complications.
Many wondered why a beautiful young woman would go under the knife to alter her body and viewed it as assimilation of Western culture, which may be accompanied by unexpected negative outcomes.
Plastic and reconstructive surgery as a medical specialty is not new in Kenya. It may have had a limited number of specialists for many years, but it has always existed.
It is now gaining visibility because of increased demand for cosmetic procedures and the increased number of specialists. The University of Nairobi has been graduating plastic surgeons for the last few years, doubling their numbers over time.
Many patients have undergone plastic surgery for various reasons.
Some are patients with physical defects such as cleft lip and others undergo mammoplasties for gigantomastia (abnormally large breasts) that cause back problems.
Most are patients requiring reconstruction following tragic disfigurement from traumatic accidents, burns and explosive injuries.
In the face of such a heavy burden, it is only humane to go the extra mile to restore function and aesthetics to one who has already suffered so much.
Plastic surgeons spend hours in theatre trying to piece together the smile that was smashed in during the car accident; release the scar tissue that has left the hand frozen in a claw-like clasp; or remove the large benign lump on the back that has caused a young girl to live with the nickname “hunchback” all her life.
However, over the last decade, there has been a marked increase in the demand for cosmetic surgery.
What was once viewed as the preserve of Hollywood stars has become commonplace even in Kenya.
The demand for breast augmentation surgery, facelifts, chin lifts and tummy tucks are no longer the preserve of the elite.
The advent of complete body transformation is evident in the cropping up of “socialites” who have gone all out to alter their bodies to conform to what is perceived to be perfection.
The skin bleaching, hip and breast augmentation, lip enhancement and cheekbone enhancement has been taken to a whole new level.
These women are regarded as trendsetters in their social circles with regard to the direction of demand. It is therefore not surprising to see that the plastic surgeons are getting very busy.
Suppliers of pharmaceutical and non-pharmaceutical products used in plastic surgery have also had to up their game. Weekly Botox is here with us.
Demand has also given rise to another super-specialty, cosmetic dermatology, that is keeping doctors extremely busy.
While every person has a right to seek plastic surgery purely for cosmetic reasons, it is important to know where we draw the line.
Body dysmorphic disorder is a well-recognised mental illness categorised using the criteria in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
A person with body dysmorphic disorder is obsessed with one or more aspects of their own body, deeming it severely flawed and warranting exceptional measures to hide or fix it. This is a condition that most patients will never discuss with their doctors.
First, it is not well recognised in Kenya and it only comes to the attention of the psychiatrist when the patient has inflicted severe self-harm or is suicidal.
This is not to say that every person opting to get a hip enhancement surgery is mentally ill.
However, when one is preoccupied with one or more non-existent or slight defects or flaws in their physical appearance; is repetitively and compulsively responding to this perception to change it; and their preoccupation is interfering with their capacity to function normally, then a diagnosis of body dysmorphic disorder may be considered.
The disorder requires treatment as it has a great impact on the quality of life of the patient.
The patient is greatly debilitated, and may be unable to hold down a job or concentrate in school.
Medication and psychotherapy are the mainstay of therapy, but it is difficult to institute treatment when the patient fails to understand that they have a problem, in what is described as absence of insight.
There is need for public awareness on the condition so that we are better able to support those in our midst who are suffering.
Therefore, before we judge the neighbourhood college student who is constantly bothered by her dark skin, or call the office administrator a “slay queen” for perennially wearing huge wigs because she is convinced she has a massively prominent forehead, it is important to remember that their self-esteem may not be only issue taking a beating. Their mental health may be in distress too.
In the same vein, our plastic surgeons must always remember that they may be the safety net for our patients, diagnosing those who may need to see the psychiatrist instead of heading to the operating table.