Cosmetic surgery

That men are just as vain as women in trying to improve their looks by cosmetic surgery was the lively topic at Tuesday’s Bulong-Pulongan sa Westin Philippine Plaza. A good many men go for facial and nose lifts and liposuction (removal of ungainly fat around their waists), and want even more – penile implants and enlargement.

Resource persons at the forum were Corazon Collantes-Jose, M.D., and Mariano Agcaoili, M.D., two of the most active "duly certified" cosmetic surgeons in the country. Dr. Jose is the president of the Philippine Society for Cosmetic Surgeons and Philippine Society of Liposuction, and of the Asia Pacific Academy of Cosmetic Surgeons, and Dr. Agcaoili is secretary of the Philippine Society for Cosmetic Surgeons.

I emphasize "duly certified" because there are non-medical doctors who have been practicing — and making a fortune – from performing cosmetic operations, and these are the people who are giving the certified doctors a bad name, i.e., that they are "quack doctors."

Quack doctors they are not, said Dr. Jose of the 45 duly certified cosmetic surgeons in the Philippines. These are medical graduates who passed the board examinations and have a diplomate, i.e., they have had years of training for specialized fields, and also taken two years of preceptorship, i.e., special training in cosmetic surgery. So if one would like to have a lift (face or nose or breast), one should look for those framed certificates hung on the walls of the surgeons.

What constitutes cosmetic surgery? Dr. Jose ticked them off – starting with the face. There’s hair transplant, brow lift, bleparoplasty (removal of fat and excess skins on the upper and lower eyelids), nose lift, lip enhancement (thinning of too thick lips and making lips heart-shaped), chin augmentation (adding silicon or hard fillers like aquamid), or making the chin longer if it does not exist), maxillafeatures (breaking the bone to make a new face), chiseling of too long chins (babalu), partial or whole face lift, mesotherapy (injection with fillers to remove wrinkles on the neck and lips. Botox is a process that removes wrinkles, with a painless, swift injection of a fluid. Putting cleft on the chin is also a simple procedure.

Then one goes down to breast enhancement and reduction. Dr. Jose said breasts can be enhanced with an injection of a fluid, and reduced by cutting off breast tissue, especially from pendulous breasts.

Then farther down – fats on certain parts of the body by liposuction. Abdominal lepectomy is a process of removing redundant skin that looks like an apron. Women can have colporrapy or vaginaplasty – removal of wrinkles or enhancing of the vagina (a process popularly called landscaping or flower arrangement).

The men resort to surgery to enhance their facial features and improve their sex life. Those who do not want to take Viagra would like to undergo penile implants wherein a rod is inserted in the penis to make it erect. A pump is inserted in the scrotum or abdomen and pressed when one wants to have sex.

As to penile enlargement, Dr. Agcaoili said, this is actually a myth. The process calls for the enlargement of tissue surroundings; ligaments are cut and attached to the public bone.

There are those who want sexual reassignment (conversion of the male to the female organ). Neither of the two doctors perform this procedure.

Dr. Agcaoili has done liposuction since 1985, and the results have been good, he said. "One thing I don’t do is silicon injection as filters for butt enhancement because this hardens over time." He is also against the use of paraffin or collagen which when used for nose lifts, results in the nose turning violet, "or simply bad-looking."

Dr. Jose emphasized that cosmetic surgeons have their own specializations. So it’s eye-eye-nose-throat doctors (like Dr. Jose) who do facial and nose lifts, obstetricians who do liposuction and other abdominal repairs; opthalmologists who work around the eyes, dermatologists who do skin transplants. "It’s not just any doctor who can do cosmetic surgery. One has to be a specialist to be a cosmetic surgeon," said Dr. Jose.

At the Bulong Pulongan, the doctors said cosmetic surgery does not require general anesthesia. That is why patients can go home after undergoing a procedure. Dr. Jose, however, said that on her part she wants to make sure that the patient’s blood pressure is normal, that if he/she is a diabetic, his/her blood count is under control, and that he/she does not have a serious heart condition.

The duly certified cosmetic surgeons, Dr. Jose said, take pains to protect their reputation. Non-medical doctors or medical doctors who have had no real training in cosmetic surgery have lent it a bad name because of lack of knowledge of surgical procedures. Cases of deaths resulting from liposuction and breast surgery have been reported. The societies of which Dr. Jose is president is making representations with the Department of Health so that practitioners are certified trained and fit for their profession.

In addition to malpractices committed by untrained personnel, the societies have to deal with the opposition raised by plastic reconstructive surgeons (who repair facial and body parts damaged in accidents) who reportedly claim only they have the right to do cosmetic surgery. Dr. Jose said the cosmetic surgeons have aesthetics in mind when they do surgical procedures on the face and body of a patient.

Be that as it may, Dr. Jose said that there is no stopping the increasing number of people who want to look better. She said that women in their 40s, 50s, and even 80s, want to look younger. Some return to the doctors after a year or two to look even younger.

Cosmetic surgery may be expensive (P50,000 or more for lifts), but people will save money just to have a chin lengthened or wrinkles removed. "Looking good makes them feel confident," said Dr. Jose.

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