Looks that kill
Want to look better, younger, slimmer or rounder?
Dena Rashed discovers that the quest could cost you your life
Nirvana Mohamed is a beautiful 24-year-old woman who disliked her nose. To find a reputable cosmetic surgeon she went through the standard procedure of asking her friends for recommendations. Paying top price -- LE9000 -- for a nose job guaranteed her the perfect silhouette. "Although my nose hurt at the beginning, I don't regret having had the operation now. I think I look better," she said.
Not everyone who fell for the allure of plastic surgery in Egypt has been so lucky. The death of two women last week during liposuction operations in private clinics has brought public attention to the predominance of unregulated plastic surgery centres.
"Over the past 15 years, cosmetic surgery has attracted a huge number of people, not just women but also men. And with this surge, many bogus centres have gotten into the field," said Mahmoud Attallah, a plastic surgeon and a member of the Egyptian Society for Plastic Surgery (ESPRS) since 1974.
Soon after the death of the two women, the Ministry of Health announced that it had shut down over 1,000 unlicensed private clinics and centres. But it seems this is just the tip of the iceberg. Assem Abdel-Nasser, head of the General Department of Non-Governmental Curative Institutions and Medical Licenses at the Ministry of Health, calls the number of such clinics "simply unbelievable".
Alaa Gheita, a plastic surgeon and the head of ESPRS explained to Al-Ahram Weekly that increased exposure to foreign films in Egypt has generated an interest in looking "perfect". He thus refers to the proliferation of plastic surgery among Egyptians as a cultural change.
However, those willing to go under a cosmetic surgeon's knife for the sake of beauty do not always have the information or the financial means to seek out the most professional doctor or clinic. "Some women will see the picture of a beautiful girl in a bikini in perfect shape in an ad for a plastic surgery clinic at very low prices and find this enough reason to go have an operation at this clinic, although it should have been clear this clinic did not perform any operations to bring the body of the model to such a perfect shape," Gheita said.
Attallah explained the problem in terms of the commercialisation of plastic surgery. "Many of the so-called plastic surgery centres do not have qualified doctors, and sometimes the patients do not even see the surgeon who actually operates on them. They are examined by one doctor and then operated on by another," he said.
According to Attallah these centres thrive on ignorance. "They are competitive, but not because they are efficient but rather because they are offering cheap prices to people who are unaware of the negative consequences of such operations," he said.
Gheita has a file in his clinic listing bogus centres, or the malpractice centres, as he prefers to call them, "These centres offer patients prices that would never match the cost of the operation," he said. "I keep these files to keep track of who is involved in these scams. If I find out that one of the members of our Society is involved, action is immediately taken to disqualify him." Disqualifying action has been taken only once to date.
ESPRS membership numbers around 250 doctors and is limited to those with a PhD in plastic surgery. Such an exclusive group takes time to break into. Gheita, for example, became a member only when he was 34 years old. "I spent three years as an intern, working on my MA and then another four years on my PhD, and another four years in France. Only then could I become a member," he recounted.
As he spoke he furiously pointed an incriminating finger at an job vacancy advertisement published in a leading national newspaper by a hospital seeking "two personnel to deal with government paperwork" at a salary of LE3,000 per month. Gheita claims this hospital is on his list of suspicious institutions and that the personnel are required to deal with the problems it has with the Ministry of Health.
ESPRS and the Ministry of Health say that the media is largely to blame for the flourishing of bogus clinics. Gheita blames the media for allowing these ads to be published. Attallah emphasised that newspapers should ensure all ads receive approval from the Ministry of Health before publication. Approval by the ministry would signal that the clinic is licensed to perform cosmetic surgery.
In an attempt to rectify this situation, the Health Ministry's Abdel-Nasser recently sent a complaint to Mostafa Kamal Helmi, the secretary-general of Supreme Press Council. "We have to stop these phony ads," he said to the Weekly.
But this is not enough. "What we need is a very strong law that prohibits the work of these suspicious centres. It should also stipulate very severe punishments, because any mistake here means the death of a patient," Gheita said. "Without such a law we should not be surprised to hear about deaths [in the operating room]."
Abdel-Nasser became increasingly agitated as he discussed the role of the ministry in supervising the work of the private clinics. His argument begins with the semantic problem of calling these clinics "centres", "because there is no such thing as a 'centre' in Law Number 51 for the year 1981, which authorises the establishment of medical clinics and hospitals." He admits that the law now needs to be changed to redefine the term "medical establishment" since the current law fails to include some legitimate medical specialisations, such as kidney dialysis.
"Many people are trying to make easy money, which explains the proliferation of the so-called beauty centres that do not have licenses," he said. "We are doing our best to curb this phenomenon. Over a year ago we launched a project that aims at collecting information about any and all medical institutions, licensed or not." This project has resulted in the closure of 74 clinics in Cairo, four in Giza, seven in Qalyubiya, and three in Alexandria.
These closures are initiated when the Ministry of Health obtains a closure order from the governor. The police then close the clinic and ensure continued compliance with the order.
Abdel-Nasser cited the example of a well known hospital in Heliopolis that the ministry shut down several times because it operated without a license. The hospital nevertheless continues to publish its cosmetic surgery ad in the national papers. "They have even filed a case against me because the we did not give them a license," he said.
Gheita suggested that among the ways to seek a qualified cosmetic surgeon are to solicit word-of- mouth or Doctor's Syndicate recommendations, to call the ESPRS and request a list of licensed doctors, or ask around at the major universities.
