Nip and tuck, but do it right
New Straits Times  |  July 2011

Plastic surgery, when done well, can be an extremely rewarding experience, said consultant plastic and reconstructive surgeon at Prince Court Medical Centre (PCMC) Dr Yap Lok Huei.

"The popular image of surgery is that of significant discomfort, open wounds and pain with nausea after surgery.

"So, for most patients, coming to see a surgeon is a rather intimidating experience and actually making it to the surgeon's office is a big step.

"The reality, however, is that surgery, if carried out properly, should provide good results and minimal scarring."

But not all patients end up with good results, especially those who succumb to marketing promises of "guaranteed results after one procedure only", "cheapest price in Malaysia", "free consultations" and procedures carried out in unlicensed premises by unqualified, unregistered surgeons.

Dr Yap, who is also a member of the Malaysian Association of Plastic, Aesthetic & Cranio-maxillofacial Surgeons (MAPACS), said usually when there is "free consultation" advertised by certain centres, most often, it is with a salesperson or "beauty consultant" whose main job is to "sell" the surgery of treatment since their income depends on commission.

"If they run it solely as a business rather than as a professional medical practice, you would probably meet the surgeon only on the day of the procedure, without the opportunity to assess the surgeon's decision-making process, his skills or experience, and whether he or she is the right person to treat you."

He said it was not good medical practice as it was important for surgeons to build good relationships with patients.

"Qualified and experienced surgeons charge for consultations -- a fee-for-service consultation which should provide the patient information about the procedure including the risks and benefits. It should help the patient make the most appropriate decision based on whether the procedure is suitable for that patient's anatomy."

He urged those keen to undergo plastic surgery to ensure their surgeon is properly trained, qualified, experienced and able to take care of them if there are complications.

Complications, he said, were a real possibility when it came to surgical treatment as it could be due to various reasons, including medical fitness or underlying illness.

He pointed out reports of doctors flying in from other countries in the region to operate here in privately owned clinics and even hotels.

He added such doctors may not be qualified surgeons.

"When complications happen, it is easy for some of these clinics to inform the patient that the doctor is no longer there.

"Sometimes, the reason these doctors travel is because they are not successful in their own countries."

Dr Yap added that a doctor must also be responsible to ensure that any drug used is approved by the relevant authority, is correct in dosage and is unlikely to cause complications.

"We have seen cases where unregistered practitioners have carried out inappropriate injections, and then blame their 'suppliers' when things go wrong.

"In fact, this safety issue should be the responsibility of the person carrying out the injection or treatment."

For those thinking of plastic surgery, Dr Yap advises a thorough online research, as well as validation from previous patients.

He said Malaysians often focused only on the price factor, looking for the cheapest solution.

"Patient awareness in this country can certainly improve, with the public taking more time to obtain information about procedures and doctors before deciding on cosmetic treatments."

Cosmetics doctor and wellness specialist Dr Alice Prethima said it is important for there to be total honesty from a patient in order for a surgeon to make the right call.

"For example, where fillers on the face are concerned, if they have used silicone injections and don't tell me beforehand, I would not know about it and I would place the permanent filler on it. There might be problems with it (later).

This, she said, was because people were afraid that the surgeon would not work on what they wanted.

In many cases where patients come to her for help after a bad job, Dr Alice said they did not know the name of the products used on them.

"They also need to find out from the surgeon what is being injected into their faces or put into their bodies.

"If they do not get this information, it will be difficult for another doctor to repair it."

Dr Alice, who runs her own practice in Bangsar and Klang, added that there was still low awareness on the kind of treatments available in Malaysia and many patients go overseas to get similar treatment.

"We lose a lot of revenue because our people are not aware of what procedures are available.

"We have great infrastructure and we have all the treatments available but many people still go overseas.

"It's a perception that (treatment) abroad is better. I don't think that is true."

Help University College vice-president and psychologist Dr Goh Chee Leong advised those considering cosmetic procedures to make an educated and informed decision.

"Spend time reflecting on why you want to do the procedure and make sure you are not rushing into anything."

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