Social media driving cosmetic surgery trends in Uganda

Constance Nyiramugisha became pregnant soon after her wedding. She was 34. She gave birth at age 35, but her belly became a problem. While she expected it to flatten back to normal, it simply did not budge more than a year after delivery. 

She was one of those types who, when they gain baby weight, they find it almost impossible to lose it no matter how hard they try. Nyiramugisha went to the gym regularly, paid an expensive trainer with the aim of regaining her normal waistline. She even cut carbohydrates and sugar out of her diet at the advice of a nutritionist, but her efforts went fruitless. In all her possible futures, she had never pictured herself with a big tummy at 35 years. Her self-esteem hit an all-time low.

“In my frustration, I started thinking of cosmetic surgery. I remembered having heard about liposuction from a friend, and that it solves such issues. So, I asked around until I found a hospital my husband and I, were comfortable with financially,” Nyiramugisha says. 

Plastic vs cosmetic surgery 
Like many people, you may conflate the cosmetic and plastic surgery. However, there is a difference between the two terms. The former has everything to do with beauty and bodily aesthetics while the latter is mostly for purposes of restoring damaged body parts after accidents, cancer, congenital defects and so on.  
Cosmetic surgery is a lifestyle choice while plastic surgery is often a medical intervention. People go for cosmetic surgery seeking to re-shape body tissue and to improve appearance while plastic surgery is used for medical purposes, often to relieve people of pain. 

“Plastic surgeries mainly depend on creating the self-satisfaction and the self-confidence that comes with looking better. These interventions are intended to make people feel more beautiful, to boost self-confidence and live better. We offer surgeries and other cosmetic interventions such as injections,” says William Lubega, a cosmetic surgeon at C-Care hospital, former IHK.

Of all the patients that seek these surgeries, 50  percent are medical interventions while the other 50percent are cosmetic, according to experts. Half of the patients come seeking help with medical conditions such as burns that need to be corrected or facial features that need reconstruction.

Tummy tuck, most sought-after 
Nyiramugisha ended up getting a tummy tuck. Her belly was flattened to her satisfaction. A tummy tuck, also known as abdominoplasty, is a cosmetic surgical procedure aimed at improving the shape of the tummy. During the operation, three things happen; excess skin is removed, belly fat is gotten rid of (liposuction) and belly muscles repaired to make them stronger and sag-proof. That may explain why a tummy tuck goes for between $4,000(approximately Shs15 million) to $5,000 (approximately Shs 19 million).

Nyiramugisha happens to be one of many Ugandan women who  have had the tummy tuck. It so happens that the tummy tuck is the number one cosmetic intervention sought after by Ugandan women by far, according to cosmetic surgeon Hassan Salaheldin, an Egyptian professional who works at C-Care Hospital (former IHK). While he is based in Egypt, he spends one week of each month in Uganda.  

He is one of several surgeons from Andalusia Health Care Group based in Egypt and Saudi Arabia. The group supports the health care sector in Uganda and one of the specialties they bring with them is plastic and cosmetic surgeries.
Salaheldin says after giving birth to a few children, especially if there have been some C-section deliveries, the muscles of the belly become weak and flabby. 

“It becomes challenging to get rid of it using any other means, at least for most women. So they comes to us,” he says. 
The intervention, the surgeon says, is suitable for women who have stopped having children because becoming pregnant again takes away the benefits of the procedure. 

“It is advisable to get a tummy tuck after one has finished having children because then it will just be a one-time surgery, beautiful forever. If you become pregnant again, the muscles will become weak and flabby again, necessitating another tummy tuck,” Salaheldin says. This is why tummy truck patients (are they patients?) are asked if they will be having children in future. If yes, the surgeons recommend that she first finish her deliveries. But, Salaheldin adds that some patients still insist on it, knowing that in future when they have a baby, then, they will have to come for the procedure again. 

Weight gain after tummy tuck
While it is advisable to keeps one’s weight in check after the surgery, it will take gaining a whopping 20 kilos to lose the benefits of a tummy tuck, according to the experts. 

Social media
The trend has been fuelled by social media sites such as Instagram, Telegram and Snapchat that have popularised and romanticised sharing of personal images that are designed to look near perfect. 
One of the most famous Ugandan women, Zari Hassan, aka the Boss Lady, stuns her fans with her great looks. The mother of five has on several occasions said cosmetic surgery is partly responsible for her great looks. She has told the media that she has had to do liposuction on her legs to make them leaner and has had to do a tummy tuck as well. 

According to cosmetic surgeon William Lubega, people are inspired to look like the superstars that they see on social media sites such as TikTok and Instagram. There is a social pressure to look a certain way these days because of social media, according to Lubega. 
“People follow superstars including Kim Kardashian or Zari Hassan on social media and they also know that these stars have done cosmetic procedures to look good. So, they come to us to get a similar appearance,” he says.  

War against age
Lubega adds that some people come for cosmetic procedures not because of social media, but because they are simply fighting aging. These are well-off middle class people who want to feel good. 
“Someone is 45 years old and she is finally done having children and she just wants to look good again. They want to get rid of wrinkles or any other thing that makes them look old. This category is common too,” Lubega says. 

Skin and hair
Other than common procedures like the tummy tuck (the commonest), people are doing all sorts of other interventions for skin and hair. 
Ugandans are going to cosmetic surgeons looking for a more uniform complexion, a clear skin, etc. The intervention that improves skin is called Platelet Rick Plasma (PRP). PRP is a component of blood that contains growth factors and other proteins that promote healing on a cellular level. 

“When PRP is injected into the skin, it helps improve the texture, the complexion and tone of the skin. It is used to reduce wrinkles and encourage the skin to appear young again. PRP can also be used as an effective treatment for hair restoration,” Lubega says. 

When it comes to hair procedures, some of our clients come seeking a restoration of their hairlines after losing them to years of braiding or balding. This, according to experts, goes for between $400 (Shs1.5million) to $800 (approximately Shs3million). 
“We also carry out hair transplants and every hair follicle is charged $1(Shs3,800),” he says.

Breast  jobs
Breast reduction and augmentation or enlargement is another surgery that is highly sought after, according to the experts. Just like the tummy tuck, the aim here is to make the breasts firm, shapely and ‘instagramable’.

Breast reduction surgery consists of removing fat, tissue and skin from the breasts to make them smaller. The procedure suits those whose breasts are so large that they cause them discomfort or make it hard for the person to do physical activities. 
“Usually, when we remove fat from one area such as the breasts, we put it elsewhere where it might be needed to improve the patient’s appearance, like if she has dimples in areas where roundness would be preferable, we transfer them there,” Salaheldin says. 
He adds, “For breast augmentation, we take fat from a part of the body where it is not needed, such as the belly, and put in in the breasts to make them bigger and firmer,” he says. 

The rear
One of the more procedures that are becoming more common in Uganda is the Brazilian butt lift (BBL), according to experts. If you know someone who used to have a flat rear only to come back from maternity leave with a great behind, it is highly likely they did more than just deliver a baby at the hospital. 

To do the BBL, the surgeons take fat from areas where it is not needed such as the tummy, and in a very specific way, put it in the buttocks area. Contrary to what people assume, the buttocks do not burst if not handled with care because it is just your fat. 
“Yes, there is very high risk of infection during and after the procedure. So, we use a lot of antibiotics after the operation. The patient has to be highly sterilised. We use a lot of equipment. To do this well, you have to make it perfectly round. We have done it here many times,” Salaheldin says. 

Men
Do men ever get cosmetic surgery? Yes, according to Salaheldin. In fact, 20 percent of all cosmetic surgery patients at C-Care are men. And as expected, men mostly come seeking a six pack, bigger arms and chest.
“We do liposuction for it. We take fat from the belly and put it in the chest and arms,” he says. 
The surgeons believe cosmetic surgery is not just a vain endeavour by their patients, but it is important for good health.

Ineligible patients?
But, there are times when a patient is not eligible for cosmetic surgery. There are medical conditions that stand in the way of cosmetic surgery. Several lab tests are done before the operation. They ask for the history of the patient, the heart health has to be great, the patient should not be taking any blood thinners. If the patient has suffered some blood clots before in the legs or in the lungs then they can’t go on with the surgery.

“Low haemoglobin levels or severe anaemia are conditions we look out for. Because these surgeries are ultra-elective so, I will not put a patient in a danger zone for the sake of beauty,” he says.
Some of the ethical lines that will not be crossed include cutting off body parts or giving female parts to males. 

COSTS
A tummy tuck, also known as abdominoplasty, is a cosmetic surgical procedure aimed at improving the shape of the tummy. It costs between $4,000(approximately Shs15million) to $5,000 (approximately Shs19million).
When it comes to hair procedures, some clients seek a restoration of hairlines after losing them to years of braiding or balding. This, goes for between $400 (Shs1.5million) to $800(approximately Shs3million). 
For hair transplants, every hair follicle is charged $1(Shs3,800).

TWO CENTS
Zari Hassan, a mother of five, in a interview with Nairobi News last  year, emphasised that the choice to undergo cosmetic surgery is not for everyone, primarily due to the financial implications and post-surgery commitments.
Zari advised women to carefully weigh the costs involved in such endeavours.

In her view, the expenses do not stop at the surgeon’s fees.
She disclosed that after the surgical procedures, a commitment to living a healthy lifestyle becomes paramount. This involves monitoring one’s diet, engaging in regular exercise, and maintaining a regimen of vitamins and supplements.
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EXPERT SAYS
Plastic surgeries mainly depend on creating the self-satisfaction and the self-confidence that comes with looking better. These interventions are intended to make people feel more beautiful, to boost self-confidence and live better,” says William Lubega, a cosmetic surgeon at C-Care hospital, former IHK.