Top Dubai surgeon urges caution over rear enhancement operations but doesn't back ban

On Friday medics in the UK will vote on banning a procedure that allegedly causes death in 1 in 3,000 patients

DUBAI, UNITED ARAB EMIRATES,  JUNE 17, 2013. Working moms. Dr. Houriya Kazim BSc, MPH, MB BCh, FRCS, Medical Director and Specialist Breast Surgeon, an Emirati and the country's first female surgeon at work on a surgery at the Dubai London Speciailty Hosptial on Beach rd.  Freelancer is Rachel Lewis. (ANTONIE ROBERTSON / The National)
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Plastic surgeons need to exercise caution when asked to perform 'extreme' operations, a top cosmetic doctor said.

Dr Maher Al Ahdab said patients are asking for increasingly bigger implants to gain the kind physiques popularised by celebrities such as Kim Kardashian.

“In plastic surgery, we know if you aim for extreme results, you get extreme complications," he said.

Dr Al Ahdab, who runs Med Art cosmetic surgery clinic in Jumeirah, spoke ahead of a vote by British surgeons on Friday.

Reality TV personality Kim Kardashian speaks during an interview with Reuters at the World Congress on Information Technology (WCIT) in Yerevan, Armenia, October 8, 2019. Vahram Baghdasaryan/Photolure via REUTERS  ATTENTION EDITORS - THIS IMAGE WAS PROVIDED BY A THIRD PARTY.
Surgeons say many patients cite celebrities such as Kim Kardashian when they ask for enhancements and fillers. Vahram Baghdasaryan / Reuters

The British Association of Aesthetic Plastic Surgeons (BAAPS) will ask its members whether gluteoplasty - known as the 'Brazilian butt-lift', should be banned.

The procedure has an estimated death rate of 1 in 3,000 surgeries, according to the association.

“Patients are becoming overly greedy about the size of their rear-ends,” said Dr Al Ahdab.

“They want it bigger and bigger and often it is just too much.

“Doing things moderately would reduce these problems.”

But Dr Al Ahdab said the procedure can be performed safely with the right technique and training.

“The plastic surgery community in general is quite concerned, as we have seen quite a few mortalities from the procedure,” he said.

Silicon implants do not have the high mortality rates, but fat transfer or lipo-filling used for Brazilian butt-lifts is more dangerous

“Silicon implants do not have the high mortality rates, but fat transfer or lipo-filling used for Brazilian butt-lifts is more dangerous.

“I do not support a ban altogether, but there should be better education, training and information for patients.”

The surgery is done in two ways - either by injecting fat into and below the muscle or by injecting fat under the skin and below the muscle, in the layer with naturally occurring fat and tissue.

The increased risk in mortality happens when the fat is injected into or below the muscle.

This leads to a migration of fat into the blood vessels via circulation which can eventually reach the lungs, causing a pulmonary embolism.

Surgeons often choose to inject into the muscle, below the skin surface, to achieve a more natural appearance.

“There should be education of surgeons through proper training to make them aware of the risks where they are told to strictly inject above, not into the muscle,” said Dr Al Ahdab.

“Patients should also be educated so they know the risks of mortality and are fully aware. Their expectations need to be managed.”

In the UK, four out of five plastic surgeons reported a dramatic increase in patents needing corrective surgery after visiting sub-standard clinics overseas.

One UK NHS hospital reported a six-fold increase in the number of patients requiring corrective surgery flowing botched operations, since 2013.

The issue has been in the spotlight in the UK after a British mum-of-three died following a visit to Turkey for a Dh22,000 procedure. Leah Cambridge, a beautician from Leeds, suffered a fat-clot during the operation in Izmir in August, 2018.

In 2018, the BAAPS distributed a circular recommending its members refrain from performing the surgery until more data on its safety was available. Similar concern has been shown in America and Australia.

Speaking last year, outgoing BAAPS president Simon Withey warned social media was driving

“A vulnerable group of patients are openly being targeted through social media and the web to travel abroad for cheaper cosmetic surgery – and this trend is likely to rise,” he said.