surgery to make your face fit
by Jenny Bryan
Model and stripper Prince takes criticism on his chiseled chin, which is one part of his face that hasn't been under the surgeon's knife. For narrowing his nose and raising his cheekbones he's been accused of selling out his black heritage – even cutting his flesh to suit the European slavemaster.
© Getty
But Prince, like most of the African and Asian men and women who are changing their faces to a more European look, insists he is not losing his cultural roots, just changing his looks to suit his personality and his career.
'I'm a black guy and I'm very happy with my features but I was modeling and the feedback I got was that it would be better for me if I had my nose slightly altered,' he says.
Aisha from Sierra Leone is beautiful by any standards and her job as a property developer in Britain isn't threatened by her nose. She too insists that, in undergoing surgery to raise the bridge and the tip of her nose, she isn't trying to look more Caucasian. She says she's just doing it for herself, but her cousin thinks differently:
'She's African and being African she should look as she really is rather than trying to disfigure herself. She's doing it to fit into the type of culture she thinks that she's in,' he says.
overcoming prejudice
Getting a surgeon to change your appearance to make your face fit isn't new. Professor Sander Gilman, author of Making the Body Beautiful, traces the practice back 100 years:
'It begins with one single impetus – people belonging to one ethnic or racial group who want to fit into a society that is prejudiced against them. Jews in Germany, the Irish in New York State, light skinned blacks in South Africa.'
What is new is the scale of cosmetic operations amongst the Asian and black communities of the UK. Surgeon Gary Horne estimates that the numbers requesting nose operations has increased by 25-30% in the last five years. Usually the request is to raise the bridge and lift the tip so that the nose looks narrower and less flat.
what the surgeons do in a nose job
To reduce the size or change the shape of a nose, surgeons trim away surplus tissue.
To make a nose look less flat, they insert an implant under the skin to raise the bridge. This can be done with bone or cartilage or, increasingly, with synthetic material produced in a range of sizes to fit different noses. The implant can be inserted through an incision inside the nostrils or by cutting through the strut of skin which separates the nostrils.
The nose is then stitched up, dressings put into the nostrils and a splint plastered over the nose to keep everything firmly in place while the tissues heal.
Surgery is usually carried out under a general anaesthetic – something which carries a small risk of chest infection and blood clots. Small implants can be put in under local anaesthetic, which means simply numbing the nose before making the incisions.
The operation is likely to cost between £3,000 and £4,500 depending on whether an implant is needed.
after the operation
The nose is likely to bleed a little after the operation and it and the surrounding area of the face will be bruised and swollen for several weeks after surgery, but the nose shouldn't hurt. Before leaving hospital, you should be advised what to do if you are in pain or your nose continues to bleed, and who to contact.
The splint will probably stay on for 1-2 weeks. Any stitches inside your nose are likely to be soluble so they will dissolve on their own.
Putting an implant into a nose inevitably changes the way it feels. The bridge may feel hard and, if the implant does not become fixed to the underlying tissue, it may move about under the skin.
judging success
Prince and Aisha are pleased with their new noses but, as Prince realistically points out, no one's appearance is perfect. It's important to be sure you are happy with your proposed operation well before you go to theatre. Both you and your surgeon should be realistic about what can and cannot be achieved. You may want to see some 'before and after' photographs of other people on whom your surgeon has operated.
As cosmetic surgery is rarely available on the NHS, you will probably need to find a surgeon who operates privately.
Surgeons who have trained in general surgery should have FRCS after their name. If they perform plastic surgery, including facial operations, they should have had special training in plastic surgery.
The General Medical Council keeps a Specialist Register of Plastic Surgeons who are considered to be suitably trained in plastic surgery. Many of these surgeons are also members of the British Association of Aesthetic Plastic Surgeons (BAAPS).
Members of the British Association of Cosmetic Surgeons (BACS) have satisfied that organisation that they are suitably trained to carry out cosmetic procedures.
not always the solution
Plastic surgery changes people's faces but it won't necessarily make them happier about themselves. Emotional problems are rarely skin deep and trying to conform to a popular image of the body beautiful may not solve more deep rooted problems of disillusionment and lack of self esteem.
Professor Gilman points out that it's human nature to judge by appearances:
'Every time we meet somebody we make judgments about them and the thing we use to make those judgments is our way of looking at the face. We say where is this person from, what is their ethnicity, do I like them?'
But will changing our appearance change what other people think of us?
physical versus cultural identity
Simon Lee works as a TV producer in the UK for a Chinese channel. He used to present food programmes, but lost confidence in himself. The new generation of presenters have more westernised features – quite simply they look less Chinese. Simon decided to boost his confidence and put himself back in the running for a presenting job by having surgery on his eyelids and a facial acid peel to freshen up his skin.
'A couple of months ago I was very low, I couldn't get out from my flat. My self esteem was very low. I think the plastic surgery will give me confidence,' he explains.
Surgeon Jan Stanwick explains that the oriental eyelid is different from the western eyelid. In the western eyelid, multiple connections run from the skin of the lid into the underlying muscle, but these are missing in the oriental eye. The effect is to give the western lid an extra fold and make it look thicker than the oriental lid.
To give Simon the creased eyelid of a western eye, Mr Stanwick removes a sliver of tissue, just a few millimeters wide across the middle of each of Simon's eyelids. The edges are stitched together and Simon's eyes will look brighter and more open.
Once the swelling and bruising around his eyes goes down, Simon is pleased with the results, feels more confident, and is eager to start presenting again. With his new eyes, he will fit in better with the lively young presenters who are most popular with viewers.
A face that fits the place where they live may be the solution for Simon, Prince, Aisha and the thousands of other African and Asian people who are opting for plastic surgery. But there are plenty who would question whether the cost to their cultural identity is too high.
help and info
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organisations
British Association of Aesthetic Plastic Surgeons (BAAPS)
at The Royal College of Surgeons of England
35-43 Lincoln's Inn Fields
London WC2A 3PE
Advice Line: 020 7405 2234
E-mail: info@baaps.org.uk
Website: www.baaps.org.uk
Offers information about aesthetic plastic surgery. The website features a search facility for accredited surgeons, gives details of the common cosmetic surgery procedures, and tells you the risks and limitations of each.
British Association of Counselling and Psychotherapy
35-37 Albert Street
Rugby CV31 2SG
Tel: 0870 443 5252
E-mail: bacp@bacp.co.uk
Website: www.bacp.co.uk
BACP can provide you with a list of private counsellors in your area, plus information on counselling and choosing a counsellor. Please telephone or send an SAE to the above address. Alternatively, you can search for a counsellor at the website which, along with an online directory of counsellors, contains details about membership, training and an extensive publications list.
General Medical Council
Regent's Place
350 Euston Road
London NW1 3JN
Tel: 0845 357 8001 (general enquiries) (Mon-Fri 8am-5.30pm)
Tel: 0845 357 0022 (doctors' fitness to practise)
E-mail: gmc@gmc-uk.org
Website: www.gmc-uk.org
Holds general and specialist registers of doctors practising in the UK. The registration department can provide registration details of specific, named doctors, free of charge. Contact them to check if the doctor or surgeon you have chosen is on their register.
Healthcare Commission
Finsbury Tower
103-105 Bunhill Row,
London EC1Y 8TG
Tel: 020 7448 9200 (switchboard 8.30am-6pm)
E-mail: feedback@healthcarecommission.org.uk
Website: www.chai.org.uk/Homepage/fs/en
The independent inspection body for both the NHS and private and voluntary healthcare, set up to regulate and improve standards in healthcare services throughout England and Wales. It also acts as an independent review body for NHS complaints.
Medical Advisory Service
PO Box 3087
London W4 4ZP
General Medical Helpline: 020 8994 9874 (Mon-Fri 6-8pm)
Men's Health Helpline: 020 8995 4448 (Mon, Tues, Thurs 7-9pm)
E-mail: info@medicaladvisoryservice.org.uk
Website: www.medicaladvisoryservice.org.uk
Telephone advice and information service for all general medical enquiries. See the website for details of other helplines.
websites
American Society of Plastic Surgeons
www.plasticsurgery.org
Has extensive information about different types of cosmetic operation.
Asian Eyes
www.modelminority.com/youth/fold.htm
Article discussing how common blepharoplasty (eye surgery) is among Asian-Americans, and considering the reasons behind this.
British Association of Cosmetic Doctors
www.cosmeticdoctors.co.uk
Aims to represent cosmetic practitioners and maintain standards to benefit doctors and the public. You can search for members online and read about different non-surgical treatments.
British Association of Plastic Surgeons
www.baps.co.uk
The professional representative body for plastic and reconstructive surgeons in the UK, based at the Royal College of Surgeons. The site offers authoritative advice on the different clinical areas of plastic surgery and has a reading list of up-to-date articles on treatments.
British Association of Cosmetic Surgeons (BACS)
www.b-a-c-s.co.uk
This organisation represents surgeons who undertake cosmetic surgery but who may not have completed the specialist training now required for new cosmetic surgeons in the UK. To join BACS, surgeons need to show that they have cosmetic surgery experience but they do not need to be qualified plastic surgeons. BACS represents many of the surgeons working for private clinics or hospitals that advertise directly to the public.
Choosing a Cosmetic Surgeon
www.embarrassingproblems.com/cosmeticsurgery.htm
Useful advice on what to think about when considering cosmetic surgery and on choosing a reputable surgeon.
In the Eye of the Beholder
http://education.guardian.co.uk/ ...
Article from The Guardian newspaper discussing why black and Asian women are spending thousands of pounds on plastic surgery to look more Caucasian.
The Royal College of Surgeons of England
www.rcseng.ac.uk
An independent professional body committed to promoting and advancing the highest standards of surgical care for patients.
reading
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The Body Image Workbook: An eight-step program for learning to like your looks by Thomas F Cash (New Harbinger Publications, 1997) |
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Bountiful Women: Large women's secrets for living the life they desire by Bonnie Bernell (Wildcat Canyon Press, 2000) |
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Creating Beauty to Cure the Soul: Race and psychology in the shaping of aesthetic surgery by Sander Gilman (Duke University Press, 1998) |
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Safe Cosmetic Surgery: A complete guide by Dai Davies and Judy Sadgrove (Metro Publishing Ltd, 1996) |
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The Smart Woman's Guide to Plastic Surgery by Jean M Loftus (Contemporary Books Inc, 2000) |
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Making the Body Beautiful by Sander L Gilman (Princeton University Press, 2001) |
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(March 2003, resources updated January 2005)
