The quest for eternal beauty is probably as old as the human kind. Back in ancient days, there was not much possibility to improve the way you looked, except for some minor cosmetic corrections, usually only in domain of the rich, which sometimes included very bizarre practices. While Egyptian queen Cleopatra took regular baths in donkey milk in order to preserve skin softness, Hungarian Countess Erzsebet Bathori from 16 century was said to have bathed in the blood of young virgins to preserve her youth.
Nowadays, superstitious practices have been replaced by contemporary esthetic surgery medicine, which, in many aspects, has reached the desired ideal of staying (or becoming) beautiful and in top shape. More importantly, it has become available to wider population. Esthetic surgery is becoming ever more popular in the Gulf countries, too. Global pop culture, glossy magazines and social media’s selfie obsession has had additional impact on consumer behavior, and many esthetic surgeons lunched this branch of medicine into a very lucrative business, worth hundreds of millions USD.
For example, Saudis spent USD 220 million on esthetic surgeries last year, according to the Makkah Daily. The absolute number of operations in the sector of esthetic surgery is steadily growing every year, and International Society of Esthetic Surgeons (ISAPS) report from 2013 ranks KSA in 28th place in the list of the countries with the highest rates of cosmetic procedures.
No longer a taboo
One of the world’s leading esthetic surgeons Dr. Luiz Toledo from Dubai stated for bqdoha that “There should be no distinction between reconstructive and esthetic procedures. All reconstructive procedures are also esthetic and all esthetic procedures are also reconstructive. They heal body and mind.” Dr Addel Quttainah from Kuwait shares this view and says, that due to the increased media exposure as well as the general increase in cases, esthetic surgery is more accepted than ever. “The main source of new patients is definitely personal referrals, which proves that many patients are talking about their procedures and no longer feel they need to hide them.”
Women still predominant
While women still predominantly lead in the esthetic surgery use, all global statistics have been confirming consistent annual increase in men seeking esthetic surgeons’ services. Similar trends have been noticed in the Middle East, as their number in past years increased greatly and according to the Arabian Business, accounted for around 9 percent of cosmetic procedures in 2012, while international trends show that men represent almost a third of all clients. According to Dr. Quttainah statistics, approximately 85% of his customers continue to be women, “however we have a large proportion of male customers in our hair transplant clinic.” Majority of GCC surgeons attribute significant increase in liposuction, rhinoplasty and tummy tuck to an ever greater problem of obesity among the GCC population.“ In the last few years significant increase has been in fat transfer – taking fat from areas such as the stomach to put in the buttocks or face,” said Dr. Quttainah, adding that breast surgery (implants and breast reductions) with botox and filler are still the most popular among non-surgical procedures.
Dubai – regional esthetic surgery hot spot
Intensive developments in the field of esthetic surgery in the GCC, especially in Dubai, have already established this emirate as a medical hub of the region, competing with Switzerland, Germany and UK. The Dubai Health Authority reported that around 120,000 medical tourists came to Emirate last year, generating revenue of around USD 200 million. Their number is expected to increase to half million by the 2020.
The national background of Dr. Toledo’s patient proves that Dubai has taken big steps towards becoming a regional leader. “The majority of my patients are local Emiratis (40%). UK citizens are second (18%), and the rest is a mixture of 73 different nationalities. About 28% are from the Gulf area.” Dr. Toledo states that “the new Board of the EPSS is doing its best to increase the quality of the doctors, by providing congresses, seminars and monthly meetings.” In order to develop into a world class medical center, UAE have managed to attract some world class surgeons from Brazil, USA and Europe whose standards and knowledge have had great impact in improving the standard of care in entire GCC. GCC governments are investing heavily in educating local medical personnel as well. Kuwaiti doctors for example, “are supported by the government to train overseas and the expense is covered in full. Scholarships are offered to the best students and this is how I received my training,” said Dr. Quttainah.
Prices still much lower compared to the West
Dr Quttainah said there is not much difference in prices in Qatar, Kuwait and Saudi Arabia. The prices in Kuwait are probably 1/3 less than what is being charged in the US and Canada for the services provided by qualified western trained esthetic surgeon. Nevertheless, in his experience price is not a factor for his patients: “Price is not the reason why they come to our clinic. Patients who are concerned exclusively with price will search for the cheaper doctors and even have some procedures done in salons by beauticians. That is another source of complications we encounter often.”
In Qatar, government used to fully cover the surgery expenses for the nationals whether it is cosmetic or medical procedure, while expats had to pay for the same procedures while government subsidized part of the costs. However, new Health Insurance Scheme (NHIS) does not envisage such practice in the future. Only reconstructive surgery will be covered, if it is judged medically necessary by the NHIS communication department states.
For many years GCC citizens would travel to USA, UK, Germany and Lebanon to have invasive cosmetic procedures done, but nowadays many of them choose to do it in the region. Just like in so many other industries, the GCC is becoming a home of a booming esthetic surgery market
Dr. Toledo sees UAE as the fastest growing market especially in terms of quality. “The Emirates have been improving the quality of esthetic surgery, especially in the last 2 years with monthly meetings of the EPSS Emirates Esthetic Surgery Society. Dubai is probably replacing Beirut as the Middle East capital of esthetic surgery, considering the quality of the surgeons.” Beirut’s reputation as once the region’s regional medical hub is quickly fading away due to turmoil in Syria and violence often spilling into Lebanon. And there is also Iran, with great number of surgeons, especially in the field of rhinoplasty, adds Dr. Toledo.
But the significant market rise and quality improvement can be expected in Kuwait as well, as our respondent Dr. Addel Quttainah reveled to bqdoha its ambitious undergoing project of building 16-store Cosmetic Surgery Centre which will be the largest in the GCC and is expected to be launched in 2015.
Low price not always the best option
With growing demand for the esthetic surgery, more and more international cosmetic surgeons are coming to the Middle East to practice there. While Qatar Daily reported there is 300 esthetic surgeons in the area, (ISAPS) report counted 226 in Saudi Arabia only, so their number is probably several times larger in the entire GCC region.
As Dr Toledo observes, “supply is exceeding demand in some countries, such as the Emirate of Dubai. In other GCC countries there is a need to increase the number of surgeons and improve training. “ Moreover, Dr. Addel Quttainah warns that a big problem in Kuwait and some other parts of GCC is the number of unqualified personnel, meaning non – specialized surgeons who have not had specialized training in esthetic surgery, but are nonetheless promoting themselves as “cosmetic surgeons” after taking a weekend course on liposuction or tummy tuck.
Such a practice is very dangerous for the patients, as these doctors have a tendency to offer lower prices to lure in patients, especially when they are just starting their business. This comes at the price of a great risk for the patient. Quttainah adds that “a fully qualified western trained esthetic surgeon takes 7 years undergrad and medical school, 5 years esthetic surgery residency, 2 years of fellowship and usually one year working in a licensed facility before starting on their own. So that is a total of 15 years of training.” The prices of surgery in the West are therefore significantly higher.
However, Kuwait and other GCC countries are still facing the problem of inadequate legal regulations related to the acquisition of medical licenses. “In Kuwait, unfortunately, there is a large number of doctors who are granted licenses because they know the right people or “wasta” and this has had a tendency to lower the standard of doctors who are performing procedures,” notes Dr. Quttainah.
Since the esthetic surgery in many countries in the Gulf is still in its infancy, there is big variation in prices and quality provided. In the past several years, there have been numerous reports from all over the Gulf, about non-skilled semi-professional practitioners performing esthetic surgery in questionable facilities. Experienced doctors advise to take time and explore the surgeon’s credentials before going under his particular knife.