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Cosmetic Surgery and Kolkata

One of my friends once remarked - “Kolkata girls are one of the most beautiful, but upto the neck”.

What happens to the beauty below the neck?  “Compared to any other part of the world, they seem least concerned about it.”  Until marriage they remain slim like any other college or university goer - but soon after marriage, due to a combination of multiple factors ranging from oral contraceptives to less extraneous activity, they just put on weight.

Then, is weight not an emblem of beauty? The concept of beauty has changed from ages to ages, generation to generation, from one culture to another, from one civilisation to the next.

My general view is that, the appreciation of beauty is relative to the cultural and socio-economic background. Where there is an affluence of food, slim ladies epitomise the concept of beauty. On the other hand, in countries, where food is not so in plenty-  slight or more voluptuousness appeals more to the male crowd.

But beauty is not just the face - it is an entity as a whole, with the balance of figure and face. That is exactly where cosmetic surgery comes in.

One of the reasons why cosmetic surgery has not developed in Kolkata is due to lack of properly trained personnel. Cosmetic Surgery is not just a glamour name to be stamped with any qualified plastic surgeon - it is a name which needs years of structured training of the concepts of beauty, of surgery -as a few millimetres can make a mammoth difference to the outcome. It is an art - which has to be learnt, learnt by operating on thousands.

People may remain in a myth that cosmetic surgery is expensive and hence it is for those who are in show business. No- it is not so. It is as expensive as any other surgery.

What is cosmetic surgery? It is improving the profile of a person from normal to super-normal level ; which means enhancing the appearance to the desired level.

What does it cover? Cosmetic Surgery can be broadly divided into three groups:

  1. Facial Cosmetic Surgery
  2. Breast Surgery
  3. Body Contouring Surgery

(1) Facial Cosmetic Surgery

The appeal of face or the need for facial cosmetic surgery varies with age.

(a) Facial Cosmetic Surgery for the young

The people who form the bulk are girls from eighteen to forty.

Though it is comparatively rare in Kolkata, “bat ears” form the most popular cosmetic surgery for children in the western world. Usually children face a difficult time in school playground when their mates pull upon their ears. This operation or otoplasty is a simple operation, which needs one night’s hospital stay and the results are very pleasing.

Nose is perhaps one of the most appealing features of the face. But one must remember, nose is not an individual entity, but a harmony with the mid-face and the chin. To shape it to an appealing appearance one has to know in detail the aesthetics, evolution and ethnic authenticity - in short one has to have a detailed knowledge of art and beauty. Rhinoplasty or re-modelling of the nose is one of the most difficult operations - which any plastic surgeon in the world will tell you - not to do it, but to get it right. The operation once wrongly done can become a nightmare to the next plastic surgeon.

Lips can be thinned or augmented, chin can be advanced or receded, cheekbones can be altered. Scar revision on face is normally done by plastic surgeons, but strangely acne pits, vitiligo, hirsutism and wrinkles seems to be treated only in Kolkata by anyone who-so-ever can lay hands on it - right from dermatologists to beauty parlours, whereas elsewhere in other parts of the world people know to land upto a cosmetic surgeon. One has to understand the difference of application of techniques of dermabrasion, chemical peel and laser resurfacing, to venture to treat the conditions. This training forms an integral part of the training of a cosmetic surgeon.

Adjusting the slant of the eyes to correction of the “double chin”, especially in obese, is possible by cosmetic surgery.

(b) Facial Cosmetic Surgery for the not so young

In western world, the main bulk of cosmetic surgery of the face is from people around their peri-menopausal age to the older age group. All these stem from the gravitational changes with ageing.

They range from correction of eyelid bags to give it a ‘younger look’ to face and neck lift sometimes combined with a brow lift. These days I do endoscopic brow lift. Blepharoplasty or correction of eyelid bags has taken a new turn in a trans-conjunctival approach with laser resurfacing. Face Lift - the most popular risky (in untrained hands) operation can be done as a simple skin lift (usually short lasting) to SMAS and extended SMAS to the composite lift described by Hamara. For the upper face sub-periosteal face-lift has got a distinctive role.

But who cares? Where ageing in Kolkata is taken as a form of conversion from the young girl next door to the ‘granny’ sitting in front of you- what does it matter as which way a face lift is done. Even in show business, where competition is minimal, a ‘name’ with a sagging skin all over and increasing girth all round - can still fetch a few rupees, who bothers about cosmetic surgery?

(2) Breast Surgery

To understand breast surgery one has to be familiar with the psychosexual disposition of the individual; and indeed with the socio-economic taboos. To discuss anything about breast in Kolkata, even today, is a relative ‘shame’ - how can we talk about cosmetic surgery? As much as the nose or the eyes can enhance a feminine look the breast can add to the overall femininity of the individual. One must remember, like the eyes, the nose, the lips, -  breast has an important profile in the psycho-sexual disposition of the female. As much as it is ornamental, it is the first essence of motherhood, where a newborn child establishes its first rapport with the mother. In short, it gives a lady her femininity.

Indeed big breasts do form a physical problem causing back, neck and shoulder pain, abrasion of skin by bra straps due to its sheer weight - needless to say the social ‘comments’ do distress the ladies who are victims of hypersensitivity of the oestrogen receptors during puberty. Breast reduction is one of the most popular operations performed in other parts of the world.

Small breasts seem to cause a severe psychological problem for a female in the development of her femininity. ”Sh! Sh! Thou shalt not discuss these issues” - mums would say, disregarding the psychological trauma the girl is going through. Yes this simple operation can change a girl’s life.

After childbirth by natural phenomenon, the breast sags. Modern mothers would say, “ I do not want to breast feed” - disregarding the golden rules of the Omnipotent. Not only are they depriving their child of the warmth, but also they are laying a base for breakage of rapport and bondage between mother and child. Lifting the sagging breasts is a simple operation, sometimes with minimal scars.

(3) Body Contouring Surgery

Where good food is readily available, where activity is minimal, where girth is not as important a factor, as labour to make fitting dress is so damn cheap, where voluptuousness is an attraction to the male eye - why bother about body contouring?

But alas ! India is unique in many ways - more so in its individuality of dress. And this uniqueness exposes more the belly of a female than any other social dress. And this exposure makes the ladies conscious too! After childbirth this normal phenomenon of sagging belly perturbs them to run from one fitness centre to the other in vain for reducing this exposed laxity. Nothing works.  Only abdominoplasty, be it open or endoscopic can help.

Liposuction has received a widespread publicity and the common myth is that it reduces weight. No - certainly it is not so. Liposuction cannot reduce weight. It improves the body contour. Liposucking more than two litres of fat can cause serious problems.

Though ‘arm lift’ may have role with the people who like the ‘sleeveless’ look, yet I must confess where sari is the natural dress, thigh lift may not be so in demand. Yet it is awkward when you see in the cable TV, an actress, with less shapely thighs, dancing away in glory in her mini-skirt, least concerned what impact it is creating for the crowd, who has to watch her aerobics without a choice.

Though cosmetic surgery in other parts of the world form the bulk of plastic surgery practice, - in Kolkata it has still to take off the ground. Whether it takes its shape and flies in the normal way, depends a lot on the doctors, socio-economic and cultural aspects of the society. They say, every event takes its own course. So will be cosmetic surgery in Kolkata. But before it has even started to fly - let it not be mis-represented to the masses just for the heck of making some quick money.

It is not just a glamour name to attach to, in order to throw some extra rupees to the bank - it is an evolving art, which is only learnt, like any other thing, with the sweat of your brow and the tears of your eyes.