Once it was the rich and glamorous of Hollywood who epitomised the desire for cosmetic surgery. Today, the Emirate of Abu Dhabi is rapidly catching up when it comes to grasping the nip ‘n’ tuck culture; and much of the new business appears to be coming from local clients rather than expats.

Increased publicity as well as television coverage on makeovers – and even the ‘Nip and Tuck’ TV series – are responsible for the gradual disappearance of the mystery and taboos surrounding cosmetic surgery.

It seems women want to look more glamorous. Perhaps this is an effect of rising divorce rates; if marriages are not lasting as long these days, many women might undergo cosmetic treatment because they feel it would help to keep their husbands if they appear more attractive, rather than risk losing them to a younger and more attractive woman.

There’s also some anecdotal evidence that the international financial crisis has prompted increasing numbers of women to demand treatment – because they don’t want to risk losing their job to a younger and more attractive rival."

Men are also becoming increasingly aware of how cosmetic surgery can enhance their looks. The reduction of male breast tissue is becoming popular.

Surgeons and consultants in this field generally argue that it is a universal and basic human instinct to want to look good – the correlation between looking good and feeling good is apparent.

In fact cosmetic treatments are not always appropriate, and surgery is certainly not always the answer to everything. These days there are many alternatives, and a reputable clinic will advise on all of them.

Choose your surgeon

With the boom in cosmetic surgery in the past two decades has come an explosion in the number of people who are willing to perform these procedures. In fact not every doctor has had the necessary training. In most countries, including the UAE, any licensed medical doctor can call themselves a plastic surgeon, and can practice cosmetic surgery, regardless of training, (or the lack it). And many of the clinic proprietors for whom cosmetic procedures represent such a lucrative business do not even hold a medical degree.

So it makes sense to ask the surgeon and clinic for evidence of qualifications. These vary widely and there are many different licensing authorities around the world that enforce professional standards for members and licentiates; if in doubt ask about the nature of a particular qualification, or take the time to do some Google research.

The better-known qualifications include FRCS (Fellow of the Royal College of Surgeons) for a UK-trained specialist (and especially FRCSPlast, indicated that the holder has passed specialist exams in cosmetic surgery). Membership of the British Association of Plastic Surgeons (BAPS) or the British Association of Aesthetic Plastic Surgeons (BAAPS) is an alternative indicator of professional standing.

For US qualifications look for certification by the American Board of Plastic Surgery, the only plastic surgery qualification that is recognised by the American Board of Medical Specialties. For Canadian qualification, your surgeon should be certified by the Royal College of Physicians and Surgeons of Canada.

The description ‘cosmetic surgery’ is often used interchangeably with ‘plastic surgery’. Plastic surgery actually encompasses reconstructive surgery, which is to correct serious defects and traumatic injuries, whereas the former is concerned with aesthetic appeal.

Pick a procedure

Here are some of the cosmetic procedures most commonly offered by clinics:

• Abdominal etching - contours and shapes the abdominal fat pad to provide a flat stomach
• Abdominoplasty (“tummy tuck") - reshaping and firming the abdomen
• Blepharoplasty - reshaping of the eyelids or the application of permanent eyeliner
• Breast enlargement - augmentation of the breasts typically with saline or silicone gel prosthetics but sometimes via fat grafting
• Breast reduction - removal of skin and glandular tissue
• Mastopexy (“breast lift”) - removal of breast skin (as opposed to glandular tissue) to lift or reshape breasts to make them less saggy, often after weight loss
• Buttock implants - augmentation of the buttocks using silicone implants or (less frequently) fat grafting
• Rhinoplasty (“nose job") - reshaping of the nose
• Otoplasty - reshaping of the ear
• Rhytidectomy (“face lift") - removal of wrinkles and signs of aging from the face
• Liposuction - removal of fat from the body, usually the abdomen
• Chin augmentation - usually done with a silicone implant or sometimes by manipulation of the jawbone
• Chemical peel - minimising the appearance of wrinkles, acne and other scars, age spots, freckles, and minor skin damage in general. Chemical peels commonly involve carbolic acid (Phenol), trichloroacetic acid (TCA), glycolic acid (AHA), or salicylic acid (BHA) as the active agent. A surgical qualification is not usually required for this procedure
• Laser skin resurfacing - improves skin texture especially around the mouth, eyes and cheeks by using a laser to remove the outer layer of skin and allowing the skin to regenerate with fewer wrinkles and blemishes
• Fillers - injection of collagen, fat, or specialist compounds like hyaluronic acid to minimise the appearance of lines and wrinkles
• Scar removal - in fact no scar can be removed completely, but the appearance can be made less obvious through surgical or other procedures

Extra care required

Doctors agree that cosmetic surgery is not for everyone. Here are just a few of the treatments that you might think twice about...

Fat-dissolving injections:
There’s widespread agreement that one procedure to avoid when shopping for a slimmer look is called lipodissolve – an injection that claims to dissolve away stubborn fat deposits. There is little scientific evidence to show that it definitely works. The treatment frequently involves the use of a compound called lipostabil, which can indeed dissolve fat and other structures. However, it can in rare cases cause pain, swelling, hard lumps, ulceration of the skin, and contour irregularities.

Despite the lack of evidence of the long-term effectiveness of this procedure, the growing number of clinics offering lipodissolve in USA and the Gulf is testament to the growing desperation of patients who fear liposuction – which is very safe and effective when done in the right hospital by well trained physicians.

Combination breast lift/breast implant:
The combination of two tried-and-tested techniques in a single operation can cause problems and is widely associated with malpractice suits in the USA. Mastopexy essentially tightens up the tissues of the breast to eliminate a flabby, loose appearance and is often aimed at breast reduction – while the aim of breast augmentation is obviously the exact opposite. The chances of complications are reduced if the two
procedures are staged six months apart.

Permanent filler injections:
Injectable fillers are gels injected into the skin to plump up lips, push out wrinkles and smooth out fine lines – basically filling out spaces in the face where extra volume is needed. Most of the fillers that are on the market today are temporary, because after a certain amount of time they are absorbed into the body and the results are lost.

A number of the newer gels such as hyaluronic acid can last between five months and two years. But some fillers are designed to stick around in the body for longer time. These ‘permanent’ fillers include liquid silicone and the product known as Aquamid.

Buttock implants:
Unlike breast implants, which are filled with either silicone gel or saline, buttock implants are solid slabs of silicone and are positioned beneath the fibrous lining of the buttock muscles. The result – a rounder, more voluminous rear end – can come at a
price: there is a high rate of problems with these implants. Among these is an increased risk of infection. To hide the incision from plain view, surgeons will often place it between the buttocks, perilously close to the anus and the germs that reside there. One in five patients for this procedure experiences a life-threatening infection that requires removal of the implant and a long hospital stay.