Not always the Third World

My husband is a Plastic Surgeon and we do watch Dr 90210 from time to time and are amazed at how differently things are done in the USA. Firstly, the most obvious difference is the fact that they use so much larger breast implants. Whether it’s something to do with their culture or just fashion I don’t know but they obviously want everyone to know that they’ve had their boobs done and so it is a fairly unnatural look. It is also not legal to use silicone implants, unless it is for a revision augmentation (second time one is doing the op) or reconstruction (in the case of breast cancer). I could easily be incorrect as to the circumstances under which silicone implants may be used but I think those are the reasons when it’s allowed. Silicone is much better from what I understand. I’m also not going to get into all the reasons why they don’t allow silicone for primary (first) breast enlargements. The other thing is that the poor patients are sent home immediatly following major surgery. A tummy tuck and breast reduction are major surgical procedures and liposuctuion can also have a pretty major effect on the body because by removing large amounts of fluid (fat included), it can be like losing a lot of blood, being dehydrated or whatever and one can react badly and so should be monitored. On Dr 90210 you see these half-groggy people getting wheeled out in a wheelchair and often being sent home or to a hotel. This is rather alarming but the astronomical cost of healthcare in the USA means that most cosmetic procedures are not performed at a hospital but rather at the doctor’s rooms or clinic. Now, this does happen in SA as well, but it’s usually the smaller, less invasive and the less painful procedures which are done in the doctor’s rooms but all the bigger stuff is done at a hospital and the patient stays 1 or 2 nights while they recover. With a tummy tuck, your scar is quite a bit longer than for a c/section, so that would be like having an op bigger than c/section and then pretty much as soon as you’re awake, you get sent home. Often the First World is not really the First World at all. Another example of this is ante-natal care. In South Africa we really are spoilt and incredibly blessed with the private ante-natal care that is available. Friends of ours live in Canada. He is a doctor and she is a physio, although she is now a mom. They have just had their 4th baby, a 4th boy. They were pretty sure it was another boy, but also not 100% (that’s unheard of here, if you want to know what you’re having you will definitely know by the time you give birth). That’s not the issue I want to tackle though. The baby was born without a left hand and they had no idea. Now, there isn’t obviously anything that one could have done about it, but at least they would have been prepared. At both of my 13 week scans and again at the 22 week scans, they checked every bone, organ, etc of my babies in the finest detail and for all sorts of abnormalities such as cleft lip and palate,etc.. There is no way we wouldn’t have known if one of our girls was missing a hand. Some people might not want to know but I really do think it helps to prepare oneself.

Getting back to Dr 90210 though, there was once an episode where the patient had a nose job. When the doctor started doing the op he discovered that the guy had had a previous nose job and it made the op far more complicated. I obviously am not in the position to explain why it makes the operation so much harder but it does. In fact, it doesn’t really matter for most other cosmetic procedures whether one has had the same procedure done previously but when it comes to a nose job, it makes a massive difference. One obviously gets various kinds of nose jobs, depending on the problem (removing a hump, straightening a broken nose, making it thinner, whatever). The most difficult one (I’m told) is to make a long nose shorter. So, the other day Chris had this type of nose job, so he was already a bit apprehensive about the op and despite denying having had a previous nose job, once he started with the op it became obvious the person had had a previous one done and this made for a very difficult operation indeed. When he questioned the patient as to why they hadn’t told him, when he’d asked them, they said they were scared he’d refuse to do the op, which ironically is probably what would have happened. The reason is, I think, that one can’t really make enough of a difference to justify the money spent so it’s actually that one has the patient’s best interests at heart. So, as always honesty is always the best policy. Not too sure why I’m telling you all of this today but I can’t stop thinking about our friends’ baby and how they are learning to accept a shock like this. I know when one compares it to the innumerable birth defects, syndromes, diseases,etc that could have happened, then life without a hand is not really too bad, but it still isn’t nice and I’m glad I live in a country where I can afford the type of medical care that I feel should be available to those living in much “wealthier” countries but because of whatever reason, it isn’t.

Just to add that all the plastic surgery related stuff is purely my opinion and what I think are the facts, based on me listening to my husband telling me stuff and what I’ve picked up over the years of being married to someone whose been studying to become (and now is) a plastic surgeon. What I’m trying to say is that I could easily have got the wrong end of the stick with regards to a lot of the facts so don’t hold that against him!


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