Press Room | Bahamas Institute of Plastic Surgery

	FREEPORT NEWS REPORT Surgeon says plastic surgery can be a positive life changing experience. Rotarians were apprised yesterday of the benefits of plastic surgery and about how a simple surgical procedure can become a positive life-changing experience. Veteran plastic surgeon Dr. Kenneth Dickie took members of the Rotary Club of Freeport on a historic journey back to the advent of plastic surgery and the time when it gained mainstream popularity - during the first World War when injured soldiers would return home with battle scars and serious physical defects. "Doctors were seeing many persons coming in with disfiguring wounds, especially to the face. And out of that came the necessity for reconstruction and repair," he said. "And this is where we saw so many of the people that may have had gunshot wounds to the face and things of that nature and this is where plastic surgery really began coming into its own." After dealing with so many of the war injured people, he said that as time went on major improvements in the methods of cosmetic surgeries were made. "New developments such as skin grafting, and other techniques of tissue repair such as micro surgery, and pre-tissue transfers that we started to see more and more types of repairs that became possible," he said. "Plastic surgeons started to see a lot more burn patients and children born with congenital disease and accident victims and so our specialty started to expand in areas where any form of reconstruction or repairs may have been required." Dickie noted that in recent years, the increase of many children being born with facial defects such as cleft-lips, plastic surgery has helped greatly in providing some sense of normalcy for these children in their lives. "There are now certain techniques where foetuses can be diagnosed with certain defects before birth and in that case some repair work can be carried out without interfering with the pregnancy," he said. Dickie explained that the evolution of reconstructive surgery ultimately leads to concern about aesthetics. "If we're doing repair work or reconstruction on a patient who has been deformed as a result of a car accident or burn injury, our goal is to restore the aesthetic image as best we can," he said. Aesthetic surgeries, he noted, are most popular for burn and car accident victims and also for older persons seeking to bring a little youth back into their faces. "As people age, they lose their skin elasticity, but they also lose bone mass, our facial skeleton stars to shrink, our fat starts to disappear and of course progressive aging of the skin much of which can be accelerated by excessive exposure to the sun," he said. "Techniques have now been developed for facial rejuvenation such as face lifts and eyelid techniques, one where we use procedures to tighten up the muscle under the neck and chin and also where we use carbon dioxide resurfacing lasers that will actually strip away the top layer of the skin and take away many of these lines." Not all surgeries, he explained, are done for aesthetic enhancement. Some, he said, are actually done for serious health matters such as skin cancer, mastectomy and obesity. "There are many good reasons for persons to look into weight loss surgery. There are types of reconstructive surgery for persons that have lost a lot of weight, the extra skin that's left under the arm can be tightened up and the excess skin around the tummy and waist can be improved upon," he said. "The thing of course that we want to do with these patients is to really try and give them the best health benefits that they can get with these procedures and at the same time not project on them unnecessary risk."

	EN ROUTE MAGAZINE Trip/ Tuck Lipotourists are discovering the perks of cosmetic surgery vacations. From the private balcony of you suite at the Westcliff, a luxury hotel perched on a hillside that rises above the city, you can gaze out over the grounds of the Johannesburg Zoo. Directly below, your fellow guests lounge by the pool. Like m, you’ve come to South Africa looking for adventure and relaxation, otherwise known as safari and spa. But there’s one item on your itinerary that sets you apart: Tomorrow, Surgeon & Safari, a tour operator specializing in plastic surgery, will have you skip the massage and microdermabrasion. Instead, Dr. Rick can der Poel will be waiting for you at the Rosebank medical clinic to perform the latest in liposuction. When Surgeon & Safari set up shop in 1999, founder Lorraine Melvill had a novel idea: take advantage of the low South African exchange rate and offer tourists sessions with the country’s top plastic surgeons. Surgery is followed up with private convalescence in a push hotel like the Westcliff, the boutique hotel Ten Bompas in Johannesburg or the Relais & Chateaux-approved Cellars-Hohenort in Cape Town. Once the bandages come off, patients can choose to recuperate among the elephants and giraffes on a safari, visit South Africa’s famous wineries or even cross the savannah on board a luxury train. A natural evolution of the spa vacation, “lipotourism” is now reshaping the face of traditional travel all over the world. In Argentina, the Plenitas clinic had everyone talking when it started offering its “tango and breast implant: package deal. In Thailand, more that 600,000 tourists headed for the operating table in 2004, contributing about $500-million to the country’s economy. And now, popular vacation spots like Brazil, Costa Rica, Mexico, Malaysia and Cuba combine affordable cosmetic treatments with luxurious pampering under the palm tress. In Canada, a facelift will set you back about $8000.00 while in Malaysia the cost is more like the equivalent of $3500.00 not to mention the valued-added perk of communing with the orgutans. It’s not only the savings that explain the popularity of these surgical get-aways. The idea that travel is life changing may be a cliché, but lipotourism gives people the time they need to adjust to their extreme makeovers both on the outside and the inside. “Recuperation in the Bahamas is so beautiful”, says Donna, a businesswoman who during her vacation last year, had a tummy tuck performed by Dr. Kenneth Dickie at the Bahamas Institute of Plastic Surgery. Within 10days, she had dropped the pounds, recovered from the operating and regained her peace of mind by going boating, walking along the beach and exploring the region. She says the trip was a great way to relax – except for the three days that followed the procedure when she didn’t want to see anyone. “People don’t want their family or neighbors around while they’re recovering”, says Dr. Dickie, who relocated to the Bahamas after 20 years in Canada. “You don’t want young children running around after you’ve had you tummy tuck” He set up his clinic in a gorgeous blue and white colonial building and has since been offering his patients (about half f them tourists) a choice of accommodations at the boutique hotel of Pelican Bay at Lucaya or the Sheraton or Westin Grand Bahama Island Our Lucaya Resort, situated right on the beach. His dream: to open a well-being anti-aging center that would offer the whole gamut of youth-enhancing treatments. “A lot of middle-aged Baby Boomers are looking for a more comprehensive approach,” he says. There was a time when only Hollywood stars would take off for an incognito facelift abroad, but since the advent of reality shows, nips, and tucks have become more commonplace. But Dr. Gaston Schwarz, Canada’s national secretary to the International Society of Aesthetic Plastic Surgery, has some serious reservations about that kind of cost cutting. “Plastic surgery is no small matter,” he warns after treating many vacationers whose trips had turned catastrophic. He says that trying to do things on the cheap without being well informed can be risky and that TV, which tends to gloss over complications, can make surgery seem way too easy. What if you land up with a hack Dr. Jekyll instead of a trained Dr. Dickie? Or what if the clinic isn’t properly equipped in case of a medical emergency? Travel has always been a rite of passage, an adventure that can be life altering. Consider our current obsession with beauty and aging, that idea takes on a whole new meaning –even if it’s only skin deep.

Anius at 13 years of age

Anius in 1987 (6 yrs old)

Anius Before Surgery

Anius Post Operation

Anius Post Operation

Anius 2 Years Later

Anius 2 Years Later

THE ANIUS STORY

Many people today hear the words "plastic surgery" and immediately think of facelifts, liposuction, breast augmentation and a myriad of other procedures intended to enhance one's appearance. Not all plastic surgery however, is intended to counter the effects of aging. The foundation of plastic surgery still rests on the surgical treatment of deformities that may be either present since birth (congenital) or acquired as a result of traumatic events such as burns, car accidents or even injuries sustained during combat.

People often ask me if there is a particular case that stands out in my mind. A case that exemplifies what plastic surgery is all about. Let me tell you about Anius...

During an elective surgical procedure which I was performing in our surgical centre in Canada, I received a call from a colleague of mine who was on a Medical Missionary visit to Haiti. He told me that he was in a remote village in Haiti, and happened to come across a little boy who was hiding in a small hut - a place from where he apparently rarely ventured. He said that the child was severely disfigured as a result of scald burns he had sustained when he was 2 years of age (he pulled a cauldron of boiling soup on top of himself). The family did not expect him to survive this accident, as they did not have access to medical care, and had no means to travel with a child so severely burned - so they simply comforted him, nourished him as best they could - and waited for him to die.

Anius did not die. He survived his scald burn. However, due to the ensuing scarring resulting from the burns, he developed severe contractures, and grotesque deformities of his face, neck, arm and had - deformities so severe that he was labeled as an outcast in his village. He was to live a life of torment and ridicule - his only comfort was in the arms of his mother. He lived this way for 4 years after his injury, until a missionary medical doctor saw him peering out from the back of a hut.

So started the Anius story. Anius came to Canada in 1986. At 6 years of age, he had the physical stature of a 3 year old. He was malnourished, anemic, and required prolonged treatment to rid him of parasites. He lived with his missionary "family" throughout his treatment. He would need their support. The surgery we were to embark on would be the second greatest challenge he was about to face in his life.

After 3 months of preparation, Anius was ready for his reconstructive surgery. His burn scarring had resulted in extensive distortion of his normal anatomy, so his surgery would be anything but predictable. None of the medical team we had prepared had ever seen anything closely resembling the deformities that Anius had. We knew that doing this surgery would entail risks. We knew that his young age and his fragile medical condition would make the stress of a major surgical operation an obstacle that he may not be able to overcome. But what was the alternative? We chose to go ahead with his surgery - knowing that this would likely be his only opportunity to re-enter a life that had essentially ceased to exist 4 years ago.

Anius was so severely scarred at his neck and chin, that our Anesthesiologist could not place a breathing tube into his lungs to administer the anaesthetic. Therefore, the first hour of Anius' surgery was performed under local anaesthesia, with the anaesthesiologist administering minute doses of sedative intravenously so that Anius would remain calm while we began to release the scarring that fused his chin to his chest. Once his neck was freed from the tethering scar tissue, Anius was then given a general anaesthetic, and the remainder of the surgery was completed.

The surgery required release of the structures that had been fused together as a result of his scald burn. Skin grafts were taken from his buttocks and thighs, and were then "meshed" so they could be expanded to cover a wider area. His joints in his arms, which had not moved for years, were stiff and unyielding. The physiotherapists would have their work cut out for them. Ligaments in his arms, wrists and hands required lengthening. Prolonged splinting would be required to prevent recurrence of the contractures. After 4 hours of surgery, Anius was swaddled in dressing from head to toe. The toughest part was now behind us, and behind Anius.

Anius had 3 subsequent surgical procedures to complete the process that began 3 months ago. As each week went by, we began to see the sparkle return to this little boy's eyes. The fear of interacting with other children was now, gradually, being replaced by the anticipation of the next game to come. Anius would never look like a normal person. His skin grafts and scarred tissures would preclude that. But Anius would at least have a chance to live a life that was otherwise beyond his reach.

I met Anius again when he was seventeen. He was shy, and was not really sure who I was, or why I was so interested in examining all of his scars. I think he knew that I had something to do with the surgery he had had 10 years ago. He was attending school, and seemed to have the mannerisms one would expect of a typical 16 year old. I guess being considered a typical 16 year old is the best indicator of the life that Anius now has, and the life that he has to look forward to.

My greatest moments in my practice career have been those where I have been fortunate enough to be involved with someone like Anius. They are the ones that make this work worthwhile.

Dr. Kenneth Dickie

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