“Tell me what you don’t like about yourself”. The two plastic surgeons of famous TV series Nip / Tuck open their meetings with their clients with this opener. This sentence is more and more heard in Vietnam as plastic surgery business is booming. As disposable income has greatly increased in cities, urban citizens are now taking care of their appearance, and not only with cosmetics, thus following the worldwide trend and fashion. But these services are not reserved for wealthy people: prices are indeed lower than anywhere in the region and it is affordable for many people in Vietnam, even for modest wages.
“Women want to be more feminine”
“Even a secretary can afford plastic surgery. Not only millionaires spouses cruising in Lexus cars”, explains Doctor Siegfried Franckhauser, a French plastic facial surgeon working in Ho Chi Minh City. “Lots of secretaries get a lifting at lunchtime, it’s quick – 20 minutes – and not too expensive, around 2 million dongs”. And it is the same for other operations. The most demanded operations concerns breast augmentation and nose job (flat nose enhancement). Unlike in South Korea and in China, there is not much demand for eyelid surgery. But another specific operation is maxilla (jaws) surgery. “I did not see such demand in other countries or in France. But here, there is quite a lot of demand for that operation. Some women find that their face is too masculine due to the shape of their jaws, which is too square according to them”, Dr Franckhauser says. “For that, the procedure is a bone resection of the maxilla angle. It makes the face rounder and more feminine”. But he faced new difficulties here with this procedure because Vietnamese skin will not heal properly, as it leaves a scar in most cases, due to their reaction to the medicine. Therefore, Dr Franckhauser had to innovate by operating internally, which means inside the mouth of the patients. “The scar is then invisible. If the operation was external as I usually do in France, it would leave a large scar under the jaws, near the ears. That is not a souvenir you want to leave to your patient!”.
”Women have models, doctors should have ethics”
What are the motivations? In previous years, Vietnamese women wanted plastic surgery to resemble a foreign actress or singer. Nowadays they refer to Vietnamese or Asian models. To sump-up, some Vietnamese women used to think that they would look prettier with a caucasian look (high nose, white skin, bigger breasts, rounder eyes). But more and more, they want to look prettier in an Asian way.
“Canon of beauty is different here than in the West. Sometimes I find it hard to operate a woman that I find lovely. Women have a small nose and I think that it is quite cute. In France, it is easy to discuss the legitimacy of an intervention because we would both have the same culture and canon of beauty. But here, I have to adapt. Sometimes I think that a client does not need a nose job while she asks for it”, Dr Franckhauser says. “It poses me metaphysical problems sometimes!”. Even if he admits to adapt to the local taste, there are still things he will not do. “I refused a client once. She wanted to remove a wrinkle under her eyes. She was only eighteen! I refused and tried to convince her not to do it as she was too young and it was clearly unnecessary”. But then, she might have got it done in another clinic…
The culture is somewhat different but what still remains is ethics. For Dr Franckhauser, you cannot do everything in this industry. There is a serious need for a legal frame in plastic surgery industry right now: it is said that there are 500 plastic surgeons in Vietnam but only 100 may have a degree (the Hanoi university of medicine delivers a diploma in plastic surgery). Others would just be doctors attracted by quick fortune of this booming market. In such situations, accidents and bad jobs are frequent. A woman had a nose job and a few days later a hole appeared at the end of her nose, near the nasals. When she went to the doctor, a plastic pipe, same as used in plumbing, was removed. The so–called surgeon placed it to “enhance” her nose… Clients trust doctors and they are still reluctant to go to court in case of mistake. As medicine is quite technical, they don’t feel they have the knowledge to demonstrate a doctor’s error. Doctors have an aura, a prestige, like teachers at school. You just don’t question their authority and expertise. So much so that surgeons do not even care to take an insurance in case of accidents, which could arrive during an operation. Unlike in the West, no one would sue them.
“The future is now”
Botox is arriving and it is already on every lips (so to speak !) of the jet set people. Where is it available? Where can I get some? Which doctor is doing a good Botox job ? Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. Doctors use it in small doses to treat health problems, including temporary removal of facial wrinkles, severe underarm sweating between others. Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves. The effects last about three to four months. Ohui, a Korean cosmetics company is advertising for their Botox product in Vietnamese magazines. As people can also see on internet and on TV, movie and pop stars have been using Botox for a long time already… and it is becoming the ultimate “show off”.
Even if people tell plastic surgeons what they want to change, they usually do not say the reasons behind. Plastic surgery has of course cultural aspects. As a result of economic development, obesity has also become a problem… as a consequence, liposuction’s demand is soaring. Liposuction is the process of removing excess fat from various areas of the body (tummy, buttocks, hips) via small, hollow instruments called cannulas. These instruments are introduced into the area of fat removal by tiny holes or incisions, generally no bigger than one quarter inch in diameter. Like in the West, liposuction has also become a “must” for women who want to stay in shape.
“Vietnam specials”
But sometimes, it is not for fashion or westernisation. People may resort to plastic surgery for traditional reasons! For example, fortune telling is quite present in Asian cultures. In Vietnam, people can give a lot of importance to the date and time of child’s birth. For this reason, many women call for caesarean operation, instead of a natural delivery. Doctors have nothing against it, especially when a caesarean operation is charged usd 500 while natural delivery is charged usd 100 ! An increasing number of these women then go to plastic surgery to remove the scars of the operation, as many times as they deliver babies…
Also, plastic surgery clients are in majority women. While there are 30% men in the West, the proportion in Vietnam is as low as 10%. In most cases, men go for rejuvenation operations. But in Vietnam, men would do so because they get married with a wife who is 20 or 30 years younger than them. Such a reason does not exist in the West yet…
Finally, one could think about plastic surgery as superficial and overly luxurious in a country like Vietnam. But plastic surgery is not only for aesthetic purpose. Reconstructive surgery is what gives sense to this profession. It helps people who suffered accident injuries or difformities to go on with their life, in a society attached to beauty and appearance. “I am specialised in facial surgeries. As I am currently the only one in Vietnam, I try to make myself helpful by operating children who have harelip, sometimes for free”, Dr Franckhauser says. In Vietnam according to Operation Smile, a US-based non-profit organisation which provides free surgeries for children with facial deformities, 1 in 500 babies are born with a facial deformity. Operation Smile Vietnam provides training, knowledge transfer, international cooperation and partnerships with local partners so that a greater number of children can be helped. “This reconstructive operation is quite simple. But it changes the whole life of the child and his family. It is very rewarding”. (Photo by Siegfried Franckhauser)
