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In this report, Amarachi Okeh explores the increasing prevalence of cosmetic surgeries among women in Nigeria. The report delves into the reasons driving this trend, sheds light on the associated health risks, and examines the societal impact of these procedures.

For Gazelle, a 28-year-old American woman living in Nigeria, cosmetic surgery brought her fame and fortune, but at a cost. After her surgery, her body changed dramatically, with fuller breasts, a flatter stomach, and more defined curves. These changes catapulted her into a new social stratosphere.

“I basically became a celebrity based on my body,” she recalls. “It was just rare to see such a perfectly shaped body. The hips, the stomach, the butt, the breasts and with my smile already as a pretty girl, they enhanced my personality, and my confidence took me places.

“I’ve travelled the world. People have invited me to exclusive events just because of my body. So, it upgraded my way of thinking, my lifestyle, my goals and the group of people that I desire to be around,” Gazelle said.

After her surgery, Gazelle’s body underwent significant changes. Her breast size became more proportionate, and her figure more defined, which she said helped her feel more comfortable in her appearance.

Her physical transformation often drew attention in public spaces, she said. However, before 2016, this level of confidence was a far cry from her reality. At 20, Gazelle loathed her body, feeling insecure about her lack of curves and sagging breasts.

“I didn’t have any hips, butt, and my breast at 20 years old was already sagging. I’d gotten an abortion at 16 after I gave away my virginity. So, my breasts began sagging and they were not proportioned or plump as they should at that age.”

Her self-esteem took a nosedive whenever she compared herself to other women. The insecurity was so overwhelming that, despite her fears of a botched surgery or death on the operating table, she decided to go under the knife.

After researching for a while, she travelled to Columbia from the United States of America, without informing her family, and paid $10,000 at a hospital to get a new body.

At the Colombian hospital, she underwent three surgeries: lipo 360, which involves the removal of fat from the entire midsection, breast reduction with implants, and lipo transfer, a procedure that removes fat from specific areas of the body.

The next time her family saw her, they were in awe of her transformed figure, she said. “As long as I had the best results, I was ready to endure any pain. It’s like sitting in a salon chair for 12 hours getting knotless braids.”

Gazelle’s road to recovery was painful, with excruciating post-surgery massages to aid healing. “Beauty is pain,” she said, justifying it.

After the surgery, the 28-year-old said she stayed for 20 days and got the compulsory lymphatic drainage massage.

“Every time the nurse put her hands on me, even if it was a light touch on my stomach, it was like beating my bruises. I was crying from the pain but I knew that I needed that massage because if I did not, my stomach would not be healed and flat.

“The more she massaged the bruises, the slimmer my waist became. I had to undergo the massage for almost a month but I didn’t recover immediately. My body was still sore for a year before I could officially walk around without wincing in pain,” she added.

According to Gazelle, her doctor told her surgery alone wouldn’t do it to maintain her new shape. She needed to keep working to maintain her new body. So, eating healthy, exercising and constantly wearing waist trainers became a part of her new lifestyle.

“Without those things, you can gain the fat back, but not where you got surgery but in the area that you didn’t get surgery. That’s the downside of getting surgery. If you do not work out, your stomach might stay flat, but your back will become large, your arms will grow fat, and your face will get swollen. The same thing too with the butts,” she said.

Fame, stigma, regret

While Gazelle initially relished the attention and opportunities her new body brought, she eventually found herself trapped by societal stigma.

She said, “Over time, I began to regret my decision due to the judgment I faced. Women who get their bodies done are often labeled as prostitutes and escorts and that they are doing it for attention and they’re getting the attention so they can make money and that’s not a problem.

“But if you are a good girl and you’re a corporate or a professional girl, you should be very mindful of making a decision that can ruin your reputation. Even men don’t take me seriously in relationships. They see my body and think I’m just in it for casual flings.

“The societal stigma against women who have enhanced their bodies is real. I wish I could do things differently. I would’ve never got my body done. I would’ve never got my breasts done. I would’ve just been working out and had a physically fit body. I do regret undergoing those surgeries. It’s not even worth it.”

Gazelle’s story highlights the paradox many women face. While cosmetic surgery can provide a confidence boost, it also opens them up to criticism and judgment, often leading to emotional and mental tolls.

BBL, new nose in search of love

A woman claim her quest for love drove her to work on her body. But two years later, she had yet to find true love.

“I used to be very slim and pretty but I have never had luck with men. Men don’t really stay with me. It is as if there’s something wrong with me or I was not good enough,” the anonymous woman on Tuesday poured her heart out to @diaryofanaijagirl, Ifedayo Agoro, an Instagram influencer, who shares people’s stories with her followers for their advice.

Continuing, the woman wrote, “So, I fell into the peer pressure of getting BBL surgery and I did my nose too. Two of my friends told me that’s what men are going for now and it would boost my confidence.

“After the surgery, I was really happy because the doctor did a great job, to be honest. I knew my life would change from then. When I healed and started posting, people gassed me up and I have received so many DMs.

“It was just an interesting time for me. It’s been two years since I had this surgery. I have become more unhappy. I have done everything. I have submitted, acted like a bitch, acted nice and even accepted some things I am ashamed to admit here. Ife, no man has stayed with me. Is it a curse? I attract them now but they don’t stay.”

The woman noted that she is perfect physically and only wants to be married and settle down but none of that had materialised despite undergoing a cosmetic body makeover to attract a man.

Changing standards of beauty

The entertainment industry has established a standard for feminine body types, portraying video vixens with large backsides, flat stomachs, and voluptuous breasts as the ideal representation of women in real life.

The influence of music videos may have also distorted women’s views of their bodies and beauty standards. Actresses, Instagram influencers, and reality TV stars have embraced this, putting pressure on some women to meet these standards. This is especially difficult for those who come from homes where they are not valued or are constantly teased due to physical imperfections.

Women now want more. More bosoms, more buttocks, more Coca-Cola-shaped bodies. But this has come at a cost for some people.

Aesthetic professionals often showcase their creative patient transformations on social media. However, it has been observed that the most common surgeries sought by Nigerian women are Brazilian butt enlargement, liposuction, and breast augmentation.

Dark side of cosmetic surgery

However, for some unfortunate patients, cosmetic surgery can result in botched, permanently disfigured bodies or even death when poorly done by unqualified aestheticians.

This captures Omotola Taiwo’s case. In December 2019 when she was 28 years old, Taiwo, a social media influencer, had two simple desires; to have a flat stomach and a larger backside.

After undergoing cosmetic surgery with the now-convicted aesthetician, Dr Anu Adepoju of Med Coutour, where she paid N1.2m for the two procedures, Taiwo left the bed with a botched body that sent her spiralling down the path of mental illness, financial emptiness and fear for her life.

In a July 2020 interview with BBC Pidgin, Taiwo narrated the horrendous journey that befell her after going under Adepoju’s knife.

Just two days after the surgery, she said she began battling recurring infections, and fat necrosis – a benign condition in which fat tissue in the breast or other organs is damaged by injury, surgery, or radiation therapy.

“After the surgery, I started having complications. I started having belly burns, waist burns, and waist numbness and after two months, I started getting fat necrosis. The liquid fat that has turned to dirt starts to come out like a boil. As I stand up like this, my body is not complete, one is bigger than the other,” she said.

Since the surgery, she had spent more in treating her damaged body than she had on the enhancement itself. Once Taiwo said she spent N435,000 for staying six days in a hospital to treat some of the complications.

The woman braved the consequences and took to social media to call out the doctor, but she was still met with condemnation.

“People abused and cursed me. Some even came to my dm to say this money millions wey you take go do this thing, you no fit give me make I go do business. They called me useless woman, some wished me death,” she said.

Responding to Taiwo’s allegations during the interview on BBC pidgin, Adepoju denied any wrong, adding that she was qualified and certified to carry out cosmetic surgery due to her MBBS degree and also the certificate courses she had undertaken.

The doctor also clarified that she was not a plastic surgeon, but just a cosmetic surgeon.

However, four years later in May, 2024, Adepoju was convicted for the death of one Nneka Onwuzuligbo, an ex-beauty queen, who died after developing complications while undergoing cosmetic surgery in 2019. Her facility was also sealed by the Federal Competition & Consumer Protection Commission in 2020 for violation of patient rights.

Recently, there was news of the death of a 36-year-old woman named Abiola. She had gone to undergo a butt enlargement procedure at an undisclosed aesthetic hospital in the Lekki area of Lagos state when she tragically passed away.

It was gathered that on arrival at the hospital, the clinic owner, one Idara Bassey, allegedly instructed a nurse to administer an injection to the woman but shortly after receiving the injection, Abiola began gasping for breath and lost consciousness.

To address the issue, the woman was rushed to another hospital in the area where she was confirmed dead. Following the death of the woman, the hospital owner, Bassey was declared to have been on the run by the state Police Public Relations Officer, Benjamin Hundeyin.

Body enhancement business

Cosmetic surgery, also known as aesthetic surgery, usually involves an operation or invasive medical procedure in which a person chooses to change their physical appearance for aesthetic reasons.

Data from the British Association of Aesthetic Plastic Surgeons and the American Society of Plastic Surgeons indicated that breast augmentation, liposuction, and fat transfer procedures are among the most sought-after surgeries globally.

Data by the UK’s British Association of Aesthetic Plastic Surgeons and the American of Plastic Surgeons disclosed that in 2022, the top 10 surgical procedures requested by men and women were: breast augmentation, breast reduction, abdominoplasty, liposuction, blepharoplasty (eyelid surgery), rhinoplasty, face/neck lift, fat transfer, breast implant removal, labiaplasty, otoplasty (ear correction), brachioplasty, browlift, thigh lift and lower body lift.

Women accounted for 93 per cent of all cosmetic procedures recorded in 2022 whereas the men accounted for just seven per cent.

As of 2022, the Global Cosmetic Surgery Market was valued at $45.50bn and is projected to exceed $59.45bn by 2030, Yahoo Finance reported.

Cosmetic surgeries improve quality of live – Surgeon

A plastic surgeon, Dr Olaniyi Majaro, clarified that only dermatologists and plastic and burns surgeons can perform aesthetic surgery in Nigeria.

Majaro said aesthetic surgery is not only about giving a person the kind of body they want, it restores confidence, improves quality of life and also prevents long-term health implications for some people with certain conditions.

“For example, a woman with gigantic breasts. If the woman does not do cosmetic surgery to reduce the size of the breast, some of them have shoulder pain, and fungal infection and some may develop back pain and some other problems.

“You can improve the person’s life when the surgery is done. One cannot say they are ungodly. Some people have facial wrinkles that make them look older than they are, if you do plastic surgery, called face lifting, in which the person looks younger, the psychological aspect of a person’s life will improve and the tendency for the person to live longer. So, it is because people don’t have a full understanding of the surgery that is why they are condemning it.”

He bemoaned that unqualified personnel are infiltrating the industry in Nigeria thus putting patients at risk, noting that if done correctly, complications should be rare occurrences.

“Plastic surgeons are the only ones qualified to do this,’” he warned. “Anyone who doesn’t know anatomy, biochemistry and physiology of the body system and is allowed to be doing all these things, will put a lot of patients in problems, that is why you see patients dying from cosmetic surgeries.”

He also urged people seeking such surgeries to be sure they are counselled on the disadvantages or complications that may arise from it and also explore legal options when complications arise.

Cosmetic surgery driven by low self-esteem

A certified clinical psychologist, Oluwakemi Akintoyese, said the trend of body enhancement for aesthetic purposes is driven by low self-esteem, self-confidence and value.

Akintoyese said, “For some people, it is a way of making themselves happy. It could be for an aesthetic reason for some people; for some people it is to create a personal narrative; for some people, they are trying to find themselves, in a way they are lost and looking for who they are and in answering the question of who they are, they tend to look at other people, imitate them to find themselves and so they would conform to that.”

Body enhancement offers a temporary solution but the real issues the patrons grapple with had not yet been dealt with and the void has remained.

A consultant psychiatrist at the Federal Neuro-Psychiatric Hospital, Yaba, Dr Dapo Adegbaju, also added that body dysmorphia could also be another issue fuelling the uptake of cosmetic body enhancements.

Body dysmorphic disorder or body dysmorphia is when someone has an obsessive focus on the way they look and is common in women, Adegbaju added.

“People exhibit signs of this condition when the thought of their body not being perfect is always there to the extent that it takes over practically the thinking of that person that no matter what other people are saying, the person does not think so. Such people usually have a negative attitude and they have low self-esteem.

“It is not until they satisfy their thinking that is when the obsession actually starts dwindling but research has shown that more often than not, such people are often not satisfied because there will be something they feel is not perfect so they keep on doing it over and over again,” Adegbaju said.

Quackery, standardisation issues

The founder and President of the Association of Practitioners of Spa and Medical Aesthetics of Nigeria, Dr Felix Avajah, explained that the two major issues bedevilling medical aesthetics in Nigeria are standardisation and quackery.

Avajah explained that aesthetics medicine is not taught in the Nigerian medical school system but with collaboration with various schools in Nigeria, the association introduced the course into some schools where people are trained and accredited as aesthetic doctors and nurses.

“No matter what you’ve studied, unless you’re a consultant in dermatology, consultant in plastic and burns in Nigeria, you have to go to school to study strictly aesthetics medicine,” Avajah said.

On the issue of quackery, Avajah observed that unqualified practitioners posing as aesthetic doctors and nurses pose a danger to patients hence, more collaborations with government and health agencies are necessary to sanitise the industry.

Just like in other areas of medicine, Avajah said there are different peIn June 2024, the Federal Government through the Ministry of Health pledged to regulate aesthetic healthcare practice in the country.

In a Guardian report, the Minister of State for Health, Dr Tuni Alausa, acknowledged that aesthetics is not just appearance but it is also intertwined with health and quality of life.