The 20-something girls in the plush waiting room have lots in common: long, blow-dried hair, impeccable nail art, full make-up and they are all clutching Grazia tear sheets of pictures of Angelina Jolie and Nicole Kidman.
While they wait to be called in, they chat and bond over their similar dreams. One wants “Angelina’s lips”, the other “Nicole’s nose”, yet another “Jennifer Aniston’s eyebrows”, and someone else tells everyone she won’t feel perfect until she has “breasts like Angelina Jolie’s in Tomb Raider”.
It feels like being at a modern-day tailor. Only, it’s not the suits that are getting adjusted, it’s the body: the tailor has been replaced by the cosmetic surgeon.
This is Malta 2012, where cosmetic surgery has become the order of the day. Over 600 cosmetic breast augmentation operations are estimated to take place on the island every year.
“Plastic surgery and cosmetic outpatient interventions have been unaffected by the world’s recession,” said Maria Bugeja, director at Saint James Hospital.
Over the past five years, cosmetic surgery in Malta had taken a gigantic leap forward, with patients coming from all walks of life, she said.
And the waiting lists are getting longer. There are only three Maltese registered plastic surgeons in Malta, supplemented by a number of specialists who perform cosmetic-related work such as ENT surgeons.
The two plastic surgeons who operate at Saint James Hospital are working at full capacity, and according to Ms Bugeja they cannot accommodate more clients in any one week.
600
The estimated number of yearly breast augmentation operations
Cosmetic surgery has come a long way since it was introduced in Malta over 30 years ago. Today, for purely aesthetic reasons, people are willing to undergo risky major interventions like abdominoplasty or, in modern day parlance, tummy tucks.
Both Saint James Hospital and Cosmetica Plastic Surgery Clinic at St Anne’s, concur that rhinoplasty – nose correction – is the most popular cosmetic surgery in Malta.
Maltese men and women seem to think nothing of having a long syringe inserted up their nose, having their nostrils sliced away and their nose hooked up around the forehead, so that the surgeon slices the cartilage and chips away at the bone. This is what having a nose job entails – at costs starting from around €2,000.
Topping the surgery popularity list for Maltese women is the breast augmentation operation. Although Saint James and Cosmetica would not release statistics, consultant plastic surgeon Joseph Briffa told The Sunday Times he performs four or more breast augmentation operations per week.
These figures exclude breast restructuring operations, which normally take place after illnesses or accidents. Saint James Hospital said the demand for breast jobs had doubled over the past three years.
It is estimated that the three plastic surgeons carry out at least 12 operations per week, which means nearly two Maltese women are going under the knife daily to enlarge their breasts.
Prices for the surgery vary according to the needs and demands of the individual, but normally start at €3,000. The recent PIP scandal (which brought to light implants made of an unauthorised silicone with a higher rapture rate) put some people off; although clients are querying the products used and seeking reassurance.
Larger breast sizes are mostly popular with women in their 20s, but ages vary from 18 to 60, said Mr Briffa. Interventions classified as major operations are normally sought by the 45-plus age group.
“It is company policy that patients have to be over 18 years to be eligible to undergo plastic surgery at our hospitals,” said Ms Bugeja, adding that they do make exceptions in case of children who are bullied at school due to a bat ears, for example.
Cosmetic surgery is definitely more popular with women, with women outnumbering men by 9:1.
However, Maltese men are becoming keener on surgery, with hair transplants being the most popular among men, followed by nose jobs.
“The number of men resorting to laser hair removal is also on the rise,” said Ms Bugeja.
Some cosmetic operations have a seasonal appeal. Come summer, more Maltese men are starting to resort to gynaecomastia – male breast reduction. Just before summer, women tend to resort to tummy tucks and liposuctions, he said.
Plastic surgeons are often presented with requests for multiple procedures, claiming they have “seen it done on television”.
“We have to take into consideration that television programmes are edited and every individual has medical problems which we have to address,” said Mr Briffa.
There have been cases where he turned down clients: “If someone is excessively obsessed with body image, then the probability is they will never be happy with the result of the procedure,” he said.
Cosmetica’s consultant plastic surgeon, Raymond DeBono, stressed the importance of the timing of opting for cosmetic surgery: “Avoid taking decisions during difficult times, such as during a relationship breakdown.”
He said it is important for potential patients to be more aware of the risks and complication of various procedures.
“People are becoming more concerned about risks because of either previous experience or stories they hear. Dissatisfaction after cosmetic surgery is unfortunately downplayed in Malta,” said Mr Debono.
Mr Briffa added: “We are talking of living tissues here and not a case of photo-shopping.”
Breast augmentation surgery is painful. “The recovery period is at least six weeks and there are risks of bleeding and infections, although the chances of these happening are less than one per cent,” he said.
There is no doubt that the increase in interest in cosmetic surgery is related to media influence. What do plastic surgeons do when faced with a 20-something girl with cuttings of Angelina Jolie in her hand?
“It’s not a good idea. The best candidates are not those who come in with cuttings of celebrities, but those who tell you specifically what it is that they don’t like about their body part,” said Mr Briffa.
They should be blown-up in a poster and plastered all over the waiting room wall.
Rhinoplasty
Peter Zarb*, 31, IT administrator
Peter was always conscious of his arched nose, which he says, he inherited from his mother’s side of the family. “My mother was, in fact, one of the very first ones in Malta to have a nose job. I was 12 when she did hers, and from then on I was always asking myself if I should go for it too.”
The shape of his nose was detrimental even to his breathing. One of his nostrils was always completely blocked and he suffered from acute sinusitis.
He took the plunge when he was 26. “The ENT specialist immediately said to me: If you come here and you tell me ‘I want a nose like Brad Pitt’ I will show you the door, because psychologically you will be disappointed – I can never make you look like Brad Pitt’.”
Instead he informed him how he was going to straighten out the arch and lift up the tip of his nose which was causing the breathing problems.
After the operation Peter spent three weeks at home. “When I took off my gauze, I was almost nauseous with anxiety: you never know how it’s going to look. You’re still bruised and have a swollen lip.”
After six weeks he started seeing the difference and his confidence shot up. “It changed me completely and even my breathing is 100 per cent on both sides now.”
His only regret is that he didn’t do it before, adding it would have spared him being bullied at school. He threw away all his old photos and is adamant that if his children inherit his nose he would do it for them at the earliest age possible.
“If you can improve why not do it? You have to be aware of the risks involved and always look at improving yourself but not wanting to look like other people.”
* Name has been changed.
Breast enlargement
Claudia Faniello, 23, Singer
Ms Faniello had wanted to increase the size of her breasts since she was 14, admitting she was always obsessed with image.
Over the years she did her research well. “I always watched Dr 90210 and knew lots of people who underwent the operation. I knew exactly what I wanted – I never liked exaggerations or the fake plastic look.”
When she went to the plastic surgeon in September 2010 she told him: “Make them the biggest you can as I don’t want to come back. €3,000 is quite an expense so I wanted to get them right first time round,” she said.
Since she’s had the operation, she feels more confident and more “feminine”.
Despite the discomfort during the recovery period she is very happy with the result and has absolutely no regrets.
“I went from an AA cup to a C cup. I didn’t even have a cleavage and now look at this – I love it. I have to try to be careful what to wear so as not to look vulgar,” she said.
Ms Faniello is her own biggest critic and went through a difficult phase some years back when she suffered from bulimia.
People should make sure they are not resorting to surgery to hide other problems: “If you are unhappy on the inside no amount of cosmetic surgery will make you happy.”
The singer has been open about the operation from the beginning: “I think it’s ridiculous to pretend you didn’t have any work done.”
The only disadvantage now is that men are no longer talking to her face but to her breasts.
“A friend had warned me this would happen. I don’t mind but I don’t want people to just see a pair of boobs, I want them to see Claudia the singer,” she laughed.