Dubai: Patients’ expectations — often unrealistic — drove demand for aesthetic procedures in 2014 but they also raised Dubai doctors’ concerns on the procedures not really addressing the patients’ underlying concerns.

Some 10,000 new patients underwent weight-loss surgeries, invasive and non-invasive aesthetic procedures at the American Academy of Cosmetic Surgery Hospital at Dubai Healthcare City (DHCC) in 2014. Of these, UAE residents made up 72 per cent of the numbers while the remaining 28 per cent were medical tourists, mostly from Saudi Arabia.

DHCC officials noted an upward trend in procedures done in 2014 compared with 2013 in all the top five procedures in demand. Body shaping or contouring procedures topped the list, with liposuction taking the top spot with 51 per cent, up by almost 20 per cent in 2013.

Breast surgery rose to 18 per cent from 10.6 per cent, while abdominoplasty or tummy tuck increased a little at 8 per cent from 5 per cent. Cosmetic gynaecology and rhinoplasty or nose surgery also increased by 5 and 1 per cent, respectively.

With more and more residents and tourists paying to fix their appearance according to their liking, managing patient expectations is the biggest challenge, doctors find.

“It’s a tricky specialisation because the physician is trying to do the best for the patient but the patient has different expectations in mind. It’s not about an [urgent] need for a surgery today, mostly it’s about getting the surgery to improve the cosmetic appearance,” said Dr Ramadan Ebrahim Al Beloushi, Managing Director, Dubai Healthcare City Authority — Regulatory.

Skin issues such as ironing out wrinkles and improving skin elasticity, dealing with acne, post-acne, hyperpigmentation, among others, made up 60 per cent of the main concerns of medical tourists in 2014.

This explains why Botox tops the list of the most in-demand non-invasive aesthetic procedures for medical tourists at 47 per cent, followed by fillers at 27 per cent.

Dr Jeehan Abdul Qadir, Executive Chairperson, American Academy of Cosmetic Surgery Hospital at DHCC, said they make no promises to clients and give them realistic expectations. But it doesn’t always work out that way.

“[There are] patients coming to a clinic saying ‘I want to look like Jennifer Lopez’. Some patients’ expectations are such that they are in their 50s but they expect to look 20, 25, or they expect to look like someone else [after the procedure],” Dr Jeehan said.

Dr Jeehan said she could not specify how often these cases happen. But she cautioned that if left unchecked, patients can develop addictions to ‘beautifying’ himself or herself that could lead to serious problems.

“There are patients who are addicted to cosmetic surgery. So it is the doctor’s role to tell the patients to stop. And we do tell them. But, unfortunately, they shop for procedures somewhere else in Thailand, in the Philippines, in Lebanon, and sometimes they come back to the clinic with bigger problems. And correcting these problems is very difficult sometimes,” Dr Jeehan said.

Dr Ramadan said most of the complaints they received in 2014 were from people who have had multiple surgeries. The issue deals mostly with patient expectations and failure to achieve those expectations. DHCC received 26 complaints last year, out of which four progressed to a case. Two have been closed due to another ‘failed expectation case’. The physician was cleared. The remaining two cases are still ongoing.

The problem, though not common, boils down to perception. In some cases, this is a symptom of an underlying psychological concern.

Dr Gabi Wazz, Medical Director at the Obesity Surgery Centre at Dr Sulaiman Habib Hospital at DHCC, has performed weight-loss surgeries for 900 patients out of the 3,600 patients operated on in Dubai for the past three years. Three out of every four patients he operated on were UAE nationals. “Obesity surgery is a purely medical surgery but many patients come seeking aesthetic results. They don’t care if they have hypertension, they don’t care if they have diabetes, [they just want to do the procedure],” Dr Wazz said. “We have strict guidelines. We don’t just operate on people who demand that.”

All three doctors agreed that psychological evaluation of the client requiring treatment is crucial before the procedures begin so as to provide a holistic service to the client.