He had his medical degree at the Ahmadu Bello University Zaria, did his postgraduate at the University College Hospital, Ibadan, where he trained for six years, qualifying as a plastic surgeon in 2002. Dr. Josiah Gana is a consultant plastic surgeon in Abuja. He tells Stanley Nkwazema the reasons women must go for breast cancer treatment and how cosmetic surgery rejuvanate women
Experience over the years
Since I came back, I have worked in both the public and private sectors but I must confess that it has been very challenging because the technology required and the level of practice I want to undertake is not possible within the public sector. This is why I am developing a facility within the private sector, where we have the technology, the environment that will provide people with the sort of care that will approximate what we have in the Western World.
We are trying to provide for Nigerians care that matches what they get internationally so that people donâ€™t have to travel. I practiced mostly plastic surgery which is my area of specialty and we have technology to do a lot of cosmetic surgery; like liposuction, fat transfer from one part of the body to another part, where it is needed. Liposuction is good for example for somebody who has lost weight but there are some areas of the body that are resistant to exercise and diet; liposuction can take care of such diet resistant fat. The fat can be transferred to another part of the body if the person wants; meaning we can redistribute fat in the body. We have the best in class machine for liposuction, from Moller Medicals, Germany. It is a tower with three machines.
We can also do breast surgery; breast reduction, enlargement and lift. There are some people whose breasts are very small, we can make it bigger. Some people have very large breast, causing back pain, shoulder pain and when you do the reduction the symptoms all disappear. Or may be some young girls growing up, can have differentials on the size of the breast; one breast bigger than the other. We can equate it and also reshape the breast. In some people, the size could be adequate but the shape is not, especially after child birth and breast feeding it could look saggy; breast lift is beneficial in this instance, making it look more youthful.
We can even contour the whole body and improve the shape. Generally, there is something we call Mommy Makeover. A number of women after having all the children they want are not happy with their body; through a combination of procedures we can restore the youthfulness of her body. Some of these procedures include tummy tuck to make the tummy flat and reshape the contour of the waist. Vagina tightening improves marriages. Some husbands are not happy because there is too much room there, we can actually make it tighter and more appropriate.Â So there is a sense, my work improves and save marriages and help people rediscover themselves again.
We also undertake other kinds of surgery on the face. We can improve the face and make it look younger. On the face, we have something we call fillers which we can use to treat wrinkles on the face to make it look younger. We can augment different parts of the face such as the chin, cheeks etc. Yes we can do facelift without formal surgery. There is a special product called Silhouette Soft. Without actually cutting we can use this product to lift the whole face or part of the face; the procedures takes about 40minutes.
Some men have what we call Gynaecomastia (men who have prominent breast). We can treat it through a pinhole procedure.
Licensed to do plastic surgery
I have been licensed; we can offer a lot of services that people donâ€™t need to travel. Everything is done here in Abuja and you donâ€™t need to go to London, United States, Spain etc. You can have the procedure and be happy about it. We can make you look very good here. When you travel to have a procedure, how do you do follow up? But if you have your procedure at home, follow up is easy; you are saved the distress and anxiety of travel for follow up.
Before the surgery or makeover
We donâ€™t just enrol people for a procedure; first of all, we ask them to come for consultation and complete evaluation to ensure the person is the right candidate and is medically fit. If the person is not then we advise accordingly. We check to see if the person has any strain like diabetes, hypertension, heart disease, asthma kidney disease. Mostly, the clients we get are people who are in a very good state of health; but we do blood test, cardiograms, x-rays, to check the person is fully fit for anesthesia and surgery. After some of the procedures, you can go home same day or after one night stay in hospital.
Cost of the procedure
I must tell you that our costs are very moderate. It is a lot cheaper than traveling. It is cheaper than Dubai, Europe, US and others. You are not talking of your flight tickets, hotel and other costs. Our fees are way cheaper or about 50 per cent cheaper.
Complications as part of surgery
Complications are part and parcel of the work we do in hospital; even paracetamol has side effects. However, our procedures are safer than a caesarean section. Complications are few and mostly wound related complications. We keep complications within accepted spectrum and have the requisite expertise to treat complications should any occur. We only do procedures for which we can manage the complications.
On both the surgery and anesthesia aspects, we have some of the best personnel in the country, personnel with exposure to technology and current practice standards. There are challenges in the public sector relating to work environment and technology. But in the private sector we have created the right environment and have state of the art technology.
I also perform reconstructive surgery. Reconstructive surgery is the surgery of repair or restoration of a body part. If any part of the body is not the way it ought to be, we can repair it and make it look better. For example if somebody is born with some birth defect, like the face is not what the normal face should look like, some kind of deformity in the face, we can repair it. A good example is cleft lips and palate. I have repaired hundreds of clefts. We can do other malformations of the face. We can do congenital abnormally of the hand and foot; such as when two fingers are joined together; also extra fingers or toes. We can also handle any machine injury to the hand or loss of body part in accident.
The issue of breast cancer is one very important item I want to mention here. We can reconstruct and make new breast after the breast has been removed for breast cancer. This is something we can do very safely. We are offering very special discount to women who had their breast removed and wants to have a new breast after breast surgery. We are offering them at least 70 per cent discount. We want to encourage women who had breast cancer to take advantage of breast reconstruction, as it improves the quality of life; it reduces the depression associated with breast cancer. A new breast that can equate with the other side can be made. Breast cancers doesnâ€™t have to be a death sentence; there are people who now live 20 â€“ 30 years after breast cancer surgery. The issue is early detection and early treatment. I want to encourage women who have been diagnosed with breast cancer to take early treatment. When you take early treatment, you increase your survival and quality of life. There are very effective treatments available for breast cancer. I am very passionate about the issue of breast cancer because, I think that we lose too many women in Nigeria to breast cancer and which ought not to be so. We want to see our mothers live long, to see their children and grandchildren.
Motivation for returning to Nigeria
First and foremost, I want to make a difference. I would have lived overseas and not come home. I believe I can contribute. I want to make medical care available and reduce medical tourism. In fact, we can make money out of medical tourism in this country. I have had patients from Ghana and Europe. I just returned from South Africa where I did a presentation on breast reconstruction in Nigeria; I was one of the speakers at the conference. This conference is breast Oncoplastic conference which holds annually in Johannesburg. I presented a well-received paper on the Nigerian perspective on breast reconstruction post mastectomy for breast cancer. I think people donâ€™t appreciate the fact that doctors in Nigeria have the experiences to share on complex diseases and surgery.
Recently the Presidentâ€™s son had an accident and was treated in a hospital in Abuja and that shows what the private sector can contribute to propelling our health care forward and this is the kind of thing I am trying to do here in plastic surgery; to offer care comparable to what you find in Europe and North America. It is the task I have set