Plastic looks good even in downturn

The plastic business thrives despite the economic downturn, as people use the downtime to improve their looks. Cosmetic surgeon Martin Huang bares his secrets to our senior correspondent.

It is almost 10 pm on Friday when Dr Martin Huang puts away his scalpel at the close of yet another long workday. Plastic surgeon to Singapore's TV stars, tai tais and corporate titans, the 41-year-old is knackered, but thanks to a combination of his own skin-rejuvenation treatments, genes and a low-carbohydrate diet, he still looks a good 10 years younger than his age. The suave surgeon with the cropped and gelled top is perhaps his own best advertisement.

One of about 20 plastic surgeons in town, half of them in private practice, he has made a name for himself for being exclusive, expensive and using cutting edge surgical techniques. Prompted by the framed awards on the walls of his clinic at the Paragon building in Orchard Road, his patients often ask the fresh-faced doctor: 'So, how old are you?' And the most common queries he gets at social functions are 'Have you treated any celebrities?' and 'Are you affected by the economic downturn?' 
To the first, his grinning answer is 'No comment'. To the second, he says his business has actually doubled recently. He reckons a lot of people are in between jobs and using the downtime to get stuff - such as endoscopic browlifts or nose jobs - done.

'The rich will be rich no matter what. As for the others, in their hierarchy of needs, looking good is still very important: they will forgo vacations and other luxuries in favour of cosmetic surgery.' He refuses to divulge names, but says his patients include show business celebrities, chief executive officers, high-society types, politicians and 'quite a number' of gay men.

Clients span the gamut - from 'filthy-rich' board members to working executives on a budget to students who save up for double eyelids, breast enlargement and acne-related treatment. For those who seek discretion, there is even a private waiting room.

Do his patients come with magazine clippings of stars or just general descriptions of the chiselled looks they would like? Not really, he says, the vast majority of people who saunter in are 'reasonable, stable and realistic people'. The most popular requests are for eyelid surgery, bigger breasts and liposuction. 
Does he make it a policy to tell them upfront if they are asking for the moon, and how does he do it? 'You just tell them that you're not God or a magician and that there are limitations to what you can do. There is a fair amount of psychological counselling that's involved.'

But so far, there has only been one patient he ever felt needed a head examination - a man who insisted his head was too small and wanted it enlarged. Technically, the job could be done - by making a cut across the patient's head, peeling the scalp down and using bone cement to build on the skull. But he refused to do it because such a major cranial-facial operation involved multiple risks. Also, in his opinion, the man's head, though a tad small, was within the normal size range.

He also draws the line at operating on the sexual organs of transsexuals, except for their breasts. 'I have a personal aversion to mutilating the genitals. It turns me off,' he explains with some distaste.

SLOB TO SURGEON

For the bulk of his growing-up years, he was 'fat, ugly and utterly miserable', not unlike the overweight boy in the Singaporean movie, I Not Stupid, he says. When he was in Primary 2, his parents, following the lead of then Prime Minister Lee Kuan Yew, transferred him from Anglo-Chinese School to Catholic High School to help him be more efficiently bilingual. 'It was a pretty oppressive environment. In the 1970s, Chinese schools were very nationalistic,' he recalls. He remained there till Secondary 4, arguing with his teachers, skipping classes, behaving like a juvenile delinquent and chafing at the regimented reins, especially after having experienced a more liberal school environment in Cambridge, England, at age 14. His father, Dr H. H. Huang, a former chemistry professor and deputy vice-chancellor of the National University of Singapore, was on a year-long sabbatical and the family tagged along.

Today, both his father and his mother, a former principal of Tanjong Katong Girls' School, are retired. He has a younger brother who works as a radiologist in Glasgow and a younger sister who runs a hotel in Canada.

While serving national service, the strong-minded 'individualist' decided to become a doctor 'for all the wrong reasons' - because securing a Public Service Commission Local Merit Scholarship to study medicine was the only way to get out of the army. So, he junked previous plans to study chemistry at London's Imperial College, applied for the scholarship, got it and escaped to medical school. He muddled through his medical examinations unremarkably until in his final year, when he set his heart on pursuing general surgery as a career. But it proved to be a mistaken hunch.

After serving national service as a medical officer for two years and spending another two years in surgical training, he realised he would be a 'misfit' in general surgery because the part of the operation he enjoyed most of all was stitching up the skin. 'All the important stuff that went on inside the abdomen or whatever, I found quite boring,' he confesses. So, he jumped ship to the plastic surgery department in 1990 and embarked on another four years of training at Singapore General Hospital (SGH).

In 1994, not wanting to waste any more time, he figured that the fastest way to 'rise to prominence' as a young specialist was to do ground-breaking research on the cleft lip and cleft palate, common birth defects in Singapore afflicting one in 570 live births. Forsaking his social life, he spent nights and weekends dissecting the heads of unclaimed bodies at the SGH mortuary and studying the anatomy of the palate. The next two years also saw him doing research and undergoing training in the United States at the University of Michigan, the Children's Hospital and Medical Centre and the University of Washington in Seattle, and the Scottish Rite Children's Medical Centre in Atlanta. He calls it a case of being at the right place at the right time.

In the early 1990s, the US had an epidemic of babies seemingly born with flattened skulls. But the world-famous cranio-facial surgeon he was working under in Seattle, Dr Joseph Gruss, suspected that this 'birth defect' was really a consequence of a nationwide campaign that encouraged parents to lay their infants to sleep supine so that they would not suffocate. As a result of this sleeping position, the side of the head which the babies kept sleeping on got flat. Thinking it was a birth defect, many anxious parents sent their newborns to neurosurgeons to be operated on. Actually all they needed to do was to change the baby's sleeping positions more often. Because the skull bones of newborns are soft and malleable, the shape of their heads would normalise.

After analysing the clinical data, he and Dr Gruss concluded that the babies were getting unnecessary surgery. It became a huge controversy. They went around the US presenting their findings at conferences and giving interviews to all the major American news networks.

In 1996, Dr Huang returned to Singapore and SGH's plastic-surgery unit, after having published several landmark papers on cleft palate and cranio-facial surgery and bagging the American Society of Maxillofacial Surgery Award that year. Two years later, deciding that restructured hospitals were not really set up for the 'personalised and high-end' cosmetic practice he had in mind, he took off to set up his own clinic at Wisma Atria. In late 2000, he joined a few friends to set up a multi-disciplinary specialist group practice at Paragon.

BUSINESS OF BEAUTY

Has the perception that plastic surgery is frivolous compared to other serious, life-saving medical disciplines ever bothered him? Not at all, says Dr Huang, who estimates that 90 per cent of his work is cosmetic and only 10 per cent is reconstructive. 'To be honest, people no longer have that perception. More and more, men and women are beginning to appreciate the value of cosmetic surgery. They don't trivialise it any more. They want it. It's different now,' he says.

Buying beauty with Botox and other anti-ageing surgery is such a lucrative business that the medical field is seeing a lot of 'crossover artistes' these days, he adds. As cosmetic surgery becomes less invasive and more popular, many general practitioners, gynaecologists and general surgeons are also getting into the act. 'It's not hard to figure out what their motives are. It's all economic,' he declares. With so many non-plastic surgeons and non-dermatologists clamouring for business, plastic surgery has become a 'consumer-driven retail business'.

'We are doctors but the patients come to us like they are customers and we are retailers. They shop around, looking for the best deal. So, the challenge is to deal with the pressures of being a retailer, yet be professional and resist the temptation to cut deals.' Often, he finds himself having to be the voice of caution when customers act like children in a candy store in his clinic. 'It's like online shopping, patients keep adding things to the cart because one thing leads to another. There's the temptation to just pile it on and take them to the checkout counter and present them with a big bill. But you have to be responsible. If you really think that the patient doesn't need this now, you've got to tell them instead of just taking all their money,' he says.

What is his vision of beauty, as he has seen countless plastic-perfect women pass through his doors? Ironically, he says his own ideal conflicts with his chosen craft. 'True beauty is never perfect. It's almost a precondition to have some imperfection. I can create beautiful features and contours but true beauty comes from within. It's a cliche but it's true.'

He is married to Patricia, 34, a former model and air stewardess with Singapore Airlines, who is now pregnant with their first child. He winds down from his 14-hour, six-day work week by spending time with her and their Jack Russell terrier in their Coronation Road condominium. But the Porsche-driving surgeon has no plans to slow down. 'I'm quite a driven person and a perfectionist by nature,' he says almost regretfully. 'That's the reason why cosmetic surgery will never be boring for me - you're always trying to achieve perfection and it's not achievable.'

COSMETIC SURGERY: Costs involved

The three most common cosmetic procedures people see Dr Martin Huang for are eyelid surgery, breast augmentation and liposuction. A wide range of prices is charged.

Eyelid surgery: Stitching on an extra eyelid to those not blessed with double eyelids costs the least among various eyelid surgery types. It can range from $500 to $2,300, depending on where the surgery is done. Older people who wish to remove droopy skin around the eyes to achieve the same effect can expect to fork out between $1,000 and $6,000. Removing eye-bags under the eyes will cost between $800 and $5,000.

Breast augmentation: Two groups of women typically ask for silicone breast implants, which can cost from $4,000 to $10,000. The first are young women born with small breasts. The other group are mothers over 40 who have breastfed children and want to get rid of their breasts' saggy appearance. Liposuction: Currently, the most advanced technique is ultrasound-assisted liposuction. Its cost varies from $1,500 to $20,000, depending on where and how much fat there is and where the surgery is done. Ultrasound breaks down the unwanted fat and semi-liquefies it, making it easier to suck out.

It's like online shopping, patients keep adding things to the cart because one thing leads to another. There's the temptation to just pile it on and take them to the checkout counter and present them with a big bill. But you have to be responsible. If you really think that the patient doesn't need this now, you've got to tell them instead of just taking all their money.'
- Dr Huang, on patients who go overboard with requests.

Source: The Straits Times, 9 August 2002