A patient doctor Cosmetic surgery

DR BUTHAINAH Al-Shunnar’s clinic in Jumeirah is tastefully decorated and exudes serenity. It reflects her personality.I have done it up myself,” she informs. “I love doing things.”

That is an understatement. Dr Al-Shunnar handles everything from botox injections to breast reconstructive surgery for cancer patients. She does tummy tucks, reconstructive hand surgery, and can put a youthful smile on your face or take a frown off it.

After an impressive academic and professional track record in Ireland and the US, she returned to her native land, the UAE, and practised in Abu Dhabi for two years, and has since established her own clinic in Dubai.

She carries her scholarship lightly on her shoulders. “Don’t take yourself too seriously,” is the dictum she follows.

This is a very unusual field for a national woman. What prompted you to become a plastic surgeon?

I come from a family of doctors. My parents are doctors. My mother is a gynaecologist. My sister — who is also a doctor — and I grew up helping my mom with deliveries — cutting the cord and such things. We grew up with the idea that we wanted to be doctors.

I wasn't sure what speciality I wanted until I went to medical school. I always liked to work with my hands. I like to paint and sketch. And I like to see visual results — the difference.

During rotation in plastic surgery, the first day there, it just felt like home, and I knew no matter how long it took, that's what I wanted to do. And it took 16 years abroad — education, training and practice.

Didn't it take a toll on your patience?

Actually it trains you to be more patient. I found that the pressures you have to be under — the training and the stress teaches you to be more patient.

What is your area of specialisation in plastic surgery?

Plastic surgery is a very wide field. It encompasses a lot of things. I do general plastic surgery. I also do general cosmetic and reconstructive surgery. I do microsurgery and hand surgery, hand trauma specifically.

I treat facial fractures and I do muscle flaps. I'm very passionate about breast reconstruction — after breast cancer. That's one of my subspecialities. It encompasses the cosmetic aspect, the emotional aspect and it involves microsurgery and makes a significant difference to the patient's life.

My job entails various things. People generally equate plastic surgery with cosmetic surgery, but that is actually a very small percentage of plastic surgery. Yes, I do body contouring, breast enhancement, facelifts, nose jobs etc. So it’s a huge field. That is why it takes so long to train.

So one day is not like another. One hour is not like another. It is very exciting and challenging.

Which hospitals are you connected with?

I have an outpatient clinic here in Jumeirah at Al Shunnar Plastic Surgery, where I do only minor procedures. All my major procedures are done either at Emirates Hospital or American Hospital. I’m also associated with the Wellcare hospital. I operate two full days a week. I operate at the different hospitals doing both cosmetic and reconstructive cases.

Plastic surgery is considered shallow and superficial. Do you think it is vain to want to look good and that people are ready to go under the knife for it?

I guess plastic surgery is looked down upon. I think it becomes shallow when it becomes obsessive — when they think they have to look a certain way or others won’t like them.

It is all about confidence. If you are confident about the way you look, fine. But if a specific thing about your look bothers you to the point of hindering you, then I don’t see any problem fixing it. You could make a huge difference to a person’s life with a simple procedure.

A patient came to me with a permanent frown on his forehead. He was a happy person, but everyone thought he was always angry. It affected his life. He found it difficult to keep his job because people thought he had an attitude. A simple procedure changed his life. Is this shallow? Is it cosmetic? Is it vanity? I don’t know.

It means there is a very thin line that separates vanity and self-confidence.

Yes. I want to say something for cosmetic surgery. To me it is very diverse. You could have a woman, for example, with five children. You do a tummy tuck for her and transform her. And it saves her marriage sometimes.

Cosmetic surgery is not like getting your gall bladder removed. There is no “Have to” to it. But then, if it improves your life, then why not?

I have learnt to look beyond wrinkles. It becomes second nature.

Are you happy with the way you look?

There’s a saying in Arabic: the door of a carpenter’s house is never fixed. I guess I don’t bother about it.

Have you ever come across typical attitudes and prejudices because you are a UAE national?

Believe it or not, no. I’m quite surprised myself. When I came back from the States to practise here, I assumed that I would encounter the usual prejudices. But fortunately, I have had a very positive response from patients, colleagues. And Emaratis have been very supportive and feel proud of me. Elderly nationals whom one would expect to be conservative, have often told me that they are very proud of my achievements because I’m like their daughter.

What about expatriate patients?

Even expatriate patients have been really supportive. I expected them to go to other doctors, but they have been very accepting. I guess my qualifications speak for me. At the end of the day, it doesn't matter where you are from. What matters is your qualifications and your work ethics. That's what comes across.

Did it take time for you to prove yourself?

It takes time to prove yourself no matter where you are. Whether I am an Emarati in the Emirates or an American in the States, how you work and the results you produce matter. Ultimately results speak.

Did you face prejudice in the West because you were from the Middle East?

Again, I was surprised. It is extremely difficult to be accepted into Johns Hopkins. It is one of the best hospitals in medicine in the States. To accept a foreigner like me is almost zero per cent. So I have to be very thankful to them.

I have to say one thing for the American system. They are very fair. If you work hard and prove yourself, they will give you a chance.

What about patients? Did they readily accept you?

I never had a problem. I worked in private practice for three years, and I was in the trauma centre. I never had a patient tell me, "I don't want you to operate on me."

It all depends upon how you present yourself. Patients can sense hesitation. They can also sense confidence. I think this is true for any field. Your confidence will be transmitted to your patients.

Especially with the media now, plastic surgery is under the scanner because it has become popular. The reality of it is, anything in medicine has complications. If you are very honest with your patients and spend more time with them and explain the positive as well as the negative aspects, they will accept you. I believe in staying connected Prejudice need not always be overt. It can be subtle. Have you ever sensed it?

It is like building a house. You might connect with one contractor instead of another. You might connect better with someone from your own country, for example.

I don’t feel insecure. If a patient wants to go to someone else, I have no problems with that because it is also something to do with chemistry. If someone doesn’t want me to operate on them, it’s their choice.

Oftentimes, I have patients coming to me from other doctors as well.

What kind of support have you received from your family?

My family has been very supportive. We are a very big family full of doctors. We are very education-oriented. I left the country when I was 17. It was very, very difficult. No one ever made me feel guilty for being on my own or taking so long to train myself. I always knew that if I ever needed anything, I could always pick up the phone and call home.

You just learn to be independent and cope. When I first arrived in Baltimore, they showed us around the emergency room. I found out that all the windows were bulletproof because of the violence around.

Almost all my patients came because of gunshot wounds at the trauma centre. I knew that this was something I would have to adjust to.

In fact, I went to Johns Hopkins with the idea of doing a one-year position. But when I went there I realised I could learn a lot. So I worked really hard and applied for the four-year programme. And my family encouraged me.

What about support from the community to pursue this unusual career?

The community feels very proud of me. Dubai is just emerging, and Emaratis are just beginning to make a mark and there are so few doctors in my field, so the community is even more proud of me. No one, however conservative, has ever told me I should sit at home.

One thing about Dubai is that compared to the West, it may be conservative, but it is not judgemental. You are allowed to do what you want to.

Why did you decide to come back?

I wanted to be with my family. And it’s home.

Do you miss the US and the freedom?

Yes and no. I spent my youth in the US. I miss my colleagues and the work environment. I feel free here too. And it’s nice to be back home.

What about culture shock and reverse culture shock?

Yes, I did experience culture shock when I went to the States. You carry a set of values with you. But I learnt to be comfortable in the West. Once you go through culture shock, you learn to be comfortable anywhere. You begin to identify how to adapt.

And when I came back, I had to adapt back to this life. There was a big difference between the UAE I had left and the one I came back to. The changes are both positive and negative. The skyline has changed and things are more exciting. But things were more cohesive earlier. Families met more often. Now everyone is busy with their own lives.

Do you feel bad that the UAE nationals are in a minority in your country, especially in the work place?

You see, things will take time. This is an emerging society. What we have now is the fruit of the past. It will take time for it to reach its potential. Look at Vice-President and Prime Minister of the UAE and Ruler of Dubai His Highness Shaikh Mohammed bin Rashid Al Maktoum’s daughter. She has won a medal in martial arts. He is not only pushing his own children to succeed, but also the entire nation. We have the support of the rulers. What more can we ask for?

How is it to work with expatriates?

I’m used to it. I lived in the States for 10 years. So I’m used to working with foreigners. In fact, you should ask me what it is like to work with Arabs.

I think bonding is person-dependent, not necessarily nationality-dependent. You could have an American who is friendly, and another one who has a chip on their shoulder.

How do you feel when you see expatriates dominating the scene?

I have mixed feelings. I have to translate that experience with my experience in the States. I was an expatriate there, and I was given a fair chance like everybody else.

My philosophy is, you should be valued on the basis of your work ethics and your educational background and how hard and sincerely you work.

Having said that, I have mixed feelings when any culture takes advantage of their rights, to the point of not necessarily working as hard as they can because they can get away with it. This applies to nationals too.

If people are hired based on their merit, I don’t have a problem with that. But if they are hired because they belong to a particular community, then it is bad. But this happens in a multicultural society. Everybody will only to hire their own, regardless of merit. This encourages a clannish attitude — a mafia-like environment. That’s when I see a problem.

What is your advice to Emarati women?

Work hard and follow your dreams. It’s yours if you want it.

Medically speaking …

Dr Al-Shunnar answers questions on topics many of us are curious about

Could you explain microsurgery?

Microsurgery involves the microscope and usually involves reconnecting very, very small vessels and very, very small nerves, which the naked eye cannot put together. Here you really need about 200 to 400 times the magnification to delicately bring the blood vessels and nerves together.

Is it usually post-trauma?

Well, it is a tool that can be used in many different avenues. It can be used in trauma, for example, someone cuts their finger — the nerve in the finger. You can bring them back together. And if someone cuts their finger off, you can put that back by reconnecting everything together by using a microscope.

It can also be used in breast cancer reconstruction wherein we can make a new breast — recreate the breast using microsurgery to vascularise the new breast.

How is a new breast recreated or reconstructed?

In many different ways, depending on the patient's body, emotional status.... For breast cancer reconstruction you can either use an implant or a person's own tissue or a combination of the two.

Do you get a lot of such patients here?

In fact, quite a few. I think it is because that was one of my trainings of speciality and also because I am a woman. So a lot of female patients come to me for that. They feel closer home.

What about cosmetic surgery?

You know the usual cosmetic surgery — nose jobs, facelifts, breast job, body contouring — all that encompasses general plastic surgery.

Typically how much would these cost?

They vary very significantly. It also depends upon how many procedures we do. Facelifts can be more expensive than tummy tucks as they involve that much more expertise.

How many days does it take for post-surgery recovery for a facelift?

The difference between the face and a tummy tuck is that the face is exposed to the public. It has bruises, it has to be covered. Usually it takes 10 days. The patient is discharged the next day, but in terms of going out in the public, it takes about 10 days.

How long does the procedure take?

Again, it varies on the type of facelift, whether it's the face alone or the forehead, chin, neck…. It depends upon which part. But it can take up to four hours.

Is it very popular here?

I think it's popular everywhere. And it is kind of seasonal. During summer and Christmas times everything becomes an emergency — everyone wants to look good.

We hear about lunchtime or weekend facelifts. Can someone just walk in and get it done?

I'd be very careful about the media regarding this. It's very important not to give a false impression about this — that it is an easy way out. Because usually, the easy way out is not necessarily the answer.

Things like botoxes and fillers and certain types of peel can be done in a lunchtime or weekend break. They are minimally invasive, yet they make a significant difference to a person.

But lunchtime facelifts often don't last. So, you have got to be very careful. Even if it is for a particular occasion, you have got to pick your patients very, very carefully. You have to match the expectations with the amount of energy and money you are going to invest in it, as they don't last. And everybody's definition of expensive is different. For botox it is anywhere between Dh1,500 and Dh3,000, including the materials. There is no standard package.

Formidable credentials

Dr BUTHAINAH AL-SHUNNAR specialises in breast surgery, body contouring, aesthetic facial surgery, hand surgery, cancer reconstruction and microsurgery.

She is a fellow of the American College of Surgeons and a member of the American Society of Plastic Surgeons. She is also a member of the Johns Hopkins Medical and Surgical Association.

After graduating from medical college with honours from the Royal College of Surgeons in Dublin, Ireland in 1991, Dr Al-Shunnar received her five years of general surgery training at the prestigious Johns Hopkins University Hospital in Baltimore and George Washington University Hospital in Washington DC, where she was elected to the Alpha Omega Alpha national medical honour society. She then completed her plastic surgery training at the Johns Hopkins Hospital. She went on to work for three years in York, Pennsylvania, as Consultant Plastic Surgeon in private practice, also covering a major trauma centre for its reconstructive needs.

source: www.khaleejtimes.com