Dr Christopher Matwa checks his WhatsApp messages. Nothing yet. He has been waiting for photos of a client.
“After her recovery, she came here to say thank you. You should have seen her, happy as though she had won a jackpot. She was all over the place telling me, ‘Doc you don’t know what you did to me. I’m going to Coast, I will send you the bikini photos you see what you did,” he says.
Dr Matwa is talking about a Brazilian butt lift surgery that he just did on a Kenyan woman.
He is among the growing number of cosmetic doctors who are doing good business as Kenyans seek enhancements or reductions in the body parts that make them cringe when they look at themselves in the mirror.
At his Jalad Aesthetic Clinic in Nairobi, the doctor says, people walk in to request for breast reduction and addition, to lift sagging parts of their necks, tuck in their tummies or arms, or create eyebrows and beards for those who have no hair, among other body modifications you may not have heard of.
“This is just a clinic where we do consultancy and minor procedures, but for major surgeries, we have a well-equipped theatre, not here,” he says.
Among the people seeking surgeries or corrections are men looking to make their penises longer or wider. The numbers may be less compared to women getting newer, perkier boobs, but the men still come.
Dr Matwa sees penoplasty, the procedure of increasing the circumference and length of the male organ, as a business opportunity for the near future, as is the case with boob jobs now.
“It is a new concept in Kenya. There are not so many cases of penile enhancements, I can confess. This year I haven’t done one yet, last year I did two and both requested the length and the girth. Most of the time what many men want is to have a longer and bigger organ,” he tells Nation Lifestyle.
Medically speaking, he says, any length more than three centimetres is adequate for normal function. Anything below three centimetres can affect conception.
“But some men feel that is short and would need some upgrade. It’s in such scenarios that we see what can be done about it,” he says.
Dr David Kimani, a urologist at Kenyatta National Hospital argues that size is dependent on many things and unless one has a birth defect, enhancement is unnecessary.
“There is so much misleading information that makes people want to exaggerate what is not significant. Size is determined by genetics and body structure. Generally, bigger boys have a penis that doesn’t appear long compared to the others. This [size debate] has fuelled the reconstruction talk, in terms of lengthening. It is hyped by the media because of body shaming and things like that.
“But in reality, there is nothing to reconstruct. It could be that you have a buried penis that needs to be removed from a buried position. Maybe it’s an undescended testis that needs to be brought down or it’s a curved penis that needs straightening, or maybe it’s a urethra that’s opening at the wrong side that needs to be restored in the correct position.
“It’s never about altering what is normal to make it longer or shorter. The public should be discouraged because it doesn’t make sense,” he says.
Dr Kimani adds that what would warrant a penis procedure is if one has hypogonadism conditions which occur when the testicles produce little or no hormones. This is usually treated by hormone supplements.
But as men yearn for one or two inches more, some are willing to pay for the procedure that takes between one to three hours.
“When you look at the penis anatomy, there are different aspects to making it long. There are things we call suspensory ligaments, which is what we release because they hold the penis to the pubic bone. We then do incisions so that we release more skin from the pubic area to advance towards the shaft of the penis. When you do that kind of surgery, you elongate it to about four centimetres. This is what has been approved as a safe procedure,” Dr Matwa argues.
In simple terms, this particular surgery is a lot like slackening the supporting line to a tent pole. It is then re-attached to the pubic bone around one to two inches lower than before.
Crucially, this offers minimal improvement in erection size, enough to make someone happy.
Other procedures include putting implants in the penis.
“If a client wants implants to make it longer, then we have to discuss the risks and if they agree (by signed indemnity agreements) then we proceed,” he says.
For those who dislike the thinness, fat grafting is done.
“Fat grafting is where fat is picked from other parts of the body, mostly the abdomen, and we process it and transfer it to the penile shaft round and nicely,” he says.
A small amount of liposuction is done (where suction is used to remove fat from the lower abdomen), then the underside of the penis is sliced lengthways so the fat can be re-injected.
The doctor says fat between 20 millilitres to 100 millilitres is enough for the grafting procedure. To use a metaphor, the surgery is akin to inflating a bouncy castle and is where you can gain another one or two inches of extra girth.
During one of these procedures, Dr Matwa recounts one interesting case.
“A guy came with his wife and she was very specific on the areas she wanted enlarged. She wanted the corners of the glans area enhanced. She wanted it bigger as she was okay with the length,” he says.
Another method, according to Dr Pranav Pancholi, a cosmetic dermatologist at Avane Clinic in Nairobi, who says the procedures are becoming common, is the use of hyaluronic acid fillers.
“These are injected under the penile shaft and skin, it’s a minimally invasive procedure,” he says,
The most important aspect of any procedure is the post-operative care. Any slight misses in after-care can leave one with problems.
For instance, the newly injected fat must be massaged around the penis for anything between six to 12 weeks after the procedure. If one does not, they risk losing the Sh150,000 plus the clinical bill that they pay for the procedure.
“We never guarantee clients that they will be 100 per cent okay. There are possible outcomes and that’s why we discuss them first. For instance, when doctors transfer fats be it to the penis or butt, under normal circumstances, you will retain 50 to 70 percent of that fat and this is affected by several factors like one’s healing capabilities. Implants can work 100 per cent (giving you 100 percent desired results) but fat transfers 50 per cent,” he says.
For procedures that involve fat transfer, reduced minimum pressure on the area is highly recommended and this explains why butt lifts will have one struggling to sit for up to six weeks. For that entire period, you are advised to stand, kneel if you have to and lie with your back facing upwards.
“Remember, fats are also living tissues and after the transfer, blood vessels will grow into it to feed it, so we try to minimise pressure. This is why the client needs to follow instructions during the post-operative care stage,” he adds.
Dr Kimani argues that the fat transfer procedure is just like puffing.
“You can remove fat from one part and transfer it to another area of the body, this is done every other day. But the question is, why are you doing it? There is no guaranteed long-term result. Yes, aesthetically you will look nice but a few months down the line, perhaps not,” he says.
Children with birth defects
For guardians and parents who might be concerned about their children’s penises, Dr Kimani says, “If you have a baby boy child, ensure that you can palpate and feel the testis in the scrotum, both of them. Secondly, ensure the opening or the urinary path is at the tip of the penis.
If you see none of these or one scenario, then you need to see a certified doctor. That takes care of the very common undescended testis condition which affects about three per cent of newborn boys. It also takes care of a condition called hypospadias, a birth defect where a boy has an abnormal opening on the underside of the penis. This needs to be corrected between the ages of six months to six years before they become sexually aware.”
He adds, “A parent should also be concerned about the retractability of the penis where you are able to pull back and forth the foreskin. In some children, the opening of the foreskin tightens or retracts but can’t be moved back. That is another concern that might affect young boys.”
Another common penile condition in young boys is a webbed penis.
“The scrotal skin attaches at the root of the penis but sometimes you will find the skin of the scrotum attaching to the mid of the penis, giving a false impression that the penis is short. That can be surgically corrected,” he says.
But as debate on whether or not to go under the knife to add inches abounds, many are unaware of the risks, including the fact that one can develop irreversible necrosis.
“This means that when the tissue is dissected and implants put in, blood flow to that area may be reduced and the tissue dies,” says Dr Matwa.
There may also be reduced sensitivity, wobblier erections, penile leaking, blood clotting and infections.
Dr Kimani is wary of the mushrooming clinics and beauty parlours in the country, especially in Nairobi, some selling creams that promise to lengthen or shorten the penis.”
“Who regulates them? No one. Think of these places as herbalists or waganga wa kienyeji (traditional medicine men). But you see once a Kenyan has made up his or her mind about doing these cosmetic surgeries there is nothing we can do. Should something go wrong you have nowhere to report, not to the police or the medical board,” the urologist says.
He faults social media, saying that people are reading many deceiving articles without verifying the information.
“Believe me many are falling for it because many people are attracted to body enhancement, so they become an easy market to target,” he says.