Surgeons and medical body butt heads over butt lifts

An association representing plastic surgeons has raised concerns over general practitioners (GPs) performing cosmetic procedures such as the Brazilian butt lift (BBL) and liposuction, arguing that only specialists may do this work.

The Association of Plastic, Reconstructive and Aesthetic Surgeons of South Africa (Aprassa) responded to a recent Sunday Times article that highlighted how increasing numbers of black women in South Africa are getting BBLs.

Dr Pertunia Mathibe, a GP and founder of the Centre for Body Sculpting in Pretoria, which is popular for BBLs and liposuction, was interviewed about her practice.

However, in response, Aprassa alleged that Mathibe, popularly known as Dr Pert, is not authorised to do BBLs, and that she is in breach of rule 21 of the Health Professions Council of South Africa (HPCSA), which stipulates who is allowed to conduct cosmetic procedures.

“She is a GP and as such is not allowed to perform cosmetic surgery operations such as liposuction and [the] Brazilian butt lift,” said Aprassa president Dr Craig Wittstock.

Injecting fat into the buttocks, which is how a BBL is done, could be a dangerous and even fatal procedure, he said. “It is widely regarded as the procedure with the highest mortality rate among cosmetic surgeries.”

However, HPCSA spokesperson Priscilla Sekhonyana said all practitioners who have received the appropriate training are allowed to perform BBLs and liposuction.

“Cosmetic medicine, or nonsurgical cosmetic procedures, may be performed by any practitioner registered with the HPCSA, including GPs and dentists, provided that, if they perform cosmetic medicine procedures which result in permanent anatomical and/or physiological changes, they [are] appropriately educated, trained and experienced,” she said.

Cosmetic surgery, or any other form of surgery, is ordinarily performed by specialists in plastic and reconstructive surgery, “but may also be performed by other qualified practitioners or specialists [who] have [received] formal, structured training”, Sekhonyana said.

These practitioners need “assessment and ongoing professional development in certain aspects of cosmetic surgery relevant to those particular specialities”.

Wittstock said: “There should be no confusion as to whether GPs can perform cosmetic surgery. The response you got from the HPCSA is rather nonspecific.”

Wittstock said specialists typically undergo a minimum of a further six years of training, and this “regulated and structured training cannot be replaced by various ‘short courses’”.

Anyone who had surgery done would have some complications, as this is the nature of surgery. “However, these complications should be kept to a minimum and, when they arise, be treated by someone who is adequately trained to do this.”

Mathibe said she does not perform procedures such as tummy tucks, but only BBL and liposuction, for which she has been trained during courses given by the American Academy of Aesthetic Medicine Southern Africa.

“I wrote for a diploma, which is divided into three levels. I did level 1, which was a certificate, and level 2, which was a diploma, which I got,” Mathibe said.

In 2017, she opened an aesthetic centre in Pretoria, where she did intravenous vitamin and facial treatments, and these piqued her interest in body sculpting. Dozens of other GPs across the country have had similar training in BBL and liposuction, and are performing these procedures.

“I did thorough research in body sculpting. I found out that you can actually perform liposuction as a GP,” she said.

She then applied for a course in fat transfer and liposuction in Dubai, which involved theoretical and practical training. “That course was not only attended by GPs, there were also dermatologists and plastic surgeons there.

“After that, I was confident enough to start doing body sculpting,” Mathibe said.

She said she feels unfairly attacked by Aprassa.

“I am not a plastic surgeon, but a GP. However, as for not being allowed to do what I am doing, there’s nothing like that. As long as you are well-trained in cosmetic medicine and you have experience, you can do that and that’s exactly what I am doing,” Mathibe said.