A day with an RSCM plastic surgeon, Gentur Sudjatmiko

Dr. Gentur Sudjatmiko, 53, is head of the plastic surgery unit at Central Jakarta's Cipto Mangunkusomo General Hospital (RSCM), where he spends his days enlarging breasts, sucking fat and erasing wrinkles. The Central Java-born father of three lives in Cilandak Barat, South Jakarta and spoke to The Jakarta Post's contributor William Furney.

JAKARTA (JP): "It's an early rise for me as I have to say the morning prayer. Occasionally I'll go back to bed, but once I'm up I'll usually keep going. I always have a lot on and I'll look at what's happening for the day. After I drop one of my daughters to school, I'll go straight to RSCM and examine the day's schedule -- what operations are being done, if particular instruments are ready and so on. Because a lot of the procedures are very specialized, I have to refer to books and prepare myself.

I do a lot of reconstruction work, especially in the face area. Cleft lips are very common. There's a huge social stigma about them, and after patients have undergone reconstruction, they become much more confident. Last week, I had a patient who had a cancerous tumor below her right eye. After the tumor was removed, the eye area had to be rebuilt. It was a tricky operation that took three hours.

Because RSCM is a state hospital, and is, therefore, subsidized by the government, patients don't always have to pay for operations and treatment if they can't afford it. We work with a lot of foundations that help with costs. But that's just for medical work that is necessary. Cosmetic, or esthetic, treatment and surgery has to be paid for in full. We're a member of the International Association of Plastic Surgeons and comply with all the international standards. The cost of cosmetic surgery here is quite low, though, compared to the West. Rhinoplasty, for example, costs Rp 2.5 million. Asian rhinoplasty is different to other parts of the world. People here want a higher nose, and we implant a piece of silicone. Westerner's want to have their noses reduced in size. It's a simpler procedure with Asians. The cost of a facelift at RSCM is between Rp 4 and Rp 6 million. That's just the surgeon's fee - the theater, anesthetic and all the other things involved are additional.

Breast implants are very popular. Asian people want to be augmented, and silicone implants are safe these days. All our silicone is imported from Europe and the U.S. Two pieces cost Rp 5 million, so breast implant surgery can reach Rp 10 million. The result of the operation is dramatic and the women feel very happy.

We get some people who want to change their sex. There are only two hospitals that can perform sex change operations in Indonesia, one is in Surabaya, the other is RSCM. There's a lot of teamwork involved and it's not something that's done quickly or entered into lightly, as there are psychological problems that have to be sorted out first. We have to find out what's going on in their minds.

Twice a week, in the afternoon, I have a consultation session with the resident plastic surgeons. We talk about the patients and upcoming operations. I also read medical journals in the afternoon, so I'm up to date with the latest procedures. Every Friday, I have a grand round, when I see all the patients.

I love being a plastic surgeon. I can change people's appearance, and that makes me happy. I studied medicine in Bandung and when I finished, in 1985, I continued at the University of Indonesia in order to specialize in plastic surgery. After that, I went to Tokyo and then Melbourne to further hone my skills and broaden my horizons. There's a difference between Asian and Western skin, and in Australia, I was able to compare the techniques. Scars on Asian skin, for example, heal differently than Western skin and are more visible. Caucasian skin heals better after surgery; the scars are better quality.

Plastic surgeons in the West may earn millions of dollars, but I'm happy with millions of rupiah. Other doctors at RSCM think I earn a lot of money, and while I do make a good living, it was difficult at the beginning as there was a lot of competition. Over the years, the number of patients has increased. But I like to give something back to the community. During the year myself and another doctor go around the country looking for people in villages that need surgery, which we pay for ourselves. It makes me very happy.

I work outside RSCM in the afternoons, at various hospitals. Some patients, especially those who have 'new money,' want everything. I have to laugh sometimes. A woman will come in and say, 'Doctor, please help make me beautiful.' I ask them what they want to look like and they say, 'Yeah, it's up to you.' I refuse these cases because they might not be happy with the end result. People who have no idea of what they want are bad candidates for plastic surgery. They're not well informed and want the trendiest procedures. They'll see someone like Krisdayanti on television or in magazines and want to look like her. They have to learn first. Most of them will come back with an idea, though. And I'll only do a little - the nose and eyes, not the whole face.

I get a lot of patients who just want to look 10 years younger, and that's a case of getting rid of crow's feet and wrinkles. After surgery, the face looks bad and terrifying. A woman has to be helped by her maids and relatives so that she'll feel confident.

Plastic surgery is very delicate and sometimes difficult. I have to work with a gentle touch. You have to ask yourself, 'What is beauty?' Society thinks a beautiful nose is one that is sharp, well-formed and has small nostrils. Most people think beautiful eyes are those that are not slanted, and the eyelids are clear, with long, curved eyelashes. In Indonesia, and all round Asia, people think Western people are beautiful. This is partly because of Hollywood movies, and it's a bad thing.

I love playing golf and I'll go to the course at least once a week and on the weekend. But it's time consuming, and if I'm gone too long my family will get angry. In the evenings, I watch my favorite channels, the Sports Channel and the Discovery Channel. I often have Padang food, as it's the best.

Bedtime is about 10 p.m., and I fall asleep thinking about my daughters' futures I pray for them."