Johannesburg – Their sagging financial fortunes have not curbed South Africans’ enthusiasm for cosmetic surgery – and the emergence of medical loans is giving the industry a lift.

First Health Finance, founded by former bankers Jason Sive and Mark Dowson, provides financing for procedures which are not covered by medical aid schemes.

In the past 18 months, First Health Finance has received 5 000 applications for various cosmetic surgery procedures, including reconstructive face-lifts, tummy tucks and dental surgery.

Sive said: “We have patients who are clearly in financial trouble, but they still apply for a medical loan for elective procedures. It seems that even though the world’s economy is in serious decline and we have just survived a major recession, people continue to apply for payment assistance.”

While most operations – like breast augmentation and liposuction – are for aesthetic reasons, fertility treatments are also in demand.

To apply for this medical loan, patients first obtain a quote from their doctor for the procedure they would like to have, and then fill in an online form.

Sive said an in-house system evaluates whether First Health Finance will agree to a loan. “There’s a score card (with) variables to determine the risk of a patient. This would also dictate the interest rate.

“A better rate is offered to lower-risk individuals, but usually we try to better the credit rates offered by banks. We are quite diligent about whom we lend to, and we don’t borrow from the bank. Also, our clients are usually not just scraping through on their backbones.”

If the application is approved, First Health Finance will pay the medical practitioner. The patient then pays monthly instalments to First Health Finance to settle the amount.

Recession ignored

According to Sive, most applicants are female, and the average age is about 33. About 90% of clients are white women, but Sive says the number of applicants from other population groups is growing.

Dr Saul Braun, one of South Africa’s leading plastic surgeons, says there has been remarkable growth in plastic surgery among the black middle class.

This has supported exponential growth in the plastic surgery industry.

“Since the recession, there has been no downturn in patient numbers. In fact, there has been steady growth since October 2008 – the recession has had no influence whatsoever.”

He said most of his patients are in the upper income group, so they haven’t really felt the negative impact of the economic slowdown.

Notable, however, is that plastic surgery is not the exclusive domain of women any more. “The number of males who get cosmetic surgery has quadrupled in the last five years. Men mostly go for facial rejuvenation and liposuction – especially around the stomach and hips.”

Braun thinks medical aids should help bear the cost of these procedures, but they mostly refuse.

“Some medical aids flatly refuse, some might make an exception if strong enough motivation is given – large breasts very often cause severe back problems.”

One woman who gladly took the plunge and recently had breast augmentation is Angela Michael, a business development consultant.

No price on positive feelings

She says the recession didn’t even feature in her decision to get the surgery.

“I didn’t even think about the money; I just figure life is just too short, so do it”. Michael’s surgery cost R37 000, and she paid cash – with a smile.

“I love the way they look and feel now; it was the best gift I gave myself, plus I paid cash. I would not expect a man, whether it is my husband or not, to pay. It feels so much better when you have done it on your own – they are mine and I love them.”

Fifty-one-year-old Michael said she is really happy she did not have the operation when she was younger, as it gave her body a chance to settle after having children.

“And somehow people see it differently when you are older and you improve yourself. I found other women were also very supportive and excited for me. I was open and honest about what I was going to do, but with hindsight I look so natural no one would have noticed.”

Steffne Spies, a teacher, had plastic surgery a few years ago. She opted for breast augmentation and eyelid surgery (blepharoplasty).

“I only did it for myself. After three kids, my breasts had sagged, and the skin on my eyelids made me look tired and run-down.”

Spies said because she had her surgery a few years ago, she was able to pay cash.

“Today I really wouldn’t be able to afford those procedures. However, if I really wanted to have more surgery I would definitely borrow the money somewhere.

“I don’t think one can put a price on fixing something that is such a drawback for you.”