BEIRUT, Lebanon — “She’s really very pretty,” said Dr. Edward Abdulnour as he drew a purple line on his patient’s cheekbone. “She doesn’t need anything.”
The patient, a 33-year-old Lebanese woman who was groggy from the anesthetic, did not respond.
“Sometimes, you just have to do what the patient wants,” he added.
Cosmetic surgery has long been wildly popular in Lebanon. Despite decades of war and political instability in this tiny country, the well-known image of meticulously preened and beautiful Lebanese women has endured. But in recent years, the practice has exploded into one of the country’s hottest tourist draws.
“It’s very important,” said Mona Faris, head of promotions for Lebanon’s Ministry of Tourism. “It’s a brand here.”
Doctors said that between 20 and 40 percent of their clients are tourists who came to Lebanon specifically to get their nip and tuck far from the watchful eyes of their friends and neighbors.
The biggest draw for cosmetic tourism in Lebanon is the price, said Roland Tohme, a plastic surgeon at the Beirut Beauty Clinic, one of several plastic surgery centers in Lebanon that caters to tourists. Many procedures can be done in Lebanon for half the cost, or less. A nose job that would cost between $5,000 and $7,000 in the United States or Europe costs about $2,000 in Lebanon.
“It’s cheaper here,” Tohme said, “And I think we have a level [of quality] that is the same as other places.”
Most of his foreign clients come from Arab countries like Saudi Arabia, Kuwait and Jordan. But recently, he said, he has seen more patients from Europe and the United States. Nose jobs are the most popular type of surgery, followed by breast implants and liposuction. More often than in the past, doctors said clients also come to tuck in extra skin after a massive weight loss.
Although medical tourism in Lebanon has long been popular, it has been only in the past year that the government, together with a private tourism company, has begun marketing the nation specifically for plastic surgery.
In 2009, Zeina El Haj opened a travel agency designed solely for plastic surgery patients. Through her company, Image Concept, patients arrange their surgeries, along with their hotel stays and other tourist activities. El Haj said in the past year, her business has increased by 50 percent.
“In the summer, they treat it like a vacation,” she said.
Besides the reduced cost, cosmetic tourists also flock to Lebanon because they can avoid judgment from their friends and family. Elias Chammas, a doctor who heads the Hazmieh International Medical Centre, a plastic surgery facility just outside of Beirut, said patients come to him from abroad because they want to keep their surgeries a secret. A woman who comes from the ultra-conservative Kingdom of Saudi Arabia, for instance, could easily get plastic surgery in Lebanon and tell her friends she was on vacation, he said.
“She comes from Saudi Arabia,” he said. “She stays three weeks here. She does her nose here. She goes back after three weeks — no swelling, nothing. They look at her and say, ‘Ahh, what happened? You look better.’ She says, ‘The weather in Lebanon.’”
Beirut, which has been called the party capital of the Arab world, is famous for its wild nightlife, restaurants and liberal attitudes. Doctors say cosmetic tourists can take advantage of the city’s decadence only a few days after surgery.
Chammas said that 20 years ago, plastic surgery was taboo in Lebanon, but that now people don’t even hide bandages or facelift wrappings.
“They go and have coffee in downtown Beirut and they don’t care who sees them,” he said.
El Haj, the owner of the cosmetic tourism company, said the reputation of Lebanese women being beautiful lends credibility to the industry for consumers abroad. Doctors and beauticians said they’d estimate that between 10 and 50 percent of Lebanese women have had some sort of cosmetic surgery.
But El Haj thinks the number is much higher. “No one just leaves it any more to nature,” she said.
The optimism, of course, like everything here, is tempered by the country’s tenuous political situation.
The posturing of Iranian-backed Hezbollah versus the Western-backed ruling party threatens to destabilize the country from within. Rumors of another war between Lebanon and Israel have also been circulating for months. Doctors say a new round of violence would, at least temporarily, kill the cosmetic tourism industry.
“If you feel there is going to be a riot on Tuesday,” said Chammas. “You will not come.”