Silicone Island / Yoani Sánchez


“A doctor implanted them during his guard duty,” she told me, while proudly feeling her breasts through her blouse. Then she points to her rear end and pouts, “This didn’t go so well for me, because the surgeon didn’t have much practice.” When I asked her where she got the silicone prostheses so obvious in her body, she told me she would only use “brand name” ones so she asked her Italian boyfriend to bring them to her. “The other part was easy, you know, you pay a doctor to do the operation.” I confess that I am not very familiar with the matter; surgeons scare me and for years now I’ve gotten used to the awkward figure I see reflected in my mirror. But still I ask her for the details and she confirms what I’d sensed, the existence of an illegal network of plastic surgeons who practice in the same hospitals where they offer free care.

The practice took off in the late nineties and initially the main clients were hookers whose foreign boyfriends absorbed the costs. But now it’s been extended to people of both sexes who have the resources to achieve the body of their dreams. Normally they go into the hospital with a false clinical history for some illness they don’t actually suffer from, and within a few hours of coming out of the operating room they are sent home to recuperate. These surgical interventions aren’t logged into the hospital records and a good share of the resources used are bought on the black market by the medical personnel themselves. Nothing should go wrong, because a complaint would expose the network involved. Discretion is fundamental and the patient is rarely followed up to see if there were adverse reactions. “We are all adults, so everyone is responsible for what happens,” warned my friend’s doctor before the anesthetic took effect.

At a price ranging between 750 and 900 Cuban convertible pesos (CUCs), breast implants are the most popular among the wide range of inserts implanted and of the clandestine operations performed. On sites like you can find a wide variety of sizes, with the most popular brands being Mentor and Femme. But you have to add “labor” to this price, which runs from 500 to 700 CUCs for a recognized specialist in these fields. Some beginners will also do it, for a little less, but the results leave much to be desired. For a Cuban surgeon whose salary barely reaches 30 CUCs a month, performing one of these operations is extremely tempting. However, they know the danger of being found out and that the risk of losing the right to practice medicine is very high. So they protect themselves in networks that almost always extend throughout the administration and leadership of the hospitals. These involve everyone from orderlies and aestheticians to nurses and public health officials. The worst thing that can happen is someone dying on the operating table; then they will have to invent some chronic disease to justify the casualty.

A few weeks ago the blogger Rebeca Monzó exposed one of these scandals of illegal surgery in a Tweet*. The scenario in this case was Calixto Garcia Hospital, but it could have been any other operating theater in the city. Without specifying the details of what happened, there was talk of an entire clandestine room dedicated to foreign patients and Cubans who could pay for the operations. Popular rumor has it that it was all discovered when a tourist who had just been operated on hemorrhaged at the airport on her departure from Cuba, but this could be a complete myth. It is true, however, that like the rest of our reality, medicine exists on two planes, in two very different dimensions. One is that of patients who have no resources to offer gifts or payment to doctors, and the other is of those who can pay for the surgery on the spot, in cash. Material resources can shorten the time and increase the quality of any treatment, making sutures, x-rays and chemotherapy all appear on time.

It all starts with a gift of soap to the dentist who fills our cavities, and goes all the way up to a sterilized room where a foreigner can get an abortion, or a Cuban can receive a pair of breast implants.

*Translator’s note: The Tweet says, “Yesterday, Dr. Fonseca, the director of Calixto Garcia hospital, was led out of it handcuffed to the astonishment of all the personnel present.” Dr. Fonseca and others at the hospital were arrested for illegally performing private plastic surgeries.

21 July 2012