When you meet Dr Anthony Kenyanya, 53, a consultant oral and maxillofacial surgeon, you might not immediately grasp what his work entails. But in his soft, deliberate tone, he paints vivid pictures of the patients he treats and the complex reconstructions he performs, from public hospitals to private clinics.
From gunshot wounds and knife injuries to domestic accidents and violent encounters, Dr Kenyanya has spent 29 years quite literally putting people back together. Working in a specialty few Kenyans understand, he has quietly rebuilt lives, one face at a time.
We deal with diseases and trauma affecting the head and neck region; the face, jaws, facial bones, soft tissues, and even the neck. Sometimes, due to accidents, surgery or disease, we need to reconstruct damaged areas. This may require borrowing tissue from other parts of the body, what we call grafts or flaps.
What does it take to become a maxillofacial surgeon?
In Kenya, it starts with a Bachelor of Dental Surgery (BDS) from the University of Nairobi. After that, one must pursue a Master of Dental Surgery, a five-year programme. Once you pass, you must also manage general medical and surgical patients before specialising further in maxillofacial surgery.
Was this your plan all along?
No. I always wanted to be a doctor since high school. I was part of the first 8-4-4 cohort that graduated in 1989. When I joined university, there was some confusion as two systems — A-Level and O-Level — were transitioning.
I applied for medicine, but we were all lumped together in pre-clinical classes. Later, students were split into dentistry, pharmacy, or medicine, and I ended up in dental school.
After completing his BDS and working for a few years, I realised that general dentistry had limitations. It became repetitive. During training, I found oral and maxillofacial surgery extremely challenging, and that drew me in.
At the time, there was no master’s programme in this field in Kenya. I considered training abroad, but finances were a barrier. When the University of Nairobi eventually introduced the programme in the early 2000s, I jumped at the opportunity. Later, I undertook a six-month advanced fellowship in cranio-maxillofacial surgery in the UK, working alongside neurosurgeons. That experience took me close to brain surgery, it was intense.
What’s been your biggest challenge in the field?
I work in both public and private sectors, and the patient profiles differ greatly. In private practice, patients seek help early. In the public sector, many come with advanced tumours or severe trauma, often due to socioeconomic constraints.
Which conditions or procedures do you handle most often?
Dentoalveolar surgery, jaw diseases, and facial trauma, which includes both bone and soft tissue injuries. Reconstruction is vast, from simple stitches to complex grafts and flaps.
Between trauma and jaw diseases, which is more prevalent in Kenya?
They’re about the same. Trauma can come from everyday accidents; falling down the stairs, slipping in the bathroom or from interpersonal violence. Both trauma and tumour surgery involve the face, jaws, and bones around the eyes.
Oral cancer is on the rise. It used to rank ninth among cancers, now it’s around sixth. But it is treatable, especially if caught early.
What’s been the most rewarding part of your work?
Outcomes. Seeing how well a patient recovers after being in your hands. Most people don’t even know what a maxillofacial surgeon is. All my patients are referrals.
Dr Anthony Kenyanya is a consultant oral and maxillofacial surgeon who works in both public and private hospitals.
Photo credit: Pool
What skills or qualities are essential in your line of work?
Solid training, lots of practice, and consistency. Your degree gets you the job, but keeping it depends on your outcomes. You also need to stay current — artificial intelligence is here, and it’s changing how we plan surgeries.
Are there common misconceptions about your specialty?
Yes. First, most Kenyans don’t know we exist unless they’ve been referred. Second, the boundaries between maxillofacial surgery, ENT, and plastic surgery aren’t very clear to the public.”
What are some recent innovations in the field?
Reconstruction has seen major advances. We now use free tissue transfers — free flaps — where we completely transplant tissue from another part of the body to the face. For instance, we can harvest bone and skin from the lower leg to reconstruct a jaw. The surgery can take up to 24 hours as we reconnect blood vessels under a microscope.
Another innovation is prosthetics. We can make artificial facial parts, say, half a face, to help patients function and heal before undergoing full reconstruction.
Are there cases that stand out as especially fulfilling or complex?
Yes. Large tumours and major facial trauma. I recently treated a man whose face was severely damaged after he shot himself while cleaning his gun. Reconstructing that was a major challenge, but the outcome was very rewarding. He’s doing well now.
June is Men’s Mental Health Month. How do you cope with the emotional toll?
There’s a difference between empathy and sympathy. Empathy is putting yourself in the patient’s shoes; sympathy is feeling sorry for them. As a professional, you must learn to compartmentalise. You can’t carry every case home.
Do you feel more empathy toward certain patients?
Children. They don’t have a say in their treatment. I’ve seen children with deep facial cuts, and when I recommend surgery, the parents decline. Adults can make their own choices, but children depend on others — and sometimes the choices made for them are harmful.
I remember warning a parent about a suspicious swelling. I told them not to wait. They did, for eight months. By the time they came back, it was stage four cancer. At that point, the chances of cure drop drastically.
