Nip-and-tuck obsession more than skin deep, says Brazil's 'maestro' of plastic surgery

If anyone had told early plastic surgeons that buttock enlargements and vaginal rejuvenation would become a billion-dollar global industry led by Brazil, they would have been laughed out of the operating room.

But when the giants of lasers and liposuction convened for the world's biggest cosmetic-surgery conference at the weekend, they did so in Rio de Janeiro. And the keynote speaker was a Brazilian.

"Even 20 years ago, there was a prejudice against aesthetic surgery and doubts about its importance," said Ivo Pitanguy, the country's most celebrated plastic surgeon. "I tried to show that it goes deeper than the skin, that it goes inside the soul."

He may have succeeded. Pitanguy, now 90, is a celebrity on a par with Pele and Ronaldo. In Brazil, they call him the "philosopher of plastic surgery" and simply "the maestro".

This year, Brazil overtook the United States as the world leader for cosmetic operations, the International Society of Aesthetic Plastic Surgery says.

With less than 3 per cent of the world's population, Brazil accounted for 12.9 per cent of the cosmetic operations performed last year. This included 515,776 million breasts reshaped, 380,155 faces tweaked, 129,601 tummies tucked, 13,683 vaginas reconstructed, 219 penises enlarged and 63,925 buttocks augmented.