Plastic Makes Perfect

There is something religious about the phrase “perfect body”. Perfection is meant to be divine, not human. In Brazilian Portugese, the language of Brazil, it translates as corpo perfeito[ITALS]. Which also sounds religious.

I found the phrase corpo perfeito in the Brazilian magazine Plastica & Beleza (Plastic Surgery & Beauty), which is like Cosmo meets scalpel; they write about plastic surgery in the same breath as diet, fitness and make-up. The women in Plastica & Beleza have great teeth, great abdomens (flat, toned), lean legs and taut breasts. They would look dressed if they were naked. Strip away their clothes and you find a perfect, fashioned surface.

All the women with perfect bodies (in the magazine) have the same smile. The flawless smile of the flawless. They have such happy, blissful smiles. You would think they were already in heaven.

There is a biblical reference for corpo perfeito; Jesus is resurrected with a ”glorious body” (in some translations it is “perfect body”) – the source is Paul (one of the books in the Bible), where Paul talks about life after death.

“Who shall change our humble body, that it may be fashioned like unto his glorious body… ”

But you are supposed to wait for this body. Or not.

Brazil and America are the world’s plastic-surgery hotspots. China comes third. There are statistics (and they may understate the figures) that say 1.6m surgical procedures were carried out in Brazil in 2010; the most popular were liposuction and breast augmentation.

“Plastic surgery is really popular in Brazil,” says THE Rio surgeon Dr Ricardo Cavalcanti Ribeiro (he has his own clinic, Clinica Vitee). “We have a very sunny country and people expose themselves to the sun in small bikinis. They require plastic surgery for tiny imperfections. We have a very young population and we have very young patients.”

The body is the centre of Brazilian fashion, said the French anthropologist Stéphane Malysse. In France, he said, clothes are central to fashion. But in Brazil the space between beachwear, casual wear and sportswear disappears. The entire history of classical dressmaking (which works to disguise the buttocks and belly) means nothing when everyone wears a bikini.

Brazil: in spring, the magazines say get ready for the “sand test” – get your body ready for the beach. The glossies show the same woman; she has contoured abdominal muscles and taut, sculptured buttocks. Brazil: more people watch soap operas here than in any other country in the world (noted The Washington Post in 2009). Brazil is the world’s largest consumer of weight-loss medication (the UN said 1 in 100 take appetite inhibitors daily). And 7 out of 10 Brazilian women said they stay at home rather than go out when they’re feeling ugly. And they would avoid the beach (from a Unilever/Harvard/LSE survey).

“Some people hide the fact they’ve had plastic surgery,” says Ribeiro, “while others use it as a status symbol. I’d say the balance is about half and half.”

There are more than 5,000 plastic surgeons in Brazil. The sheer numbers of surgeons have brought prices down. “When I started, surgery was only permitted for rich people and millionaires. Nowadays it has become cheap,” says Ribeiro.

Procedures are available on credit (some surgeons take credit cards) and payment plans. Four years ago, Brazil’s Federal Medical Council said they would outlaw ties between doctors and lending firms. The Medical Council said finance companies acted like “loan sharks”, charging low-income people huge rates of interest to pay for treatments.

But for the moment there is “no interference in financial systems”, says Ribeiro. “Several doctors finance surgeries in three to five parcels and when more time is required, it is financed by companies, in up to 36 installments.” The situation is similar in the US – there are payment plans, and figures suggest that a third of all US procedures are bought by people on low incomes.

The most popular surgeries in Brazil are liposuction and breast augmentation; the most “famous” are the “Brazilian Butt Lift” and “Brazilian Tummy Tuck”. The Butt Lift takes fat from one part of the body and injects it into the buttocks to improve shape. The Tummy Tuck (which Ribeiro helped develop) involves cutting open the patient, pulling the abdominal skin down (so the belly is now “tight”) and cutting out excess flesh. Liposuction is used to remove fat and fluid and to reshape the abdomen. “It leads to a good result and proper contouring,” says Ribeiro (he himself has had abs, flanks and chin liposuction).

English plastic surgeons say the culture in Brazil is different from in the UK. In England, says the surgeon Stephen Hamilton, who holds key university and hospital posts, it is common to work on patients who have, for example, asymmetric breasts or inverted nipples. “They are not really vain people. They are people who have quite big issues about parts of their bodies they don’t like. They are mums with excess skin on their tummies. They are women who have not developed on one side. I get patients who say, ‘You are the first person who has seen my breasts in years.’”

But in Brazil they are moving to the idealised body. “They are changing from normal to exaggerated ideals,” continues Hamilton. “It is not normal to have that well a defined buttock. It is not normal for a 40-year-old woman to have really full lips. A super-flat stomach is not normal for a woman who has had children. A trend, in part from Brazil, is to exaggerate normality. We’ve seen this in breasts for many years, but it is becoming a goal in buttock surgery, too.”

So Vaser Lipo is big in Brazil (although it’s big everywhere) – the procedure is a refinement of traditional liposuction, as highly specific areas of fat can be removed to reshape the body. “You work very close to the skin,” says the English surgeon Adrian Richards. “It’s like etching. You can etch in the abdominal muscles. You suck very specifically so the skin sticks down onto the muscles, it goes down into the depression and etches out the six-pack.”

But it helps if the patient is already fit. If they are already following a good (if not obsessive) diet and exercise programme. This, again, is the ideal Brazilian patient profile: the young, attractive, fit and slender patient who is opting for procedures to move from normal body to perfect body.

“The point,” says Richards, “is that people who tend to have plastic surgery are already more attractive than people who don’t. They look after themselves better and they are more body conscious. If you took a hundred 60-year-olds and asked them whether they would consider plastic surgery, the ones who tend to say yes already look better than average for their age. The ones who would say no already look a bit rubbish.”

There is some demand for butt augmentation and lifts in the UK, says Hamilton. But not much. “There’s a lot of interest in Brazil in reshaping buttocks. They get through an awful lot of buttock implants. Until last year I never had any patients ask me about that, but now they do. It’s driven by Brazil. Driven by the media reporting of supposedly attractive, relatively full bums.”

Hamilton divides his practice into cosmetic and reconstructive areas, the latter, for example, rebuilding tissue damaged by cancer (facial and breast reconstruction). I ask him if he’s concerned his profession will be co-opted into the fashion industry. “I think its important to keep a reconstructive practice to keep you grounded. I think there’s a risk of becoming too much of an industry. We have to be very careful.”

The British Association of Aesthetic Plastic Surgeons say there is a “lack of regulation” in the UK – too many of the people doing procedures are not specialists – they may be legally allowed to carry out procedures, but they are not specialists in plastic or reconstructive surgery. “We’ve seen GPs doing a stem cell boob job on GMTV. You can get a tummy tuck from an ear, nose and throat specialist. We would ask people to question this.”

But corpo perfeito. There’s no waiting; the glorious is now. People are not being careful. The industry is not regulated. No amount of caution is going to hold this back. The fashion may shift from the Beckham/Paltrow model. But if it doesn’t, then corpo perfeito– perfect body and afterlife smile – whether you are rich or indebted poor, this has the potential to run and run.