However the achievement of a more youthful, glowing complexion through boosters is merely the tip of the iceberg. The promise of picture perfect profiles and supermodel bodies, amplified by the age old notion that wealth, beauty and privilege constitute a holy trinity drive millions to seek answers on the operating table. According to the American Society of Plastic Surgeons, 8.7 million procedures were performed in 2003-32% increase since 2002.

The world-renowned Brazilian maverick of cosmetic transformation, Ivo Pitanguy, recently told National Geographic that, "today society accepts the improving of one's image." This in fact must be the case, for nowadays millions of Americans are glued to their televisions, watching everyday people undergo surgery in an attempt to "change their lives and destinies." The reality program, Extreme

Makeover, is taking the concept of improving people's appearances to unprecedented heights. The idea of transformation is no longer represented by the timeless images of the unforgettable movie classic, Sabrina, which featured beautiful Audrey Hepburn learning how to dress and groom Parisian style and winning the heart of the man she always loved. At the moment getting face lifts, cheek implants, chin augmentations, abdominal reductions and liposuction on television are en vogue.

Recently I viewed an episode of ABC's notorious Extreme Makeover series. Sandra, a recently widowed grandmother, weather beaten and neglected to the extent that all her teeth rotted, underwent a series of surgical procedures in pursuit

of a younger and rejuvenated outer shell. Sandra had a brow lift, a nose job, fat injections in her lips, breast implants, eye surgery and extensive dental work done, finally emerging as a new woman. Admittedly the entire experience left me with a sense of disbelief, astonishment and puzzlement. First, it was immensely difficult to come into terms with the fact that someone had let herself deteriorate so far into the gutter of corrosion-literally. This sort of decay is indicative of an overwhelming disregard for wellbeing and health. Indeed the results may have been phenomenal in Sandra's case, but improving upon ground zero hardly qualifies as a grand accomplishment. I have all the respect in the world for advanced scientific technology that can reconstruct a fractured face, heal severe burn victims or even fix minor imperfections that diminish a person's self esteem, but using knowledge to remedy a life time of mistakes is pure folly.

Taking a morbidly obese person, stapling his stomach, tucking in his now-sagging once enormous tummy and giving him a nose job while at it, disseminates the erroneous belief that it is okay to eat fast food and neglect exercise, for consequences are reversible. These programs show postmodern Cinderellas being molded into the hedonistic ideals of thin, attractive and youthful. However no one stops to ask if in the aftermath of the public displays of bloody faces, gashes, stitches and anesthetic induced babbles these people will exorcise the issues that lie at the heart of their problems. Are these operations also capable of automatically increasing

self-respect or changing amiss attitudes about life and health? Can the scalpel remove the troubled and twisted mentality that makes MTV's 20 year old twins suffer through operation after operation in an attempt to look like Brad Pitt (eventually ending up like cartoon-ish versions of their old selves)? Why aren't there psychiatrists involved in this process? Why isn't anyone making the case that it is unique features and minor "imperfections" that make individuals distinct and special? Think of legendary model Lauren Hutton's trademark gap-toothed smile or Barbara Streisand's famous nose. These traits are synonymous with their one of a kind beauty.

In an interview with Fashionlines's Editor-in-chief Christine Suppes, Dr. Olivier de Frahan, surgeon to the rich and the famous, declared that he is bored with patients who want huge lips and huge breasts. Indeed beauty is all about harmony and self-confidence, not Pamela Anderson-esque monstrosities. Nevertheless if there is a particular problem which truly preoccupies you and diminishes your poise, there is no harm in getting a consultation. A competent MD will be able to give you sound advice. Always remember, plastic surgery is a very serious matter. Unqualified charlatans can jeopardize your life, thus research before embarking on this affair. The American Association of Plastic Surgeons (AAPS) www.aaps1921.org is a valuable resource to this end.

When you are ready to make the leap, ask friends and acquiesces for recommendations. Then proceed to have your physician get a list of consultant plastic surgeon from the AAPS or apply for it yourself. When you decide on a name, verify that you are working with a fully accredited plastic surgeon, who has experience in both the cosmetic and reconstructive surgery fields. Do not even think about approaching the clinics advertised in the back pages of magazines!

When you show up for your initial meeting, be through and ask questions, keeping in mind you are being interviewed. Any respectable doctor will turn you away, if he deems you unsuitable for the procedure - AKA refrain from coming across as overly eager. Finally, beware that the computerized video-sculpting images you will be shown are more a selling technique than an accurate display of what the end results will be.

Plastic surgery, if approached with restraint and professionalism can produce extraordinary results. Conversely we have all seen dreadful outcomes of extensive cutting and pasting. The knife is not the answer to every question. In other words, new implants will not guarantee you the perfect man. Pride in your looks and a great sense of self is much more attractive than a plastic facade. Ultimately the decision lies with you. As John Kenneth Galbraith once said, "There is certainly no absolute standard of beauty. That precisely is what makes its pursuit so interesting."