... and how the UK cuts it cosmetically

So you thought only America was obsessed with the (artificial) body beautiful. Demand for aesthetic surgery in Britain has risen 400- fold in the last decade. CORA MANN reports

The chequered history of plastic surgery notwithstanding (see cover story), going under the knife is more popular than ever in Britain. A NatWest bank survey last week showed that nearly one in five bank loans taken out in this country is to fund plastic surgery, and it's not just women - men now make up approximately 14 per cent of cosmetic surgery clients in the UK. Last year, the British public spent over pounds 180m on cosmetic surgery, and the figure is still rising - it is set to top pounds 200m by the year 2002. The demand for nips, tucks, smoothings and deletions has risen 400-fold over the last decade. Even celebrities like Fay Weldon now admit to it. And as demand has increased, so new techniques are being pioneered.

THE FACE

With laser resurfacing, the outer layers of skin are vapourised to diminish spots, scars and wrinkles and help tighten the skin. This costs around pounds 3,500. The trend for facial surgery is towards gradual procedures, starting as early as the thirties, rather than going for major surgery later in life. Doctors can make less noticeable incisions, either lifting fat, muscle and skin together or leaving fat under the skin to avoid an overly taut "pulled" effect. Using endoscopes, slender tubes with cameras on the end, surgeons make less drastic cuts. A full facelift costs around pounds 4,500. Multiple procedures - such as botulinum (botox) injections to paralyse wrinkles in the forehead, an exoderm peel, plus injections of fat into cheeks - are also becoming more popular.

Chemical peels, which remove the top layer of skin to reveal smooth layers underneath, are currently the most popular form of skin resurfacing. Cosmetic surgeon Dr Maurizio Viel, of the London Centre for Aesthetic Surgery, explains that modern peels are far gentler than older ones: "The exoderm peel is the newest method, and is much safer than what went before, causing less redness and less pain." An exoderm peel costs around pounds 3,500.

THE EYES

For bags under the eyes, new cutting techniques using a laser rather than a scalpel mean that the operation can be carried out with no scarring. "There is hardly any bruising at all," says Anne Blackiston, senior nurse with the Surgical Advisory Service in London's Harley Street. Expect to pay around pounds 3,500 to have upper and lower lids done with the new technique.

THE UPPER BODY

"Anatomical" breast implants look and feel natural. They can now be inserted through the armpits to reduce scarring. Surgeons in this country favour hydrogel implants, made of water and polysaccharides or cohesive silicone gel where the filler is not liquid and therefore can't leak. These days women are as likely to opt for breast reduction as breast augmentation - the Pamela-Anderson- at-her-most-inflated look is out. Both enlarging and reducing the breasts costs around pounds 3,500. Men can opt for pectoral implants - though these have a nasty habit of slipping. These cost around pounds 4,200.

THE LOWER BODY

Breakthroughs in liposuction - using an ultrasound technique developed by French and Italian specialists to liquefy fat deposits with energy waves - now make slurping the flab out easier. They also allow the surgeon to concentrate on "sculpting" the final shape. Some clients also opt to have their unwanted fat frozen for later re-injection into areas like the cheeks or hands that may need plumping out in years to come. Taking the fat out costs upwards of pounds 2,000, putting it back a further pounds 1,200 or so. For men, calf implants are around pounds 4,000.

HUNT THE SURGEON

5 Members of the British Association of Cosmetic Surgeons (tel: 0171 323 5728) or the British Association of Aesthetic Plastic Surgeons (tel: 0181 554 2916) will be well-trained to advise you on the benefits of the procedure and the potential pitfalls - and what to expect after the operation.

5 You must feel comfortable with your surgeon - he or she should take time to explain both benefits of the procedure and potential pitfalls, plus exactly what to expect after the operation.