Hundreds of Pakistani Britons are booking cheap plastic surgery in their ancestral homeland, three times the number just four years ago. Nose jobs, tummy tucks, liposuction and breast enlargements are the favoured treatments for many who feel "pressure to have Western features" but who want to pay only a fraction of what they would be charged in Britain.
The women are mostly middle-class professionals who take 10 days out of their time abroad to travel from the small villages where their extended families live to Islamabad, Lahore or Karachi where almost all the country's 70 registered plastic surgeons are based.
Dr Abdul Hameed, the president of the Pakistani Association of Plastic Surgeons, said the trend began four years ago when doctors noticed "waves of British clients" coming during the summer and winter holiday seasons. About 400 women were visiting the country for cosmetic surgery every year.
He said: "These women are mostly educated, with 70 per cent who work and earn independently. Only this week, a woman from Maida Vale in west London came to me for a nose job. She was in Pakistan attending a marriage ceremony. The women know that the waiting lists for good cosmetic surgery in London is maybe three months long. In Pakistan, there is no waiting list. We do them whenever we get them."
About 250 women from Britain undergo liposuction treatment and tummy tucks every year, and Britons comprise about a fifth of the country's rhinoplasty patients.
Ambarina Hasan, the health and beauty editor of Asian Woman and Asian Bride magazines, said the growth could be linked to a career-oriented lifestyle in which Asian women had higher levels of disposable income and were getting married later.
Bollywood actresses, the icons of beauty on the sub-continent, are becoming more like sex symbols in the West, she said. "They are getting fairer with lighter eyes. There has always been a hankering after the Western ideals of beauty. There have been creams for lightening skins and plastic surgery is taking it one step further."
The pressure to look good is even greater if the women are expecting an arranged marriage. "With an arranged marriage, you often size [prospective partners] up in a photograph, so looks are very important," she said.
David Sharpe, a professor of plastic surgery at Bradford University, said he was aware of the trend, but warned against having plastic surgery abroad.
"I would be confident about Pakistani surgeons who have been trained in the UK or have strong connections with training programmes here as being competent," he said.
"But if you are going abroad to have surgery, there is a danger. One in 10 cases of nose reshaping and one in five cases of liposuction require additional work for up to six months, such as an adjustment to the tip of a nose. The patients would need to go back to the surgeon and this work would normally be carried out for free, as it would be part of the package."
Dr Hameed said most British patients were aware of the potential dangers of picking the wrong surgeon and advised clients to do their research before booking.