Brazilians' 'extreme makeover'

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RIO DE JANEIRO -- Ballet producer Maria Claudia Gondomar, 26, recently ex- perienced her first kiss and credits two life-altering plastic-surgery operations.

"It's my first time for everything," she said, emphasizing "everything." Miss Gondomar, who is 5 feet 10 inches tall, weighed 264 pounds two years ago when she walked into Dr. Paulo Muller's office at the Ivo Pitanguy Clinic.

Ivo Campos Pitanguy, widely considered the father of modern plastic surgery, owns the clinic. There, Miss Gondomar underwent a gastroplasty -- an operation that limits the amount of food that can enter the stomach -- plus liposuction on the thighs and hips and plastic surgery on her midsection and breasts.

The operations cost her the equivalent of $14,300 -- about the cost of a new Volkswagen in Brazil. She is now an attractive 138-pound woman.

"It's good and bad at the same time. I'm the same person inside, but people thought of me as a monster before," she said, walking down Avenida Atlantica along Copacabana beach on a recent Saturday afternoon.

"I can now do things that I couldn't do before, like flirting. I'm treated nicely when I go shopping for clothes. I'm still getting used to this."

Brazilians are conscious of image. Some of the world's top models, such as Ana Hickmann and Gisele Bundchen, come from this country of 179 million -- 22 percent of whom live on $1 or less a day, according to the World Bank. Brazil's tropical climate also leads its inhabitants to expose their bodies more than their counterparts in the United States, the world's biggest market for plastic surgery.

More than half a million plastic-surgery procedures were performed in Brazil last year, up from an average 200,000 five years ago, the Brazilian Society of Plastic Surgery says. The average cost in Brazil ranges from $1,000 to $3,000, depending on the procedure, attracting clients from around the world.

"Plastic surgery used to be just for those who could afford it. But in the last few years it's become more democratic," said Dr. Luiz S. Toledo, a Sao Paulo surgeon in private practice since 1975. "This isn't happening everywhere that plastic surgery has become trendy. It is happening in Brazil, though."

A medical specialty once dominated by private-practice surgeons catering to Brazil's upper class now is bringing in working-class patients. Dr. Toledo's client base of 4,500 has dropped 10 percent because of a rise in the number of plastic surgeons on hospital staffs performing aesthetic procedures at cut-rate prices.