- Associated Press - Sunday, March 25, 2012

RIO DE JANEIRO — A machine purrs as it delivers electrical pulses deep into the saggy skin on Barbara Penha’s jawline, a high-tech treatment used first to tighten her jowls and then to sculpt her tummy.

The technique is all the rage at the chic dermatology clinics that cater to legions of wealthy women here who invest serious time and big bucks into looking their bikini best.

But Ms. Penha isn’t a socialite, nor did she fork out the $450 that a single radio-frequency session typically runs in Rio de Janeiro. The struggling housewife got the treatment free of charge at a clinic that provides the poor access to the kinds of pricey cosmetic treatments that have become almost de rigueur among Brazil’s moneyed elite.

Free Botox and laser hair removal, free chemical peels and anti-cellulite treatments may at first seem shockingly frivolous in a country such as Brazil - which, despite phenomenal economic growth in recent years that has lifted millions out of extreme poverty, still battles with diseases such as tuberculosis and dengue fever.

But the philosophy behind the more than 220 clinics across Brazil that treat people such as Ms. Penha and thousands of maids, receptionists, waitresses and others is simple: Beauty is a right, and the poor deserve to be ravishing, too.

The Brazilian Society of Aesthetic Medicine’s Rio clinic has performed free procedures on more than 14,000 patients since its founding in 1997, said Dr. Nelson Rosas, who heads the Rio branch.

Good looks, doctors argue, are more than skin deep, and by treating what patients view as physical flaws doctors are often also healing their psyches.

“What’s a wrinkle? Something minor, right? Something with precious little importance,” Dr. Rosas said. “But when we treat the wrinkle, that unimportant little thing, we’re actually treating something very important - the patient’s self esteem.”

The notion that beauty treatments can act in much the same way as psychoanalysis, helping free patients from crippling neuroses, was pioneered in past decades by celebrated Brazilian plastic surgeon Dr. Ivo Pitanguy .

Nicknamed the “philosopher of plastic surgery” for his intellectual and psychoanalytical take on the vocation, Dr. Pitanguy, 85, is largely responsible for Brazil’s reputation as a world leader in the field and a top destination for cosmetic surgery tourism.

His skill with the scalpel catapulted him to international fame - the surgeon is arguably Brazil’s second-most famous person after soccer legend Pele. It’s made him the go-to man for A-list celebrities, international statesmen and royalty seeking a quick fix to their esthetic woes. Dr. Pitanguy’s long and illustrious patient roster is said to include such luminaries as Zsa Zsa Gabor, Francois Mitterrand and Brigitte Bardot, although the discreet doctor has rarely named names.

Dr. Pitanguy’s handicraft on the world’s rich and famous allowed him to join their ranks - he commutes to Rio by helicopter from his own private island. But he has remained attentive to the less privileged.

More than half a century ago, he founded a surgical wing to help treat the poor. While the wing at Santa Casa de Misericordia Hospital in Rio focuses on reconstructive operations for burn victims and people with serious deformations, it also provides discounted cosmetic procedures.

Other hospitals have since followed suit. Now, at least two dozen hospitals, mostly public, in Rio alone offer discounted or sometimes free cosmetic surgeries to low income people, according to a website aimed at informing potential patients.

With more than 11.5 million operations a year, Brazil is the world’s second-biggest consumer of plastic surgery after the United States, but here there is none of the stigma that still clings to the practice in the U.S.

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