- The Washington Times - Monday, August 30, 2004

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.

Fatima Duarte Chavier, 39, had three operations this year, the most recent last month. She used plastic-surgeon residents for liposuction, breast lifts and an eyelift. The first two surgeries cost her a total of $600. The eyelift cost $200.

“Without this type of clinical support, I’d never have been able to do it,” said Mrs. Chavier, a homemaker with two school-age daughters.

She said her children made fun of her “fat belly” until she shed 100 pounds through surgery this year. “It’s like I was born again. This was great for my self-esteem,” said Mrs. Chavier, who now weighs 138 pounds. She has referred 10 friends to her surgeon, Dr. Paulo Viana Silva.

Dr. Toledo said the popularity of plastic surgery in Brazil owes a lot to Dr. Pitanguy, 76, the surgeon who introduced the world to well-being through plastic surgery.

A walk through Dr. Pitanguy’s office in a restored colonial manor shows his accomplishments, including medals and awards from numerous countries. He is in “Le Livre du Millennium,” the thick, leather-bound French compendium featuring accomplished figures of the 21st century from Bill Gates to Marilyn Monroe.

A private room in his manor displays art made for him by Salvador Dali. Tropical birds jump from tree branches behind a glass partition in another room. A large fish tank is set in a wall. In a waiting room, patients as young as 16 wait for consultations with the four surgeons on Dr. Pitanguy’s permanent staff.

The pioneering physician has trained more than 400 plastic surgeons in Brazil. “We teach doctors to take a philanthropic approach to plastic surgery,” Dr. Pitanguy said. His clients are affluent.

“Ultimately, people like to feel good about themselves. If your image of yourself is not good, you don’t feel right,” he said, opening the door to Room 41, where Anna Alyria, 77, was recuperating from her third facial procedure in 20 years. Her head was wrapped in a cloth bandage; she had minor black-and-blue marks on her face, and stitches around her eyes, but said she felt great.

“This was done to make her feel better, not to make her look 40,” Dr. Pitanguy said as a young woman was wheeled past on a stretcher, heading for surgery.

“My worry about the direction the profession is going is that we are being made to look like miracle workers,” the surgeon said.

Brazil has its share of “reality” television shows inspired by plastic surgery that help promote the industry’s artistry.

One program, “Metamorphese,” Portuguese for “metamorphosis,” is similar to ABC-TV’s “Extreme Makeover,” and shows real plastic-surgery operations. Patients get the surgery at no charge if they agree to let it be taped. Another show, “Beleza Comprada,” Portuguese for “buying beauty,” focuses on life after plastic surgery.

In late July, Tania Oliveira, 25, was sitting through a consultation for breast implants shortly after being chosen to appear on “Metamorphese.”

“I’ve wanted to do this since I was 18,” she said at Dr. Ewaldo Bolivar de Souza Pinto’s clinic on Avenida Alameda Santos in downtown Sao Paulo. Dr. Souza Pinto performs the surgery on the TV show.

“Nobody does more plastic surgery on their bodies than Brazilian women,” he said. His clinic at the University of Santos in Sao Paulo has been treating poor patients at no charge since 1981.

The only plastic-surgery television program from the United States that hasn’t caught on here is MTV’s “I Want a Famous Face.” That doesn’t mean Brazilians haven’t discovered plastic surgery as a way to resemble celebrities.

Mirian Masteesouz, 27, has had more than a dozen operations to make herself look like famous samba dancer Scheila Carvalho. Miss Masteesouz, a samba dancer herself, has had nine liposuction procedures on her thighs. She later had surgery on her lower and upper back, hips, abdomen, arms and face.

“Now I’m getting invited to do samba shows in Portugal and Spain, because people know me as ‘that crazy person who wants to look like Scheila Carvalho,’ ” she said, showing photos of herself, blond and a little chubbier. “You don’t have to do it to look more like somebody else,” she said. “You do it because it makes you feel better.”

Miss Gondomar’s experience has led to a career change. “I want to help overweight people who’ve had liposuction, because once they leave the clinic, they don’t have anyone to help them with their post-surgery fitness and nutrition needs.”

Although slim and tan is part of Rio’s stereotype, no other Brazilian city has as many “fatties.” That leaves lots of room for plastic surgery’s expansion, as weight-reduction procedures are faster and often cheaper than weight-loss workouts at a gym.

Dr. Paul Nassif of Spalding Plastic Surgery in Beverly Hills, Calif., said the Brazilian doctors he knows are all “incredible surgeons and pioneers in the field.”

He said Brazil does not have a monopoly on affordable plastic surgery. “There are no financial boundaries. People will do what they can afford, or they will head off on some plastic-surgery safari to get it cheaper overseas. They just better know where they are going if they do that.”

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