Now 31, the Montreal woman decided it was time for her nose. She wanted it streamlined, the bump taken out. She went under the knife again.

An extreme makeover? Maybe. But the woman, who we'll call Jane because she asked that her real name not be used, has spent more than $10,000 on plastic surgery over the past six years quietly remaking herself - and she may not be finished yet.

Montreal plastic surgeons say they are seeing more people like Jane - young women, and men, who are spending thousands of dollars to remake their bodies with procedures that used to be the domain of the middle-aged.

They are combining breast implants with tummy tucks, rhinoplasty (nose jobs), chin implants, brow lifts, eyelid surgery, liposuction and a collection of other surgical nips and tucks from which a patient can often recover over a weekend.

For them, plastic surgery is a tool - something accessible and which they can employ almost as easily as teeth whitening and hair streaking.

Why wait until you are 55 to have a facelift, they reason, if by then the results will likely look unnatural and everyone will know?

As Jane said: "I'm open-minded to maintaining a certain look."

"There has been a shift in the patient population," said Arthur Swift, a Westmount plastic surgeon who saw the beginning of the trend about five years ago.

Brought into his practice by Botox and other injectables that can be done over the lunch hour, Swift said, the under-30 segment of his clientele has grown from 10 to 25 per cent, and many of these patients now want multiple procedures.

In years past, Swift's younger surgical patients tended to come in because they wanted to alter a nose or clean up acne-ridden skin. Now they want the full range of nips and tucks he performs, "little pick-me-ups" that gradually enhance their appearance. Many are spending $2,000 to $3,000 a year.

"This week I saw a 35-year-old guy who wants liposuction on his stomach," said Swift. When he heard it would cost him a couple of thousand dollars, Swift recalled, the man simply said: "This is my holiday. A present to myself."

While Americans are signing on for Extreme Makeover, the weekly reality television show in which real people undergo radical plastic surgery, Canadians are quiet about their makeovers.

Don't expect them to appear on the cover of People magazine, which this month featured nine ordinary women and men who had spent between $22,000 and $126,000 on nips and tucks.

Arie Benchetrit, a plastic surgeon in Pointe Claire who says about 25 per cent of his patients are under age 30, said today's younger patients are "not the idle rich."

For many, he argued, it makes sense to do more than one procedure at a time. "They are working women who only have so many days off. If they combine surgeries, they can combine the recovery," Benchetrit said.

Thanks to less invasive techniques, he said, a young, healthy patient can easily heal from a tummy tuck and breast surgery in two weeks.

Take Barbara. The Montreal woman, who also asked for a pseudonym to protect her privacy, has had liposuction on the back of her thighs and stomach. She has had her upper eyelids done while her upper arms have been made svelte with liposuction.

In total, the working mother of two has spent just over $10,000 and she is now considering a breast lift.

She also has regular Botox injections - $300 a pop, two to three times a year - to prevent small brow wrinkles from getting worse.

But what's most interesting, she said, is the fact that aside from her eyelid surgery this fall, no one but her husband has been the wiser.

"I was driving the week after my tummy tuck," she said. "Mind you it was only a partial tummy tuck. But I was out in the car."

Always attentive to her appareance, right down to her hair and nails, she said she started nipping and tucking in her mid-30s - and before losing her youthful looks.

Now in her 40s, she is fresh-faced and looks a good seven years younger than she is.

"I've always been happy about my appearance and I still am," she said.

Plastic surgery junkie? Some might say so.

But Claudio DeLorenzi, a Kitchener, Ont., plastic surgeon and past president of the Canadian Society of Aesthetic Plastic Surgery, doesn't see it that way. "It's a commodity now instead of a super special thing," he said.

And he sees no problem with it as long as surgeons vet younger patients who have unrealistic expectations of how plastic surgery will change their lives.

Gérald Rheault, who shares a clinic with two other plastic surgeons on Nuns' Island, says 75 per cent of his clients are under age 30.

Like Swift and Benchetrit, he said most of his younger patients are coming in for breast augmentation with a tummy tuck/liposuction or a nose job.

If their shopping list extends beyond that, he said, he tells his patients: "You have to do it in stages. There's nothing wrong with that."

----

Brow lift From $5,000

Eye lift$2,500 for upper or lower

Rhinoplasty $4,500 to $8,000

Upper arm lift $5,000 to $6,000

Liposuction$2,500 to $6,000 depending on location and extent

Thigh lift More than $5,000

Face liftTotal lift, including neck, ranges from $10,000 to $20,000

Ear tucks $6,500 for both ears

Cheek augmentation Over $7,000

Chin implant $4,000

Breast implants From $6,000

Tummy tuck Starts at $6,500

------

Can Cream Melt the Fat?

No more cellulite. Eternal youth. Wrinkles are gone.

Skin creams can be a jar of empty promises. But a Toronto plastic surgeon claims his cream really works.

It reduces body fat, particularly in exercise-resistant areas, said Stan Gore, the doctor-inventor.

Unveiled in Toronto last week, Gore's Infusion Lipolysis treatment can reduce fat thickness by 20 per cent within 30 minutes of a patient's first application, he said, and up to 50 per cent in three months.

Since March, he said, 200 patients have used the cream, which contains a drug that stimulates the body's system to break down fat.

The drug, which Gore declined to name, is already approved by Health Canada for reducing blood pressure and heart rate.

Busting abdominal girth and cellulite is a new use for the medication, Gore said. For proof, he offers before-and-after pictures on his Web site (www.lipidoctor.com).

He plans to open non-surgical fat-busting clinics in other Canadian cities in 2004. The three-month program ranges in price from $1,100 to $1,800.

------

Stats

The top five cosmetic surgeries in the U.S. in 2002, with percentage increases since 1997:

Liposuction, 372,831, up 111 per cent.

Breast implants, 249,641, up 147 per cent.

Eyelid surgery, 229,092, up 44 per cent.

Rhinoplasty, 156,973, up 15 per cent.

Breast reduction, 125,614, up 162 per cent.

Source: The American Society for Aesthetic Plastic Surgery.

Canadian figures aren't kept. instead, doctors here use U.S. figures and divide by 10.

ccornacchia@thegazette.canwest.com

© Copyright 2003 Montreal Gazette