It's my nose, doctor, I'd like a new one please

Cosmetic surgeons say business has increased by up to 50 per cent in the past couple of years.

Age, for many, is no barrier. Patients well into their 80s are turning up at surgeries keen to have the bits of their bodies they don't like nipped, tucked, filled or removed.

More and more women keen for a "freshen up" are having facelifts and liposuction.

Gay men are showing up for nose jobs and there are plenty of male executives keen on a shot of botox.

Programmes such as Nip/Tuck - with its catchphrase "Tell me what you don't like about yourself" - and Extreme Makeover have made people feel more comfortable about asking what might work for them.

Dr Martin Rees, president of the New Zealand Foundation for Cosmetic Plastic Surgery, says most cosmetic surgeons he talks to believe business has increased between 35 and 50 per cent over the past couple of years and it's not just "Remuera ladies" who want it.

"I'm always amazed how people who are not well off will mortgage the house or sell the car, or borrow money from family and friends.

"That gives you an idea of how badly distressed they are by their appearance," he says.

Dr Rees, who operates on children as young as 4 or 5 to fix ears that stick out, also sees women in their 70s and 80s who want facelifts or nose reductions. He has done a breast enlargement on a 65-year-old woman.

"I think as people are living longer and are healthy longer. There are a group of people who realise they are going to be around for a while, [saying] 'I'm still socially active and enjoying life but I don't like the way I look any more'. If they can afford it they come in, they have necklifts and their eyelids done. Those are the two commonest things."

And it's not just women - for every 20 facelifts on women, Dr Rees performs one on a man.

Recent research by the British Association of Aesthetic Plastic Surgeons found increased demand among women and men in their 70s and 80s for surgery to improve their appearance.

Eyelid surgery, nose reshaping and facelifts were among the top five procedures, and improved techniques meant the surgery was safe for older people.

Dr John Barrett, of Remuera's Palm Clinic and president of the New Zealand College of Appearance Medicine, says the bulk of his clients are between 30 and 50, but the oldest patient he treated with dermal fillers was 86. He has also performed liposuction on a 75-year-old.

Elderly patients aren't after a radical change but a "freshen up".

"I think in New Zealand we have a different mentality to the stereotypical Californian woman who might want the extreme facelift and be happy to look like a totally different person to what they used to be."

The New Zealand College of Appearance Medicine doesn't keep a central register of procedures but in 1996 it had six members; now it has 35 and another 35 have applied for training positions.

Why they do it

* A 59-year-old Papatoetoe woman, who recently had liposuction to reduce her breast size, says the change in her appearance has made her feel like a new person. She used to suffer neck and shoulder pain and always felt "very self-conscious". "At my age isn't it stupid? But I love clothes and fashion. I used to go out and everyone would look at my boobs, not my eyes. Lately people are starting to notice my eyes."
* A 35-year-old woman who spends up to $4000 a year on botox treatments - which her husband doesn't know about - says she is not sure if she would go as far as having surgery. "People I know think things like botox are ridiculous ... I see it as fairly essential maintenance."