Most people would have thought Nivedita Oza was a very beautiful woman. The voluptuous 35-year-old had a wonderful figure, a well-toned body, beautiful silken hair and unblemished skin. Only one person saw a flaw in a body most women would have given their right arm for-Oza herself. "My lips were very thin and this had always troubled me," she says. So Oza, the Mumbai-based creative head of an ad agency, urged an actor friend to recommend a good cosmetic surgeon. One consultation and she was ready for cosmetic surgery. In a 40-minute operation, the surgeon sucked out fat from Oza's left hip and injected it into her lips. After the swelling subsided, Oza exclaimed, "My lips are beautiful. And sexy."

GAIN WITHOUT PAIN: A patient undergoes minimally invasive surgery

The obsession with looking good at any cost is not new in India. Even before Sushmita Sen and Aishwarya Rai won the Miss Universe and Miss World titles in 1994, cosmetic surgery was being performed in India. A nip here and a tuck there could transform a plain Jassi into a Miss India finalist. But it was costly and complicated. Now, minimally invasive "coffee-break surgeries" are making beauty a made-to-order commodity.

Every part of the face is now open to alterations. Whether it is extending the fissure of the eyes to make them bigger, inserting cheek and chin implants to highlight these features, sculpting the jaw line or creating a dimple, surgeons are using minimally invasive techniques that involve less slicing and sewing. "The knife is out and the needle is in," says cosmetic surgeon Vijay Sharma.

The quick, relatively painless procedures have reduced the fear of surgery. Getting more prominent cheekbones no longer involves a 3-4 cm cut under the eye, heavy bleeding, a hard implant and two hours of surgery. Now, in less than an hour, a micro-hole with a diameter of barely a millimetre is made inside the mouth, a soft implant rolled up and inserted and then flattened out over the cheekbone. Most of these surgeries take 20-45 minutes and bleeding is minimal.

The recovery period is shorter too. In fact, in surgeries like lip enhancement, apart from some redness and swelling, there are no tell-tale signs of an operation. It is possible to visit a surgeon's clinic during lunchtime, undergo a surgery and go back to work.

What are the people who go in for cosmetic surgery looking for? Nicole Kidman's nose, Angelina Jolie's lips, Preity Zinta's dimples (three aspiring actresses have acquired dimples) and Hrithik Roshan's jaw. "We are now looking beyond designer clothes-we want a designer face," says consulting psychiatrist Anjali Chhabria who counsels people dissatisfied with their appearance. "For many, it stems from low self-esteem. Looking good makes us feel good instead of the other way round." Every feature must be perfect: a narrow facial shape, fuller lips and high cheekbones for women and for men, full symmetrical lips, prominent jaw and broader upper half of the face.

Soaring aspirations also drive the trend. "Our appreciation of beauty has changed," says senior cosmetic surgeon Narendra Pandya. "We now look at everything with microscopic eyes." Pandya, frequently invited as a judge to beauty pageants, says winners often edge out other contestants on facial features or body parts. And while it is easy to dismiss this phenomenon as limited to the modelling world and film industry, these are the people who are seen as the standards of beauty.

Globalisation has played its part. Indian surgeons are learning new techniques and procedures and interacting with overseas specialists. With the spread of awareness and the availability of trained personnel, a growing number of affluent and middle-class Indians is seeking ways to change the appearance Mother Nature gave them.

According to the American Society of Plastic Surgeons, a record 87 lakh cosmetic surgery procedures were performed in America in 2003, a 32 per cent increase over the previous year. The number of minimally invasive operations like Botox treatments, collagen injections, chemical peels, and laser hair-removals rose by 41 per cent. In comparison, Dr Mohan Thomas of the Mumbai-based Cosmetic Surgery Institute estimates that over three lakh surgical and non-surgical cosmetic procedures took place in India in 2003. The cosmetic surgery business is growing here by 100 per cent every year.

With business booming, there are twice as many impostors as qualified professionals. The procedures may be less complicated and safer now but there are cases where surgeries have gone horribly wrong. Even if the doctor is highly qualified, a surgery is not without risks.

A Mumbai-based actor had to undergo four operations before her nose was set right. The first time, her nasal structure collapsed. The second time, her body rejected the implant. Then the cartilaginous tissue used to construct the nose resulted in a depression. Only on the fourth occasion was the surgery successful. Abnormal pigmentation, displacement of the implant and rejection of implants by the body are the other hazards of cosmetic surgery. But people are willing to take that chance.

While Botox injections are popular with the 40-plus set and accounted for close to 50 per cent of cosmetic procedures last year, lip enhancement, facial liposuction and nose jobs are particularly in demand among those in the 18-30 age group. Saumya Singh not only had a nose job and her lips enhanced with body fat, the 22-year-old actor also opted for facial liposuction. "My jaw was too square and made my face look big." A 20-minute procedure, which sucked out fat cells from her cheeks, jaw and neck, took care of that.

Affordability has bolstered the popularity of these new techniques. Facial surgeries cost Rs 15,000-40,000. Singh, a small-town girl from Uttar Pradesh paid about Rs 60,000 for a combo of surgeries but she insists it was money well spent. "I want to make it big as an actor," she says.

This points to a disturbing trend: our fascination with appearance is only growing. And advances in technology will nurture this obsession. Beauty may be skin-deep. But it matters.