A different nip and tuck for every neighbourhood

AT A plastic surgery clinic in Upper Manhattan that caters to Dominicans, one of the most popular procedures is an operation to lift women's buttocks, because - as the doctor explains - "they all like the curve."

In Queens, surgeons have their attention trained a few feet higher, on upturned noses that Chinese patients want flipped down. Russian women in Bay Ridge, Brooklyn, are having their breasts enlarged, while Koreans in Chinatown are having jaw lines slimmed.

New York has developed a host of niche markets that allow the city's many immigrants to get tucks and tweaks carefully tailored to their cultural preferences and ideals of beauty. They can also find a growing number of doctors offering instalment plans to help them afford operations. If the price is still too high, illegal surgery by unlicensed practitioners is available in many neighbourhoods.

As these specialised clinics reshape Asian eyelids and Latina silhouettes, they provide a pore-level perspective on the aspirations and insecurities of immigrants in 21st century New York — a mosaic portrait buffed with Botox.

"When a patient comes in from a certain ethnic background and of a certain age, we know what they're going to be looking for," said Dr Kaveh Alizadeh, president of Long Island Plastic Surgical Group, which has three clinics in the city. "We are sort of amateur sociologists."

Alizadeh, an immigrant from Iran, admits the results can seem less like science than stereotyping. Still, he and other doctors who work in ethnic communities say they can scan their appointment books and spot unmistakable trends: many Egyptians are getting facelifts. Many Italians are reshaping their knees. Alizadeh's fellow Iranians favour nose jobs.

And there's no questioning the surge in demand in immigrant neighbourhoods, where Mandarin and Arabic are spoken in the operating room and patients range in age "from 18 to 80," as one doctor said.

About 750,000 Asians in the US had plastic surgery in 2009 - roughly 5 per cent of the Asian population, and more than double the number in 2000. Among Latinos, the number was about 1.4 million, nearly 3 per cent of that population and a threefold increase from nine years earlier. In 2009, about 4 per cent of whites underwent a cosmetic procedure.

The extreme makeover is, in many ways, a tradition among New York's immigrants. A century ago, European Jews had nose jobs and Irish immigrants had their ears pinned back in attempts to look "more American," said Victoria Pitts-Taylor, professor of sociology at Queens College, who has written about popular attitudes toward plastic surgery. "The bulk of those operations were targeted at assimilation issues," Pitts-Taylor said.

Today, rather than striving to fit in to their new country, many immigrants reshape themselves to their home culture's trends and tastes.

"My patients are proud of looking Hispanic," said Dr Jeffrey S Yager, whose office in Washington Heights - a largely Dominican neighbourhood - has tripled in size since it opened in 1997. "I don't get the patients who want to obscure their ethnicity."

While clinics that advertise in the local Russian, Spanish and Chinese media have much in common with one another and with those serving nonimmigrants - everyone wants a flat stomach and a smooth forehead - their core businesses are very different.

Italia Vigniero, 27, a Dominican patient of Yager's, had breast implants in 2008 and is considering a buttocks lift to attain, as she called it, "the silhouette of a woman". "We Latinas define ourselves with our bodies," she said. "We always have curves. My personality doesn't go with small breasts."

In Flushing, home to a vibrant Asian community, Dr Steve Lee, a Taiwan native, performs procedures that are rarely, if ever, done in Yager's clinic. Some Chinese believe prominent earlobes are auspicious, so a male client asked for a cosmetic filler into his earlobes to make them longer.

Perhaps the most sought-after procedure among Asians is "double-eyelid surgery," which creates a crease in the eyelid thus making the eye look rounder. Some people criticise the operation - hugely popular in many Asian countries - as a throwback to procedures meant to obscure ethnicity.

"You want to be part of the acceptable culture and ethnicity, so you want to look more Westernised," said Margaret Chin, professor of sociology at Hunter College. "I feel sad that they feel like they have to do this."