A nip here and a tuck there. From noses and lips, to chests and stomachs, the celebrity plastic surgery trend seems to have gone from the extreme to the pure ridiculous. Everyone from stunning supermodels to talented actresses are in search of the perfect face and body; and with competition so high in the entertainment industry, the key to staying in the game is to remain constantly beautiful – no matter what the cost. And that cost is big business, with the latest figures from the American Society for Aesthetic Plastic Surgery (ASAPS) revealing that the industry is worth a staggering $13 billion (Dh47.75bn). "Looking good is very important in a celebrity's line of work because they are constantly photographed and featured in magazines," Michael Gold, celebrity dermatologist and dermatology surgeon, and founder of the United States famous Gold Skin Care Center told Emirates Business while visiting Dubai. "If somebody gets photographed not looking their best, chances are that picture will land in every magazine, which is not the best thing for their reputation." The high demand for cosmetic surgery is apparent. ASAPS says in 2007 some 11.7 million cosmetic surgical and non-surgical procedures were performed in the US alone. The most frequently performed procedure is Botox, while the most popular surgical procedure is liposuction. Breast augmentation, rhinoplasty (nose reshaping, commonly known as nose jobs), and eyelid surgery are also common. Pierre Francois Fournier, aesthetic surgeon and founder of Aesthetic Medicine, who recently teamed up with Dubai's Aesthetica Clinic at the JW Marriott, elaborates: "The face is a passport for life, so it is vital to remain beautiful. It is the key to success. "Having a good nose is very important. Leonardo Da Vinci once said the nose represents 80 per cent of the face's beauty." And it looks like women are the ones highly contributing to this industry. One shocking result from the ASAPS revealed women had 91 per cent of all cosmetic procedures last year with only nine per cent of men going under the knife – a clear indication that females are under more pressure to look good. "A woman needs to look good to keep her husband," comments Fournier. "Women are like flowers – their stem remains the same, but they should constantly change their look and their perfume," he continues without any hint of sarcasm. In the US and United Kingdom, more celebs are opting to go under the knife to enhance their features. Pamela Anderson's career is literally based on her appearance and the same goes for British model Jordan. A similar procedure for Christina Aguilera certainly did not do her "dirrty" image any harm. Then there is Ashlee Simpson, whose entire face changed following a rhinoplasty operation. It also upped her popularity in the tabloids and gossip websites. And it seems that so called "natural" celebrities are now crumbling under the pressure to be picture-perfect. Lily Allen recently revealed she is contemplating gastric bypass surgery and liposuction to reduce her weight. She said: "I used to pride myself on being strong minded and not being some stupid girl obsessed with the way I look. I felt like it didn't matter if I was a bit chubby because I'm not a model, I'm a singer. "But I'm afraid I am not that strong and have fallen victim to the evil machine. I write to you in a sea of tears from my hotel bed in Seattle, I have spent the past hour researching gastric bypass surgery, and laser liposuction." This disturbing statement contrasts sharply with her previous comments on her body image, which displayed a confident young woman. "I'm irritated by the emphasis on being thin. I wouldn't swap bodies with anyone," she said. The demand for plastic surgery is also very much on the rise in the Arab world. While there are no official figures for cosmetic surgery procedures in the UAE, it is obvious it has become popular thanks to more and more clinics opening, particularly in Dubai. However, the Arab country flying the flag for "plastic fantastic" is Lebanon. With numerous female stars, such as Nancy Ajram, Haifa Wehbe, Elissa, Diana Haddad, Dina Hayek and Maria, all rumoured to have had at least a nose job, it seems that there aren't any natural beauties to look up these days. This may be OK for older women who are capable of making the right decisions about their body, but they certainly aren't the best role models for teenagers. In a survey with British teenage magazine Bliss , it was revealed that a staggering 40 per cent of teens wanted plastic surgery to change the way they look. Two thirds of the 2,000 girls quizzed, who were an average age of 14, said that it is the pressure from celebrities that made them consider plastic surgery. Bliss editor Chantelle Horton branded the survey's results a "21st century tragedy", adding: "The endless parade of thin yet curvy, surgically-enhanced celebrities has made girls obsessed with their own normal lumpy, bumpy bodies. They also