As a new survey reveals that two-thirds of us would like cosmetic surgery,

JO HAYWOOD asks if we are going under the knife with unrealistic expectations.

WHY just have your nose done, when you can have a tummy tuck, a bum lift and a boob job at the same time? Like package holidays for cosmetic surgery addicts, extreme makeovers are on their way to the UK.

A survey by Extreme Makeovers, a new show on LivingTV which plays on the US trend for multiple operations to voyeuristic effect, found that 64 per cent of Brits wanted to change their looks with cosmetic surgery and almost one in ten had already taken the plunge.

Not satisfied with improving their own features, most of those questioned wanted someone else's - preferably someone famous. Jennifer Lopez and her amazing pneumatic bottom topped the poll for women, while Brad Pitt had the face and body of choice for men.

Highly unrealistic goals which, according to Professor Simon Kay, consultant plastic surgeon at the Duchy Nuffield Hospital in Harrogate, ultimately lead to highly disappointing results.

"These are not just unrealistic expectations, they are pure fantasy," he said. "If a hirsute, size 14 woman walks through the door, there is no way she is going to walk out again looking like J-Lo.

"As a surgeon you have to ensure the patient has realistic expectations, as most do in this country, otherwise they will end up very disappointed and very angry."

Prof Kay blamed commercial clinics, some of which employ surgeons who are not qualified in cosmetic and reconstructive work or who have little experience in this field, for persuading patients to have ill-advised procedures.

"Our job should not be to persuade people to have operations," he said. "A good surgeon will tell his patients the down sides to surgery, laying out all the things that can go wrong. They shouldn't be selling surgery packages to the highest bidder."

The arrival of Extreme Makeovers coincides with the launch in Britain of the controversial drama Nip/Tuck, which has enjoyed massive success in America.

This is the everyday story of body-sculpting surgeons, complete with bizarre transformations and enough gore to fill your average Hollywood swimming pool twice over.

"We do depict surgery throughout the show and it's a brutal thing to see," said star of the show Julian McMahon, once married to Dannii Minogue and the son of a former Australian prime minister. "I go with the notion that once you are slicing skin open and peeling it back, it's not going to be that pretty."

As for the grumbling from some critics that it is unrealistic, he retorts that Nip/Tuck is in fact a deep show that reflects shallow attitudes.

Prof Kay begs to differ: "I was flabbergasted by this programme. It seemed to be about two completely unethical men trying to make a fast buck out of plastic surgery. It was little more than a farce - especially when a gun fight broke out in the operating theatre.

"I know it's entertainment and I don't want to come across as an old fart about this, but it really does fuel people's fantasies."

Prof Kay did say, however, that most people in the UK were sensible enough to understand a plastic surgeon's limitations.

"We can improve what they have," he said. "But we can't transform them into a new person. At the end of the day, people have to understand that surgery is always unpredictable. Every honest surgeon will tell you he has had bad results. You just have to do your best for your patient."

Barbara Barker of Wigginton took the realistic route when it came to cosmetic surgery. She didn't want to look like a 20-year-old superstar, she just wanted to look like herself again.

"When I looked into the mirror and saw my mother staring back, I knew it was time for a makeover," she said. "I first thought about plastic surgery when I was in my 20s. We have a family trait of heavy, drooping eyelids and I knew one day it would have to be an option."

She finally decided to take the plunge after nursing her mother through a painful and ultimately lost battle against bone cancer.

After scouring the Yellow Pages, she chose the Transform Clinic in Leeds.

"After an initial consultation about my eyes, the plastic surgeon said why not have a full facelift at the same time," said Barbara, who had a facelift and upper and lower eyelid reduction by the surgeon at a Cheshire clinic.

"I was 49 at the time, but I looked much older. After the operation, I looked my age, which was fine by me."

The operation inspired her to update her hair, make-up and wardrobe.

"I felt like a different person," she said. "It was not like an American facelift where you look like you've been dragged through a wind tunnel. It was a very natural result. I still looked like me, only brighter and better."

Barbara is scathing of people who see cosmetic surgery as the answer to their problems. Unrealistic expectations, she believes, can only lead to disappointment.

"People think that plastic surgery is a way of slicing off their obesity," she said. "I've got no time for liposuction. If people want to lose weight they should go to a gym not a surgeon."

Barbara had her operation nine years ago and readily admits that it might be time for another. Her eyes, she says, are becoming a little droopy again and might need a lift before she hits 60.

"I won't have another full facelift though," she said. "I'm happy to look my age."

Updated: 09:17 Thursday, January 29, 2004