A few years ago when the rand was at rock bottom, South Africa was the perfect "surgery and safari" destination for foreigners with a bit of cash and a desire to upgrade their appearance and take a little vacation at the same time.
It still is, although competition these days is fierce with places like Rio de Janeiro offering cosmetic surgery/holiday packages at cut-throat prices and boasting plastic surgeons just as good as ours.
But if there has been some attrition in pound and dollar-rich custom, it's no skin off the noses of the surgeons, who are thriving from the huge demand locally.
Women of all shapes and sizes, and within a whole range of budgets, are increasingly opting for facelifts, tummy tucks, boob jobs, nose jobs and now, so-called "designer vaginas" (see box at the bottom).
At a ballpark average of between R20 000 and R30 000 for any one of these procedures, plastic surgery remains costly for most people, but the Internet, coupled with information in women's magazines and TV programmes such as Dr 90210 and Nip and Tuck has spread plenty of knowledge about what's available and vastly reduced the fear factor.
Cosmetic surgeons have proliferated all over the country, and such is the interest that some of the doctors who were consulting abroad to attract patients have opted to focus on the local market exclusively.
One is Dr Luke Gordon from the Metamorphosis Clinic in Benoni, who says he's enjoyed a steady increase in business from the East Rand community over the past few years, not only in cosmetic but also non-cosmetic procedures.
"With foreign patients you can't always follow through if there are problems after surgery, so I've concentrated on the local market, which is booming," he says.
Celebrities are always the reference for ordinary mortals, and in South Africa we have clocked up quite a few to look at and analyse their appearances before and after cosmetic surgery.
One of the first to go public was actress and businesswoman Tselane Tambo, who underwent a televised liposuction.
Felicia Mabuza-Suttle, now living in the US, also had a lot of body work done during her time here as presenter of her show, and Connie Ferguson, otherwise known as Karabo Moroka in Generations, has had a breast job and her nose trimmed on the sides "for medical reasons".
Uyanda Mbuli, former beauty queen turned TV personality who had a nose job (rhinoplasty) done four years ago, says it was one of the best decisions of her life, even though it cost her R45 000.
"There is not a big difference between what I looked like then and now, but my side profile has greatly improved. I went to a nose specialist who worked on a computer to show me the expected result and I wasn't disappointed," she says.
Of course there have been terrible botches too, some the result of ill-considered operations by rogue surgeons like Dr Hennie Roos, who has since disappeared from the South African medical map.
Businesswoman and socialite Edith Venter had an eyelift some years ago and had a "very bad experience where they did not heal evenly".
"I was badly bruised and left with severe scarring which took ages to sort out. The doctors didn't give me the correct information about the eventual appearance and how long it takes after surgery," she says.
Edith says she's had far more satisfying results from non-surgical facial treatments, in her case, extensive mesatherapy (micro-injections that target adipose fat cells, rejuvenates collagen, and stimulates new skin) and fillers (de-ageing creams), courtesy of Dr Gordon Cohen at the Melrose Aesthetic Centre in Melrose Arch.
"I am about to undergo a deep peeling treatment which has just come into South Africa which you can do around the eyes and neck. It tightens and smoothes and flattens the skin," she says.
Victoria Wagner of Evolution Cosmetic, a surgical tourism company with an office in Cape Town, says that like Edith, more and more women are enquiring about the non-surgical procedures, one of the more popular being the titan lazer facelift, using an infra-red light causing collagen contraction to tighten the skin.
Another is photo genesis, using pulsed light to improve the appearance of sun damage, pigmentation, redness, pore size and age spots.
Back in the surgical world, the most popular surgeries are still on the chest before the face.
Breast augmentation is top of the list of pending procedures in most plastic surgeries, then they vary, but fall in the general order of tummy tuck, liposuction, rhinoplasty, facelift and eye lift.
All these procedures have become safer, and ways have been found to do them less invasively. "The incisions are smaller and you're getting a shorter scar phase," says Dr Gordon.
But as you move down the body to the tummy and hips, the emphasis turns from reshaping to removing fat, and while this can mean a dramatic improvement to a woman's body shape, it does present its own aftermath perils, like uneven, orange-peel skin following liposuction.
Uyanda Mbuli cautions against body shaping. "I know women who've had tummy tucks and lipo around the hips who ended up without their natural curves, or who put the tummy weight back on because they didn't maintain a healthy gym and eating regimen."
What it all reflects is that cosmetic surgery in millennial SA has become a professional service like any other: you do your homework, shop around for the best, book and pay for it, then take a few days off to have it done.
The reward is a new look, and happily, it's not so important these days to hide from people how you got it.