Pranee Prakit wanted the unsightly cellulite on her abdomen removed, so she went to a cosmetic surgery centre in Bangkok to have it taken out. But instead of a flatter abdomen, the 34-year-old told local media, ''I was left with an ugly, one-inch wide, raised scar across my abdomen as a result of surgery to reduce cellulite.''

In fact, Pranee said, her husband left her because he could not stand seeing the ugly scars on her abdomen. Her daughter was also too embarrassed to go to school, she claimed.

Parichart Chaikham, 33, went for a breast enlargement procedure at the cost of 50,000 baht (US$1,140). She has then had to undergo three operations after her breasts became infected after the first operation.

Pranee and Parichart, two of many women who opt for surgical solutions to fix 'problems' with their physical appearances, are suing the Ratchayothin clinic for negligence and emotional distress. Pranee is seeking one million baht (US$22,820) in compensation.

But the plastic surgeon who performed the procedures, Dr Chairoj Visuthichaikij, denies the charges, saying the patients did not follow instructions after the procedures.

Figures on cosmetic surgery procedures are difficult to come by and doctors and polyclinics are hesitant to give them, but one hospital did say it handles some 100 surgery and dermatological cases a day.

Extra money

The Medical Council, an agency under the Ministry of Public Health that looks after ethical standards in medicine, says that at one complaint about cosmetic surgery is filed every month.

In the last four or five years, two physicians have been found guilty of malpractice and had their medical licences withdrawn, it said.

"Substandard clinics would be given four levels of punishment — warning, probation, withholding of medical licences for less than two years and permanent withdrawal of licences," said Dr Chumsak Prueksapong, the Medical Council spokesman.

The council, however, admitted it is not easy to monitor unqualified surgeons because standards for cosmetic surgery centres are written in broad guidelines.

"The Medical Profession Act allows holders of bachelor's degrees in medicine and a medical licence to perform procedures even if they do not have certificate in a specialised field," said Dr Chumsak. "Many physicians can make extra money performing cosmetic surgery without having the proper skills."

Given this environment, he advises Thais opting to take the surgical route to do more homework before choosing the service.

This is a lesson that 23-year-old student Chayada Chitpieansrang learned the hard way.

"I feel sorry for them (Pranee and Parichart) after hearing their stories," Chayada said in an interview. "I myself underwent cosmetic surgery for my nose implant when I was 18."

Chayada said the private polyclinic she went to was recommended by a friend, and she paid 5,000 baht (US$114 dollars) for her two operations.

She recalls that the doctor did not explain anything to her — all she knew was that silicone would be inserted in her nose to make the bridge higher, and that she just had to wait for the better look.

"I was at first very happy with the outcome, but my nose has become disfigured after three years,'' recalled Chayada. ''I then decided to pay another 5,000 baht (US$114 dollars) to have the silicone removed."

Indeed, doctors say that the pull of surgical procedures continues to be strong for some women, despite the risks, because of the pursuit of their concept of physical improvement and its relation to many women's self-worth.

"The idea of aesthete has stayed with every woman for centuries," said surgeon Jutha Chansri of Yanhee General Hospital, a private facility well-known for plastic surgery and beauty treatments.

"It is a matter of technology that allows people to make more change to themselves in order to gain better looks,'' Jutha added in an interview.

Fair and slim

Indeed, all around a megacity like Bangkok, as in many other East Asian cities, are 'definitions' of beauty that fit the mold of fair, whistlebait women — on television, in the movies, on billboards.

''It has been a common belief, among every class of women, that the ideal image of a woman is to be very slim and have fair skin,'' Usa Lerdsrisuntad of the non-government Foundation for Women said.

''People usually make fun of the fat and the dark-skinned,'' she added. ''Commercials try to make women strongly concerned about beauty, without thinking about their health.''

''Liberalisation has allowed the government to do only little in examining cosmetics and treatments. They can examine and ban them only when there is a petition (against them),'' she said.

But Dr Jutha said, "Plastic surgery is more likely personality improvement. It is actually based on the same ground as women put on their make-up. The purpose is to gain self-confidence."

Some people also need plastic surgery health reasons, but in any case, Jutha says doctors should explain and discuss with their patients the surgical procedure, its results and effects.

The English-language daily The Nation quoted Chairoj, the defendant in the lawsuit by Pranee and Parichart, as saying he had done ''nothing wrong'' and had been willing to help when they developed complications.

Despite stories like that of Pranee and Parichart, some women are convinced of the value of being slim and fair.

"Every woman wants to be beautiful and I do not see anything wrong with that," Cherd Donkratoke, a 35-year-old domestic worker, says of women who opt for surgical procedures — and have the money to do it.

Cherd said that she normally spends a large portion of her salary on products from facial washes to lotions and powder and skin whiteners. "I think I would look much better with fairer skin. Look at all the famous actresses, they have nice bodies with very fair skin, nice hair and they put on some make-up,'' she added.

But 29 year-old private employee Panuwat Chanhom countered: "It's true that every man tend to prefer beautiful women, but physical beauty was not the first thing that men care for. Physical appearance, especially artificial beauty, is not permanent.'' (IPS)