Janet and Jaqueline Timal are 40-something-year-old sisters, and they have what they call a plastic surgery fund.

"I'm always saving money. When I see I've gathered up enough money for another surgery I do it," Jaqueline says.

She has had breast implants put in and also a tummy tuck. She's visiting the plastic surgeon's office again to do a famed Brazilian butt lift, which is the same as a breast lift, but on your backside. Janet has had a tummy tuck; she's now doing her breasts, too. Between them, they will have had five surgeries.

Janet and Jaqueline aren't rich — far from it. One works at a retirement home; the other owns a small shop.

They both say this isn't about bankrupting themselves for beauty but rather the opposite — Jaqueline says she sees the procedures as an investment.

"I think we invest in beauty because this is very important for women here. You can get a better job because here they want a good appearance, a better marriage because men care about the way you look," she says.

Brazil has just surpassed the U.S. as the place with the most cosmetic surgeries performed in the world, even though it has fewer people and collectively less disposable income than the U.S.

Last year, according to the International Society of Aesthetic Plastic Surgery, 1.5 million cosmetic surgeries were carried out in Brazil — 13 percent of all the elective plastic surgeries done all over the world.

One reason is that Brazil simply has more plastic surgeons per capita than the U.S. There's a health care crisis in Brazil that has led the country to import doctors from Cuba to work in rural and poor areas. Yet there's a surfeit of plastic surgeons.

The other reason is women's increasing financial power. In the past 10 years, Brazil has grown economically, and salaries and disposable income have gone up. Women like the Timal sisters have overwhelmingly chosen to use that money on their appearance.

While in the U.S., people may hide that they have had plastic surgery like it's something shameful, in Brazil they flaunt it. The attitude is that having work done shows you care about yourself — and it's a status symbol.

But even though people have more money and greater access to credit, many of the poor wouldn't be able to afford to pay for all of their cosmetic procedures unless they got a helping hand.

'The Right To Dream'

The Ivo Pitanguy Institute in Rio de Janeiro is named after the famous Brazilian plastic surgeon who is renowned for saying, "The poor have the right to be beautiful too."

Maria da Gloria de Sousa, 46, has had six surgeries at the Pitanguy Institute.

Maria da Gloria de Sousa, 46, has had six surgeries at the Pitanguy Institute. "First off, I do this for me. These kind of things you need to do for yourself. And second, there's nothing better than getting a compliment, right? That you're good, that you're sexy, it's really good. I like it."

Jimmy Chalk for NPR

Here the ethos is beauty shouldn't just be a privilege of those who can afford it.

The institute's lobby is packed as attendants call out the names of women — and a few men — who are waiting to be evaluated for cosmetic surgeries. This is a charity and teaching hospital, and the surgeries given are either free of charge or heavily subsidized.

The hospital offers all the usual fare: breast implants, breast lifts, Botox, nose jobs, face lifts and, of course, the ever-popular butt implant.

This is where the Timal sisters are having their surgeries. The price for Jaqueline's butt lift? It's 3,800 reals, about $1,600. At a private hospital it could run over three times that.

Francesco Mazzarone, who now heads the institute, explains why it's important to provide cosmetic surgeries to the disadvantaged.

"This is about equality, which is the philosophy Pitanguy created. Equal rights to everyone. The patients come here to get back something they lost in time. We give to them the right to dream," he says. "What we do here is altruism."

And the women NPR spoke with are grateful, but they also acknowledge that there is a lot of pressure in Brazil to conform to a physical ideal.

Jaqueline Timal says her 21-year-old daughter has already had liposuction.

"I told her she should wait, but to be very beautiful, we push ourselves — and also society pushes us. I think she is too young for that, but as it was her great desire, I supported [her] so she can be happy," she says.

Some in Brazil, though, balk at the idea that happiness can be achieved at the end of a scalpel.

Being a feminist is a lonely business in Brazil, says Karen Polaz, a blogger and women's rights activist. She says despite the fact that Brazil has a female president, it's still a very sexist country. She says beauty as a right sounds good in principle; what that means in practice is that a very narrow view of what is beautiful is being pushed onto people here.

"Before accepting the idea that everyone has the right to be beautiful, we have to understand the image of beauty that is being sold, because this is an industry, an extremely lucrative industry. They transform women into consumers," she says.

And in Brazil, that transformation has a racial component.

What's Sold As Beautiful

Brazil imported more slaves, some 4 million, than any other country. Today, it is a primarily a mixed-race country, but you wouldn't know that by looking on TV and in magazines here, which rarely feature people of color.

"If you look at the traditional body type of a Brazilian, you would see a woman with dark skin, curly hair, small breasts and a larger bottom, a body that is very different from the body marketed as desirable," says Marcelo Silva Ramos, an anthropologist and social scientist.

He says what is sold as beautiful here is someone like Brazilian model Gisele Bundchen: a woman who is tall, thin, blond with straight hair, bigger breasts and fewer curves. That has meant people who don't look the right way — and by this he means "the white way" — are often excluded, he says.

"In our culture, the view is women who look acceptable get money, social mobility, power," he says.

Take for example the popular Miss Bumbum contest, which annually crowns Brazil's best backside. All of the contestants this year are lighter skinned.

Claudia Alende, the 22-year-old front-runner of this year's competition, looks like American actress Megan Fox, right down to the blue contact lenses she wears over her natural brown eyes. She says she is competing for a simple reason.

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"The contest is famous around the world, and I want to be recognized around the world and become famous, too," she says, laughing.

She says the contest is a way for her to become a TV presenter or an actress. The rules of the contest allow for plastic surgery anywhere but on the backside. She openly admits she's had work done.

"It was [because] everyone was doing [it] so I did [it]," she says.

Previous Miss Bumbum contestants have indeed gone on to arguably bigger and better things. One became a TV presenter; others have become actors and professional dancers on TV. But they are among the few.

Maria da Gloria de Sousa is 46 but looks 30. She's unemployed but has had six surgeries at the Pitanguy Institute and speaks about her procedures with characteristic Brazilian humor and openness.

"Plastic surgery starts to become an addiction. You're born perfect, but then you have children and you know what having children does. Then suddenly comes the rebirth: plastic surgery. You can be beautiful, even more beautiful than you were before." — Maria da Gloria de Sousa, 46.

Jimmy Chalk for NPR

"I'm almost an android! I had done my breasts three times. I didn't stop there. I did a tummy tuck and then a lipo, and, lastly, I did my bottom," she says.

She says she has spent the equivalent of the cost of three cars on her operations.

"I'm much happier, there is no doubt about it. My bottom will never sag, my breasts will never sag. They will always be there, hard. It is very good to look at the mirror and feel fine," she says.

When I ask her if it was all worth it, she tells me she has a 21-year-old lover.

"Things have gotten a lot better," she quips.

She waves goodbye and, smiling, sashays down the beach — and nothing jiggles.

You can follow NPR's South America correspondent Lourdes Garcia-Navarro @lourdesgnavarro.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

MELISSA BLOCK, HOST:

Brazil has surpassed the United States and is now the world leader in the number of plastic surgeries performed, even though the U.S. has more people with more disposable income. As part of our series on the changing lives of women, NPR's Lourdes Garcia-Navarro reports that many Brazilian women see surgical beautification as a right and not a privilege.

LOURDES GARCIA-NAVARRO, BYLINE: Janet and Jaqueline Timal are 40-something-year-old old sisters and they have what they call a plastic surgery fund.

JAQUELINE TIMAL: (Through translator) I'm always saving money. When I see I've gotten enough money for another surgery I do it.

GARCIA-NAVARRO: That's Jaqueline. She's had breast implants put in and also a tummy tuck. She's here today to do the famed Brazilian butt lift, which is the same as a boob job but on your backside. Janet has had a tummy tuck too and she's also doing her breasts. That'll be five surgeries between them when this round is done. They both say this isn't about bankrupting themselves for beauty but rather the opposite. Jaqueline says she sees the procedures as an investment.

TIMAL: (Through translator) I think we invest in beauty because it's very important for women here. You can get a better job because here they want a good appearance, a better marriage because men care about the way you look.

GARCIA-NAVARRO: Janet and Jaqueline aren't rich - far from it. One works at a retirement home, the other owns a small shop. Even with the surgery fund, they wouldn't be able to afford to pay for all those cosmetic procedures, they say, unless they did it here.

GARCIA-NAVARRO: Here is the Ivo Pitanguy Institute in Rio de Janeiro, named after the famed Brazilian plastic surgeon who is renowned here for saying the poor have the right to be beautiful too. The institute's lobby is packed as attendants call out the names of women, and a few men, who are waiting to be evaluated for cosmetic surgeries. This is a charity and a teaching hospital and the surgeries given are either free of charge or heavily subsidized.

So on the wall in front of me here at the Ivo Pitanguy Hospital there is a list of the many procedures that they offer. There are breast implants, breast lifts, Botox, nose jobs, face lifts and, of course, the ever popular butt implant.

The sisters tell me the price they are paying for the butt lift, for example, is 3,800 reals, about $1,600. At a private hospital, it could run over three times that. We meet with Francesco Mazzarone, who now heads the institute. I ask him why it's important to provide cosmetic surgeries to the disadvantaged.

FRANCESCO MAZZARONE: (Through translator) This is about equality, which is the philosophy Pitanguy created - equal rights to everyone. The patients come here to get back something they lost in time. We give to them the right to dream.

GARCIA-NAVARRO: Why should only the wealthy have access to something that will increase self-esteem, he asks. What we do here is altruism, he says. So here are the numbers. Last year, according to the International Society of Aesthetic Plastic Surgery, there were one and a half million cosmetic surgeries carried out in Brazil. That's 13 percent of all elective plastic surgeries done all over the world. Part of the boom can be explained by women's increasing financial power. In the last 10 years, Brazil has grown economically. Salaries have gone up, as has disposable income. Women, like the Timal sisters, have overwhelmingly chosen to use that money on their appearance. That's the thing. While in the U.S., people may hide that they've had plastic surgery like it's something shameful. Here they flaunt it. The attitude is that having work done shows you care about yourself and it's a status symbol. But the women we speak with also acknowledge there is a lot of pressure in Brazil to conform to a physical ideal. Jaqueline Timal tells me that her 21-year-old daughter has already done liposuction.

TIMAL: (Through translator) I told her she should wait. But she'll very beautiful. We push ourselves. And, also, society pushes us. I think she's too young for that, but as it was her great desire, I supported her so she can be happy.

GARCIA-NAVARRO: Some here, though, balk at the idea that happiness can be achieved at the end of a scalpel. They say the image people chase is being defined by marketers and, in Brazil, it has a racial component. Marcelo Silva Ramos is an anthropologist and social scientist. Brazil imported more slaves, some 4 million, than anywhere else in the world. Today, it's a primarily a mixed-race country but you wouldn't know it if you look on TV and in the magazines here, he says.

MARCELO SILVA RAMOS: (Through translator) If you look at the traditional body type of a Brazilian, you would see a woman with dark skin, curly hair, small breasts and a larger bottom. A body that is very different from the body marketed as desirable, which is a skinnier, taller, blonde with straight hair with bigger breasts and with not many curves.

GARCIA-NAVARRO: That is meant that today people who don't look the right way, and by this he means the white way, are often excluded.

RAMOS: (Through translator) In our culture, the view is women who look acceptable get money, social mobility, power.

GARCIA-NAVARRO: Take, for example, the crazy popular annual contest to Miss Bumbum. All of this year's contestants are lighter skinned.

I'm at a gym in Sao Paulo, and in front of me are several scantily clad women in full makeup. Many photographers, this is a press event. And they're working, what you and I would call politely, are glutes but what is called in Brazil bumbum. The women here are contestants in the yearly Miss Bumbum contest, which, as you can probably figure out, crowns Brazil's best butt.

CLAUDIA ALENDE: I'm Claudia Alende.

GARCIA-NAVARRO: That the 22-year-old front runner who looks like actress Megan Fox. I mean, almost exactly, right down to the blue contact lenses she has over her naturally brown eyes.

Do people tell you you look like Megan Fox a lot?

ALENDE: Yes, people tell me all the time but I don't think the same.

GARCIA-NAVARRO: So tell me, why are you doing the Miss Bumbum contest?

ALENDE: Because the contest is famous around the world and I want to be recognized around the world, and become famous too (laughter).

GARCIA-NAVARRO: She says the contest is a way for her to become a TV presenter or an actress. The rules of the contest allow for plastic surgery anywhere but on the backside. She openly admits she's had work done.

ALENDE: Because was like, moda.

GARCIA-NAVARRO: Fashion.

ALENDE: Fashion - was like everybody is doing and I do.

GARCIA-NAVARRO: Previous Miss Bumbum contestants have indeed gone on to arguably bigger and better things. One became a TV presenter. Others have become actors, professional dancers on TV. But for most of the women I speak with, their dreams - the ones the Pitanguy Institute say they are giving them the right to - are much smaller. We meet Maria da Gloria de Sousa on a beach in Rio, on a chilly blustery day. She's 46 but looks 30. She's unemployed but has had six surgeries at the Pitanguy Institute and speaks about her procedures with that characteristic Brazilian humor and openness.

DE SOUSA: (Speaking Portuguese).

GARCIA-NAVARRO: I'm almost an android, she tells. I've done my breasts three times. I didn't stop there. I did a tummy tuck and then I did lipo. And, lastly, I did my bottom, she says proudly. She says she spent the equivalent of the cost of three cars on her operations. I'm much happier. There's no doubt about it, she tells me. My bottom will never sag. My breasts will never sag. They will always be there, hard. It's very good to look into the mirror and feel fine, she says. When I ask her if it was all work it, she quips I have a 21-year-old lover. Things have gotten a lot better. She waves goodbye, and smiling, sashays down the beach. And nothing jiggles. Lourdes Garcia-Navarro, NPR News, Brazil. Transcript provided by NPR, Copyright NPR.

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