JEDDAH – The percentage of Saudi women who undergo cosmetic plastic surgery has increased over the past few years. Often seen as a way of enhancing self-esteem and “imperfect” body parts, it can be used to solve health issues or restore one's appearance in the case of an accident or major surgery. However, for most Saudi women who choose to get work done, it is personal preference rather than necessity that determines whether they undergo the knife or not. There are two types of cosmetic surgery procedures: Non-invasive and invasive. The former is considered minor and can involve relatively simple procedures such as receiving Botox injections, skin resurfacing through peels, hair removal with laser treatments. The latter involves body sculpting procedures such as, liposuction, face lifts, breast augmentation and tummy tucks, all of which require surgery. A recent study conducted by a health intelligence office in the Kingdom's Eastern Province showed that 90 percent of Saudi women are not satisfied with their appearance and an earlier Saudi Gazette report titled “More Saudi women optic for plastic surgery”, revealed that nearly 40 percent of Saudi women between the ages of 30 and 37 resort to plastic surgery , while 18 percent of females between the age of 20 and 30 choose to undergo the knife. The reason behind this attitude according to Nahida al-Zuhair, general manager of the office, is that women have self-esteem issues, which means brisk business for beauty clinics and plastic surgeons. When asked why they choose to get plastic surgery, many women were unable to admit that they used cosmetic surgery as a tool to gain more social acceptance. “I underwent several procedures such as laser hair removal and Botox injection in my lips. I did not turn to cosmetic surgery to gain more social acceptance; I did it because I wanted to fix the defective parts in my face and body. However, after these procedures I was better received by people and I like the way I look now more than before,” said Eman Abdullah. Tamara Mustafa initially got a nose job to fix a breathing problem and despite the surgery being largely ineffective in its purpose, she said she is pleased with the appearance of her nose. “I decided to get this surgery because I have breathing problems. Unfortunately my breathing got worse after the surgery and yet I am psychologically satisfied,” she said. Rotana Mohammed said many women are pressured by society and even family to “improve” their appearance. “The reason behind this phenomenon differs. In general, it has become a fashion like wearing an expensive designer bag. Married women resort to plastic surgery because of their husbands' demand for having a pretty wife. Single girls often face pressure from society.” Would Rotana ever get surgery to enhance her appearance? “I care more about my health rather than my beauty, so I won't undergo any cosmetic surgery until I reach a certain age and even then, only if it is absolutely necessary.”