A pair of blood-smudged surgical gloves appears on the giant screen, then a glistening scalpel, which slides with ease into the pale, yellowy skin. “These,’’ explains the heavily-accented narrator, “are all little tricks to deal with the problem of the dog ears.’’

It is an overcast morning in Copa-cabana and in a big circus tent, erected only metres from one of the world’s most famous beaches, hundreds of stylishly dressed delegates crane their necks at two cinema screens. Welcome to what organisers have described as the biggest cosmetic surgery event in history. With about 2 400 surgeons from nearly 80 different countries in attendance, the biannual reunion of the International Society of Aesthetic Plastic Surgery (Isaps), which ended this weekend, is the multibillion-pound industry of cosmetic surgery in action.

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