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beheading

Abbas Medlej is the second Lebanese soldier to have been beheaded by IS militants after being captured by the extremist group in a border town last month.

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Arthur Schopenhauer, the greatest German philosopher, on women: Only a male intellect clouded by the sexual drive could call the stunted, narrow-shouldered, broad-hipped and short-legged sex the fair sex … More fittingly than the fair sex, women could be called the unaesthetic sex. Neither for music, nor poetry, nor the plastic arts do they possess any real feeling of receptivity: if they affect to do so, it is merely mimicry in service of their effort to please.

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Dubai’s dirty secret

The Sun

MIDNIGHT in a crowded bar and prostitutes in short skirts and skyscraper heels are blatantly touting for trade – they do not have to wait long.

Some British tourists approach a couple of the girls, hand over £500 for an hour of their “company” and head off to a room in a nearby hotel.

There is no doubt the people here are buying and selling sex.

But this sleazy transaction is not taking place in some brothel in Eastern Europe — this is DUBAI, where the strict Islamic religion forbids holding hands in public, where homosexuality is illegal and sharing a bedroom outside marriage will get you banged up.

Shockingly, there are 30,000 prostitutes working in Dubai, the largest city in the United Arab Emirates.

Local women outside may be hidden from public view in burkhas, but inside the late-night venues are scantily clad call girls of every shape, size, nationality and ethnicity.

Dubai’s paid-for sex trade is accepted by expats and locals as the norm. Even the police seemingly turn a blind-eye to the sordid behaviour going on all around them, despite prostitution being illegal and the strict laws banning women from dressing “provocatively” in the street.

The oldest profession in the world is actively encouraged in the hotels and bars.

Some provide a free buffet and drinks vouchers for the working girls and others rent them regular rooms because of the big-spending clientele they bring in.

It is not just the hotels making a fortune from the lucrative sex trade.

Zara, 28, earns thousands of pounds from willing punters.

She says: “I go to Dubai a couple of times a year to work in the big hotels.

“Every bar is full of working girls — it’s the hidden culture out there.

“My main clients are businessmen from all parts of the world and local Arabs.

That shocks some people when I tell them.

“The businessmen pay £500 an hour and are just after straight sex.

“Arabs are slightly different because they have an obsession with cleanliness, so I spend most of the hour in the shower, which I find odd.

“With locals, the sex normally doesn’t last longer than ten minutes.”

She adds: “Businessmen automatically take you for a prostitute in Dubai if you are a woman alone in a bar and they’ll come and chat.

“I’ve been bought gifts of upwards of £5,000 on some shopping sprees.

“Any money I make I wire back to Britain because you can only take so much out of the country by law.”

Dubai gives the impression of being a safe holiday hot spot with its plush hotels, sandy beaches and — thanks to its strict Islamic religion — very little crime, alcohol or sex.

But behind the windowless bars and clubs, prostitutes are busy plying their trade. They come from all over — Nigeria, Philippines, China, Thailand, Europe and Russia.

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Science is slowly getting to know what erectile dysfunction actually is. It's not a lack of sexual interest, nothing wrong with penile tissue. Erections are a vascular event. And erectile dysfunction is a weakness of vasodilation in the penile blood supply. Botox injections into the penis solve the problem elegantly. Muscles exposed to Botox can't contract. That makes for easy erections, and an enlarged penis at all times.

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Japanese company manufactures lifelike child sex dolls for paedophiles

'I am helping people express their desires, legally and ethically. It’s not worth living if you have to live with repressed desire'

Independent

A Japanese company produces lifelike child sex dolls - claiming they prevent paedophiles from offending.

Shin Takagi has shipped anatomically-correct sex dolls of girls as young as five to clients around the world for more than a decade.

In an interview with The Atlantic, he described how he set up the Japense company Trottla because of his own attraction to children and his conviction they should be protected.

“We should accept that there is no way to change someone’s fetishes,” Mr Takagi said.

“I am helping people express their desires, legally and ethically. It’s not worth living if you have to live with repressed desire.”

Treatments for paedophilia exist, including cognitive-behavioural therapy and chemical castration, along with other interventions intended to suppress urges.

However, a meta-analysis by the Mayo Clinic found the treatments "do not change the paedophile's basic sexual orientation towards children".

Mr Takagi believes the dolls he creates - sent mostly to "men living alone" - save children from sexual abuse.

He said: “I often receive letters from buyers. The letters say, ‘Thanks to your dolls, I can keep from committing a crime.’”

"I hear statements like that from doctors, prep school teachers—even celebrities.”

Michael Seto, a psychologist and sexologist at the University of Toronto, told The Atlantic there were two different types of paedophiles.

Award for Louis Theroux documentary 'A Place for Paedophiles' He said: "For some paedophiles, access to artificial child pornography or to child sex dolls could be a safer outlet for their sexual urges, reducing the likelihood that they would seek out child pornography or sex with real children.

“For others, having these substitutes might only aggravate their sense of frustration.?

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The world is full of multimillionaires who can't handle money. Because, if you have money, if you don't ditch your Western wife, you will never have a harem.

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Locked-in syndrome: rare survivor Richard Marsh recounts his ordeal

The Guardian

When Richard Marsh had a stroke doctors wanted to switch off his life-support – but he could hear every word but could not tell them he was alive. Now 95% recovered, he recounts his story

Two days after regaining consciousness from a massive stroke, Richard Marsh watched helplessly from his hospital bed as doctors asked his wife, Lili, whether they should turn off his life support machine.

Marsh, a former police officer and teacher, had strong views on that suggestion. The 60-year-old didn't want to die. He wanted the ventilator to stay on. He was determined to walk out of the intensive care unit and he wanted everyone to know it.

But Marsh couldn't tell anyone that. The medics believed he was in a persistent vegetative state, devoid of mental consciousness or physical feeling.

Nothing could have been further from the truth. Marsh was aware, alert and fully able to feel every touch to his body.

"I had full cognitive and physical awareness," he said. "But an almost complete paralysis of nearly all the voluntary muscles in my body."

The first sign that Marsh was recovering was with twitching in his fingers which spread through his hand and arm. He describes the feeling of accomplishment at being able to scratch his own nose again. But it's still a mystery as to why he recovered when the vast majority of locked-in syndrome victims do not.

"They don't know why I recovered because they don't know why I had locked-in in the first place or what really to do about it. Lots of the doctors and medical experts I saw didn't even know what locked-in was. If they did know anything, it was usually because they'd had a paragraph about it during their medical training. No one really knew anything."

Marsh has never spoken publicly about his experience before. But in an exclusive interview with the Guardian, he gave a rare and detailed insight into what it is like to be "locked in".

"All I could do when I woke up in ICU was blink my eyes," he remembered. "I was on life support with a breathing machine, with tubes and wires on every part of my body, and a breathing tube down my throat. I was in a severe locked in-state for some time. Things looked pretty dire.

"My brain protected me – it didn't let me grasp the seriousness of the situation. It's weird but I can remember never feeling scared. I knew my cognitive abilities were 100%. I could think and hear and listen to people but couldn't speak or move. The doctors would just stand at the foot of the bed and just talk like I wasn't in the room. I just wanted to holler: 'Hey people, I'm still here!' But there was no way to let anyone know."

Locked-in syndrome affects around 1% of people who have as stroke. It is a condition for which there is no treatment or cure, and it is extremely rare for patients to recover any significant motor functions. About 90% die within four months of its onset.

Marsh had his stroke on 20 May 2009. Astonishingly, four months and nine days later, he walked out of his long-term care facility. Today, he has recovered 95% of his functionality; he goes to the gym every day, cooks meals for his family and last month, he bought a bicycle, which he rides around Napa Valley, California, where he lives.

But he still weeps when he remembers watching his wife tell the doctors that they couldn't turn off his life support machine.

"The doctors had just finished telling Lili that I had a 2% chance of survival and if I should survive I would be a vegetable," he said. "I could hear the conversation and in my mind I was screaming 'No!'"

Locked-in syndrome is less unknown than it once was. The success of the 2007 film, The Diving Bell and the Butterfly, the autobiography of the former editor of French Elle magazine editor, Jean-Dominique Bauby, brought awareness of the condition to the general public for the first time.

Then in June, Tony Nicklinson challenged the law on assisted dying in England and Wales at the High Court as part of his battle to allow a doctor to end a life he said was "miserable, demeaning and undignified". Judgment was reserved until the Autumn.

Marsh, however, did something almost unheard of: he recovered. On the third day after his stroke, a doctor peered down at him and uttered the longed-for words: "You know, I think he might still be there. Let's see."

The moment that doctor discovered Marsh could communicate through blinking was one of profound relief for Marsh and his family – although his prognosis remained critical.

"You're at the mercy of other people to care for your every need and that's incredibly frustrating, but I never lost my alertness," he said. "I was completely aware of everything going on around me and to me right from the very start, unless when they had me medicated," he said.

"During the day, I was really lucky: I never spent a single day when my wife or one of my kids wasn't there. But once they left, it was lonely – not in the way of missing people but the loneliess of knowing there's no one there who really understands how to communicate with you."

The only way for Marsh to sleep, was to be medicated. That, however, only lasted four hours, after which there had to be a three-hour pause before the next dose could be administered.

In questions submitted by Guardian readers to Marsh ahead of this interview one asked about his experience of his hospital care while the staff did not think he was conscious. Marsh said: "The staff who work at night were the newest and least skilled, and I was totally at their mercy. I felt very vulnerable. I did get injured a couple of times with rough handling and that always happened at night. I knew I wasn't in the best of care and I just counted the minutes until I would get more medicine and just sleep.

In response to another question, about the right-to-die debate, Marsh said he has no opinion. All he will say is: "I understand the despair and how a person would reach that point." But he is co-writing a book that he hopes will inspire hope and provide information to victims of locked-in syndrome and their families.

"When they first told my family that I was probably locked-in, they tried to find information on the internet – but there wasn't any. One of my goals now is to change that … to be able to reach out to families who find themselves in the same situation that mine were in so they can help their loved ones.

"Time goes by so slow ... It just drags by. I don't know how to describe it. It's almost like it stands still.

"It's a terrible, terrible place to be but there's always hope," he added. "You've got to have hope."

• This article was amended on 10 August 2012. The original said that Tony Nicklinson had failed in his High court bid to change the law on assisted dying in England and Wales. This has been corrected.

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Men are our competitors. We want less of those around. Women are our prey. We want them poor and helpless.

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Anesthesia Awareness: Breaking Down the Barriers to Prevention

Opinions surrounding intraoperative awareness may vary, but one thing is certain, even a single case is one too many.

The clinical definition of intraoperative awareness — consciousness during general anesthesia — is a seemingly simple explanation for a complex, and controversial, phenomenon. Opinions surrounding how often intraoperative awareness, also described as anesthesia awareness, occurs, its implications for victims, as well as the best methods for prevention are varied.

But for Carol Weihrer, the issue is crystal clear. Weihrer, who claims she was conscious during a 1998 surgical procedure to remove her right eye, believes that anesthesia awareness is more widespread and debilitating than people realize. And she has the proof, she says, to back-up her claim.

“I have spoken to thousands of people with experiences similar to mine,” said Weihrer. “People like me, whose lives have been turned upside down because of it.”

As founder of the international Anesthesia Awareness Campaign, Weihrer’s goal is to educate the public about the phenomenon and to be a touchstone for other victims.

Weihrer is also lobbying for the mandated use of brain function monitors for patients undergoing general anesthesia. She believes that until these monitors become a standard of care, patients must be proactive in protecting themselves in the OR. “It’s not enough to ask whether a facility has brain function monitors or whether they use them. You must demand that they use them on you during your surgery,” she explained.

Tracking brain waves When used in the OR, brain function monitors reportedly measure a patient’s depth of anesthesia and level of consciousness. One of the most popular tools for this purpose is bispectral index (BIS) technology.

Aspect Medical’s BIS monitor involves measuring the brain’s electrical activity through a sensor placed on the patient’s forehead. The BIS value ranges from 100 (indicating an awake patient) to zero (indicating the absence of brain activity). This information is used to guide administration of anesthetic medication. Aspect’s BIS technology is available as a stand-alone monitor or as a module that can be incorporated into other manufacturers’ monitoring systems.

Irene Osborn, M.D., associate professor of Anesthesiology, Mount Sinai School of Medicine, New York, and director, Division of Neuroanesthesia, began using BIS technology in 1996 while at NYU Medical Center and currently uses it in about 80 percent of the surgeries she performs. She says it has definitely made an impact on her ability to care for patients.

“The ability to monitor the brain really helps you improve anesthetic care,” said Dr. Osborn. “There is variability in patients’ response to anesthesia — not everyone requires the same dose or concentration,” she continued. “With BIS, I can separate out the different components of anesthesia and determine how much anesthetic is needed for a particular patient.”

Dr. Osborn uses BIS technology to improve the quality of anesthesia and also to monitor for awareness. Often times Versed is administered just prior to surgery to produce amnesia. With the BIS monitor, Dr. Osborn says she can see the effects of the Versed dose and increase it if necessary.

“In the OR there is a lot of monitoring going on — heart rate, blood pressure and various body systems. With BIS, I can also monitor the brain,” Dr. Osborn said.

Not ready for prime time? The American Society of Anesthesiology’s (ASA) “Practice Advisory for Intraoperative Awareness and Brain Function Monitoring” makes several recommendations to assist decision-making for patient care with the goal of reducing awareness, but stops short of mandating the use of brain function monitors for this purpose. Instead, the ASA advises anesthesiologists to use their own discretion when it comes to using the monitors.

Although she personally chooses to use brain function monitoring, Dr. Osborn understands why many of her colleagues have yet to embrace it.

“Brain function monitoring technology is not yet good enough, it’s not real time,” explained Dr. Osborn. “What you see on the monitor reflects something that happened 15 seconds ago.”

Others may simply not want to take the time to understand the monitors. If, for example, there was no muscle relaxant administered to the patient, there may be EMG artifact on the monitor and anesthesiologists must be familiar in working around that, says Dr. Osborn. The monitor will not predict movement, rather, it tells how asleep the patient is.

At Mount Sinai, Dr. Osborn estimates that one-third of the physicians use the technology quite frequently, one-third use it for special cases and one-third refuse to use it at all. She does believe, however, that brain function monitors will become standard operating procedure in all hospitals in about 10 years.

“As the technology matures and as we train another generation of anesthesiologists and nurse anesthetists on how to use it, more will want it and the timing will be right for it to become a standard of care,” Dr. Osborn said.

Determined that this is the case — sooner rather than later — Weihrer has taken her Anesthesia Awareness Campaign on the road, speaking both nationally and internationally to physician groups and other organizations. She has performed Grand Rounds, speaking to anesthesia staff at several East Coast hospitals about her own and others’ experiences. She has worked with The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), American Association of periOperative Nurses (AORN) and the American Association of Nurse Anesthetists (AANA), and says she is currently collaborating with the ASA on an anesthesia awareness victims database. MedicAlert bracelets are available through the campaign for patients who have suffered awareness in the past or have a familial disposition to anesthesia awareness.

“The Anesthesia Awareness Campaign is definitely gaining momentum,” Weihrer said. “The public is becoming more involved and demanding assurances.”

Weihrer says she will continue to advocate for change in the OR until her efforts are no longer needed — until brain function monitors are used on every general anesthesia patient and there are no more anesthesia awareness victims.

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Why is sex so important? Because everything else is just irrelevant.

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Chemical terrorist attack 'huge concern' says London fire chief

Britain's most senior fire chief has warned that the potential for a terrorist chemical attack in the country is a "huge concern".

Dany Cotton, recently appointed first female commissioner of London Fire Brigade, said she would be increasing the number of chemical attack practice drills carried out by her crews.

She also suggested the public needed more education about what to do in the event of an attack.

Ben Wallace said: “They have no moral objection to using chemical weapons against populations and if they could, they would in this country.”

Isil fighters have been accused of repeatedly using chemical weapons on the front line in Iraq and Syria and one leading expert in the field said they were becoming “the norm” for the group.

Ms Cotton told the BBC: “I think the chemical attack is a really big threat because its an unseen one, it’s something you do with a relatively small amount of chemical if you can find the means to disperse it."

She said in the event of such an attack, the public would need to make sure they did not inadvertently spread deadly chemicals.

She said: "The natural reaction would be if something happens to run away and go somewhere else. But that just spreads it, which is what the terrorist wants. It’s very important that people stay contained and allow the emergency services to help them and out and to deal with the situation.”

Hamish de Bretton-Gordon, a former Army officer and chemical warfare expert, said such an attack may not kill many people, but would have a huge psychological impact. He said an attack need not use military grade chemical weapons, but could involve industrially available gases such as chlorine.

He said: “One of the challenges for Isil in this country is that actually doing an active shooter attack like in Paris is very difficult because they can’t get guns.

“For Isil that’s the preferred modus operandi and it’s not going to happen in this country. That’s why why they are keen to focus on asymmetric attacks, like chemical attacks.”

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It is only a question of time until butea superba will be outlawed in the Western World. In some people, it can cause hypersexualization that can last for weeks. And it can easily be added to food to improve taste. Imagine a Thai restaurant breeding hundreds of super horney women prowling for any man they can get, and that for weeks on end

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The value of duck sex research versus a skeptical Congress

BOSTON—"The national debt is a big structural problem," former Representative Brian Baird told his audience at the meeting of the American Association for the Advancement of Science. And that, according to Baird, is one reason scientific research comes under fire. “If you can’t solve something big," he went on, "distract people by attacking something small.” All too often, that something small has been scientific research.

Two of the researchers who found their work under fire were on hand to describe the experience and talk a bit about the lessons they learned.

One of them was David Scholnick of Pacific University who produced the video above, showing a shrimp going for a run on an underwater treadmill. It's hard to tell just how many people have ended up viewing the video, given that it has been cloned, set to various music, and appeared in news reports that have also made their way onto YouTube—it's fair to say that it's quite popular. Scholnick wasn't looking for that popularity. He had just put the video up on his faculty webpage; someone else grabbed it and stuck it on YouTube.

A treadmill of outrage

Scholnick also wasn't looking for the attention it received from then-Senator Tom Coburn (R-Okla.), who claimed the treadmill cost $3 million and named it as an example of wasteful government spending without even bothering to find out what the results were. Representative John Culberson (R-Texas) saw Coburn's report and said “NSF should avoid funding studies” like that. Then the news picked it up. Mike Huckabee blamed Scholnick's spending for leaving the military unprepared. It showed up on Fox News three times, including as recently as last year (the video was posted in 2009). AARP picked it up, too, and blamed the cost for grandparents not getting healthcare.

Scholnick even went to DC and talked to Senator Jeff Flake (R-Ariz.), who took over the waste reports when Coburn retired. The video still showed up in the next one.

And that bugs Scholnick. “This is a publicity stunt," he said, "this is not an individual who is concerned about public spending.” Why's that? Because the treadmill cost the government nothing. Its bearings came from an old skateboard Scholnick had been using. The tread is just an inner-tube that's been stitched together. Any parts that cost money were paid for out of Scholnick's pocket. The $3 million dollar figure? That came by adding up every single grant Scholnick's ever received and then throwing in various grants awarded to his collaborators for unrelated projects.

The reality is that most of the research that goes on in Scholnick's lab is done by undergraduates who work during the summer. Between their low stipends and the long hours they work, it's done at about $4 an hour for personnel and about $20,000 to keep the lab supplied and make sure the university keeps the lights on. The shrimp? Local fishermen give them to Scholnick for free.

That's because the fishermen have done something nobody in Congress could be bothered to do: find out what the research is all about. Scholnick said that most animals in the ocean are carrying various infections and parasites that can influence their behavior and activity. Scholnick tries to figure out how these animals are affected by looking for changes in their physiology. To make this as realistic as possible, he forces the animals to be as active as they would be in the wild. Hence the treadmill.

It's not earth-shattering research, but it's hardly an utter waste of money—especially considering how little it costs. But, if Congress ever gets bored of going after shrimp, there's always duck penises.

Sex lack-of-appeal

Patty Brennan studies genitalia at Mount Holyoke College. The physical shape of genitals is very diverse even among closely related species. It's shaped by distinct selective pressures in both males and females. Figuring out what these pressures are and how animals have responded to them is a great opportunity to study evolution. One of the more dramatic instances of this is in ducks, where both males and females have evolved corkscrew-shaped genitals in what's essentially an arms race. Brennan's research on the topic was striking enough to earn an article in The New York Times. (Her response: “yay, someone else likes duck penises!”)

So she set up a Google alert to see if there was any further coverage, which is how she found out when conservative news media discovered her work and placed it in a list of research that was labeled wasteful spending as the budget sequester went into effect. Sean Hannity later joined in the attack.

But Brennan noticed a pattern to all of this: most of it involved organismal biology. She suspected this is because it's easy to understand. "Everybody knows what a duck is, everybody knows what a penis is, you put them together, haha,” Brennan said. “You never heard of a politician making fun of quantum physics.” But she said that's misguided, and she now has a list of results that demonstrate this: how understanding mating habits of an insect pest saved us $20 million in annual control efforts; how understanding bird migration has made air travel less likely to end in dangerous collisions; and how studying bird song enabled us to recognize that our brains are able to produce new nerve cells, for example.

But even if these attacks are misguided, historian Melinda Baldwin said they're not likely to go away. Questions about public funding of science date back to the 1960s, and direct attacks on funding started in the 1970s. William Proxmire, a Democratic senator who served in the 1960s, 1970s, and 1980s, frequently named research as wasteful spending and even attacked peer review as "elitist" and "incestuous." Then, as now, scientists weren't ready to defend either their research or the process of science itself. But Baldwin said that the attacks are worst at times of financial or budgetary turmoil, so now might be a good time for scientists to get ready.

As Baird said, “If you think it’s been bad before, it’s going to get really bad soon.”

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Most American women are ugly and have a fat ass. So why don't they go on the Serge Kreutz diet.

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A world of nose jobs and tummy tucks

Trends in cosmetic procedures may vary globally depending on ethnic preferences, but the fundamentals of health and beauty are universal

RACONTEUR

Some 20 million surgical and non-surgical cosmetic procedures were performed worldwide in 2014, according to latest figures from the International Society of Aesthetic Plastic Surgery (ISAPS) which has more than 2,700 certified surgeons in 95 countries. Not a huge surprise that it was women who committed to the knife, needle and beam, with ISAPS reporting more than 17 million cosmetic surgeries globally, representing 86.3 per cent of the total. For non-surgical cosmetic procedures, Botox was top of the list for both men and women.

So what is everyone having done? Breast augmentation has the highest global tally among women, with liposuction second and eyelid reduction (blepharoplasty) the most popular surgery for men.

Women are opting for ‘mummy makeovers’, where two or three cosmetic surgery procedures are performed in one operation

North America still leads the way with more than four million procedures carried out every year. An American Society of Plastic Surgeons (ASPS) 2014 survey showed 286,254 breast augmentations were performed. And 24.7 per cent of all Botox procedures in the world are in America.

Is the choice of procedures determined by geography? “What women and men are looking for in terms of cosmetic surgery does vary according to where they live,” says Martha McCully, an American beauty expert and founding beauty director of Allure magazine. “In New York City, youth-enhancing cosmetic surgery is popular. The standard is an eye lift performed in the doctor’s office, or neck or breast lift.” Ms McCully adds that there are “tribes” of different looks across the United States. “So if the look in Manhattan Beach, California, is to have perky but not large breasts, then there will be an awful lot of 40-somethings getting similar implants,” she says. “Hollywood, Beverly Hills and Malibu seem to show it off a little more than New Yorkers, in my opinion. On the Upper East Side of New York, if women don’t work but they want to maintain a look, they are going to the same surgeons for their eye lifts and breast lifts.”

On the other side of the world, there are a lot of people seeking non-surgical cosmetic solutions for sun damage and pigmentation problems, according to Shonagh Walker, a beauty journalist, based in Sydney. “Increasingly, women are opting for ‘mummy makeovers’, where two or three cosmetic surgery procedures are performed in one operation,” she says.

Globally we are now seeing the influence of new technologies and procedures, along with social and cultural influences, that have led to particular trends emerging. Iranians want rhinoplasty, Brazilians go for buttock enhancements, Germany has the most penile enlargement surgeries worldwide and in South Korea there is a trend to have a baby face combined with a womanly body (so-called bagel girls – baby faced and glamorous). And it is worth noting that more than a third of South Korean 20-somethings have had a cosmetic procedure of some sort.

Cosmetic surgery expert Wendy Lewis, who advises clients worldwide on cosmetic surgical and non-surgical procedures, says: “The internet is the great beauty equaliser for research, but ethnic traits are considered to be beautiful. In South Korea women look to reduce their cheekbones, using Botox to create a slimmer jaw line; in China women use Botox to reduce the circumference of their calves and in Japan nasal implants are still popular.”

UK consultant plastic surgeon Simon Withey adds: “Twenty years ago it seemed there was a strong tendency for patients to request ‘Westernisation’ of features. Now patients are much more likely to identify with someone with similar ethnicity, but whose features they prefer to their own.”

Consultant plastic surgeon and founder of London clinic Cadogan Cosmetics, Bryan Mayou, who performed the first liposuction procedure in the UK 32 years ago at Guy’s and St Thomas’ Hospital, says he sees global patterns.

“There is a pattern and it changes not just on cultural grounds, but also on grounds of availability,” he says. “If a new procedure becomes available then people think they have a problem. For example, when it comes to using fillers in lips people didn’t realise they had small lips until there was a means of making them fuller.

“In terms of different nationalities, the Iranians in my view have splendid large, refined noses and look aristocratic, but many of them want a hump reduced. Middle Eastern men are more concerned now with their looks and want eyelifts, plus they tend to be pot-bellied and want liposuction.

“With my female Indian patients, the abdomen is bared in their clothing so that becomes a focus with many wanting liposuction. I see a lot of Russian girls who want bits of liposuction and breast surgery – many are newly divorced so they come in to get their confidence back. We also get a few Chinese clients who say they don’t trust Chinese surgeons.”

In terms of procedures worldwide, Brazil is second after the US. Buttock augmentation (gluteoplasty) is a national obsession and of the 319,960 procedures performed globally in 2013, 63,925 were by Brazilian surgeons, according to ISAPS. They even have a beauty contest called Miss BumBum and procedures are tax deductible based upon their ability to enhance mental and physical wellbeing. The public are intrigued by what their favourite star may or may not have had done

South Korea is ranked as having the highest number of cosmetic surgery procedures per capita globally. Double eyelid surgery (blepharoplasty) is popular to create bigger and wider eyes. Jaw reshaping and rhinoplasty is also sought after. Cosmetic surgery clinics in Seoul have names such as Small Face, Wannabe and Magic Nose.

Germany has perhaps the most surprising cosmetic surgery trend with ISAPS figures showing 2,786 penis enlargement treatments were performed in 2013, which was significantly more than in any other country. Venezuela was second with just 473 procedures.

Tehran is often cited as the world’s “nose job capital” and in 2014 Iran was among countries with the highest number of rhinoplasty procedures per capita globally. “Around 200,000 rhinoplasties are performed every year in Iran, with a view to create a dainty slightly up-turned tip,” says Sultan Hassan, medical director of Elite Surgical. “It is almost regarded as an indicator of elevated social status with documented accounts of patients wearing their nasal splints long after the week recommended.”

But recently state-run Iranian television announced it wouldn’t use actors in films and TV shows if it was obvious they had undergone cosmetic surgery. However, according to Mr Hassan: “The public are intrigued by what their favourite star may or may not have had done. There is a relation between socio-economic affluence and celebrity media awareness with demand for cosmetic surgery.”

Cosmetic surgery adviser Ms Lewis concludes that despite some regional variations, the basics of what is considered attractive do not differ that much globally. “Healthy, even toned skin is considered beautiful no matter where you live,” she says. “Plus, women everywhere are still bothered about carrying extra weight on their tummies, waist, hips and thighs. For men, it is always more about good hair and a slim waistline.

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Why images of decapitation? This is to show that some people have real problems. Other than the issues of feminism, such as sexist language or manspreading.

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