Why you should care

Because Nip/Tuck: Colombia is a real thing.

By day, Jenoba S. catches the occasional movie and sometimes recalls how she used to dream of being a doctor. By night — well, you already guessed that part. Several times a week, the curvy 24-year-old shimmies into a suggestive dress, straps on high heels and goes to work at a nondescript brothel in a commercial Bogotá neighborhood.

She has been doing this for three years now and longs for a change — though not from prostitution at the moment. Three months ago, she ponied up $4,000 for breast implants, an investment that she hoped would pay off quickly. And apparently it did — she says she’s already earning roughly five times more than before the surgery. “I feel more confident now, and when I have confidence I make more money,” explains Jenoba, who says the money will help her eventually move to another line of work.

It might not be the first place you’d think of for this, but Colombia is emerging as a plastic-surgery capital of the developing world, where cosmetic work is so popular that even sex workers are lining up for it. Last year, plastic surgeons in the country performed 357,000 procedures — everything from Botox to boob jobs — according to an annual survey by the International Society of Aesthetic Plastic Surgery. That may not sound like a lot, but it amounts to more than seven of every 1,000 people, higher than any other developing nation included in the ISAPS survey. There isn’t much reliable data about cosmetic surgery among Colombian sex workers, although interviews with a half-dozen other prostitutes in brothels in Bogotá and Medellín suggest that breast and buttocks augmentation are increasingly common among those who can afford them. Many see the surgeries as a competitive weapon, one that will give them an edge over rivals by virtue of the bigger-is-better mentality that permeates the machista culture here.

Cosmetic surgery is just part of a larger explosion in medical tourism, in which poorer nations offer relatively inexpensive medical care to bargain hunters from the industrialized world. Nearly 50 million people indulge in medical tourism every year, according to the OECD; there isn’t much data about the demand for cosmetic tourism, although one small online survey by a medical-tourism association estimated that plastic surgery accounted for 38 percent of demand.

Looked at another way, of course, the boom in bustlines is merely the latest instance of the various tortures women have endured throughout history to ensure their economic well-being by pleasing men. Think corsets, like the one Kate Winslet’s character wore in Titanic, or the Chinese custom of foot-binding, which maimed women for centuries until it was banned in 1911. Some women in Renaissance Italy used a poisonous, pupil-dilating extract from the belladonna plant to make themselves look like wide-eyed manga characters — a sign of desirability then and now.

Colombia Plastic SurgeryExperts like Lina Triana, president of the Colombian Plastic Surgery Society, say plastic surgery is popular given the country’s open and tropical culture, a place where people, especially women, show off their shapely bodies. Cosmetic work is also relatively inexpensive in Colombia; some surgeons offer packages that include several surgeries, an apartment and a housekeeper who prepares your meals, all for $10,000 — roughly what breast implants alone can cost at high-end U.S. clinics. But unrealistic expectations are common, Triana says: “Some women think their husbands will come back if they get a breast lift. It doesn’t work that way.”

Julieth Restrepo, a Medellín tour guide whose male clients often want to meet girls, says the implant explosion among professional escorts dates back to the days of Pablo Escobar, when narcotraffickers used their vast wealth to sculpt women to their liking, sometimes after plucking them out of the country’s poorer neighborhoods. That enhanced look remains popular among locals, Restrepo says; “the foreigners, not as much.”

While common in Colombia, prostitution remains illegal and can lead to trouble, something a few U.S. Secret Service agents know all too well. It’s a hard life for the women, between the threat of disease and fears that clients might turn violent amid a combustible mix of alcohol and hormones. Surgery, however, can improve the risk-benefit calculation. Jenoba, who grew up in a single-parent home near the Caribbean coast, can now make $500 on a good night at this no-name brothel tucked away above a snack shop, low-lit like a bohemian hostel and heavy with the mingled smells of sweat, cologne and perfume. High-end prostitutes who’ve made a significant investment in their natural assets sometimes make more than $1,000 a day. (Things are very different at the other end of the spectrum, where women who can’t afford surgery earn as little as $40 a day in low-end, and often dangerous, locales.)

Jenoba, who has striking brown eyes and long, straight dark hair, insists she’s doing all right. Sitting in the brothel’s common room — a loungelike area with a TV — she fiddles with the spaghetti straps of her midthigh-length dress as she speaks. It’s not as though she has many options at the moment in a country where the minimum wage sits slightly below $200 a month and unemployment hovers near 9 percent. She says she’d still like to go to college and land a better job, possibly as a civil engineer, and figures the money she saves will help make that happen.

The odds aren’t in her favor, though; a 1998 study of 850 sex workers in nine countries, including Colombia, found that 89 percent of them wanted to leave the profession but couldn’t. “I’d say that’s a conservative estimate today, considering what has happened with the economy around the world,” says Melissa Farley, executive director of Prostitution Research & Education, the California nonprofit that conducted the study. On a recent evening, Jenoba didn’t have much time to think about all that. It was 6 p.m. on a Thursday. She was expecting company.

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