Amira is not a war victim. Her face was never scarred by bullets or bombs. But four months ago, she decided to undergo the operation in the al-Mansour district of Baghdad.
"The first operation was to make my lips bigger. The operation was a success and it has encouraged me to undergo another one. The second was more difficult than I imagined. They injected my cheeks with silicone and I felt unbearable pain and started screaming. The anaesthesia used by the specialist did not have any effect because I am a smoker," said Amira.
All the tragedies of war in Iraq did not stop Amira thinking about beauty. Her face, swollen and full of injection scars, looked as if it had been beaten. It took a month for her to get rid of the blue bruises on her face.
Now, though, she wants more surgery: "it’s good to look beautiful," she says.
Cosmetic surgery has become fashionable in Iraq since the fall of Saddam, who isolated his population from the outside world, although plastic surgery is illegal in public hospitals, according to the Health Ministry.
When the security situation improved towards the end of 2007, many doctors, specialists in many fields including cosmetic surgery, felt encouraged to return to Iraq.
Dr. Saad Dakhel, a specialist in burns surgery at al-Wasti Hospital, one of the biggest plastic surgery hospitals in Iraq, told Niqash that "the hospital performs cosmetic surgery for congenital malformations and for malformations caused by explosions or accidents."
He said that rhinoplasty is not performed at the hospital and nor is surgery enlarging cheeks or breasts or any cosmetic eye operations because the hospital’s services are offered free of charge.
Dakhel says the al-Wasti hospital performed 4,200 plastic surgery operations by the end of 2009. Most of the hospital’s patients were the victims of bombings.
Private hospitals and clinics, however, have become the resort of those who aspire to be as pretty as TV stars.
Al-Amal hospital, which specialises in plastic surgery, is almost always full of those seeking beauty. It is rare to find a seat in one of its corridors, let alone its packed waiting room.
"Most women come carrying pictures of artists such as Nancy Ajram and Haifa Wehbe, and they want to look just like them," said one of the hospital nurses, referring to two Lebanese singers who are alleged to have undergone many operations to enjoy the beauty they now possess.
The Health Ministry has regulations designed to ensure proper hygiene conditions and licences are granted only to beauty salons owned by specialists.
However, Usam al-Zubaidi, a plastic surgery specialist, believes many mistakes are made, largely because the “centres care more about profit rather than quality of services provided for patients,” with Iraq having no established traditions in these fields.
Women are the main customers, though some men do also ask for surgery in the clinics, which are almost always fully booked. Al-Zubaidi says that over the last two years, 86 percent of his patients were women.
For the smaller male population, operations are usually hair transplants, rhinoplasty and laser hair removal, especially from the cheeks and neck.
Most patients are also young, with 65 percent aged between 28 and 50, and 31 percent between 18 and 28.
"Private medical centres do not accept to perform any plastic surgery to those who are under 18 years of age," said the surgeon.
Prior to the growth of clinics in Iraq, Iraqis travelled to Syria and elsewhere for surgery. The return of clinicians to the country will at least allow those bent on surgery to save money.
In Baghdad, the average cost of rhinoplasty is US$600, with a similar amount for cheeks. Breast enlargement costs from US$1,500 to US$3,000, depending on the reputation of the doctor performing the operation. Other costs, such as the import of certain materials required for the operation, such as the silicone used in breast surgery.
Syrian prices are lower compared to Iraq but with travel and accommodation costs factored in, the costs would double.
Sahar, who is 28, opted to have an operation on her nose in one of Jirmana's beauty centres in Damascus where she stayed for one month. She wanted to be “away from the eyes of people,” she says.
"I was able to avoid the embarrassment resulting from a swollen nose after the operation. The swelling usually takes about two weeks to go down.”
The prevailing religious tendencies in Iraq and other areas of the country did not play a role in Sahar’s decision, although she does wear the veil.
"I wanted to have a beautiful nose and I was sure that my wish does not contradict with the teachings of Islam," she said, adding that she was relieved by a recent fatwa issued Ayatollah Ali al-Sistani, the most prominent religious figure in Iraq, and the Shia world as a whole.
Sistani’s fatwa, released on his website, stated that a hair transplant is more acceptable than wearing a wig because as wig may fall off during prayers.
Breast enlargements, it went on, are not outlawed, as long as they are performed by female doctors.