And then, to top it off, she went for a facelift.

"After five operations on my face, as soon as I recover, I will have liposuction on my belly," says the 50-year-old woman, her face swollen and covered in bandages.

Once the bandages come off, Tram could look like a wax model in Madame Tussaud's museum. But at least she feels healthy. Many others having plastic surgery here are not so lucky.

Vietnam, which posted economic growth of more than 8 percent last year, has seen the emergence of a burgeoning middle class, mainly in and around the commercial hub of Ho Chi Minh City and the capital Hanoi.

Having a more generous cleavage or a slimmer nose is the new dream for many up-and-coming Vietnamese women, but demand has far exceeded supply, leaving women in the hands of unqualified surgeons often working in unsafe conditions.

Result: serious medical problems.

Tom Cuong Nguyen, an Australian- born Vietnamese doctor who runs the "perfect skin" ward at the Columbia Saigon Clinic, says many women suffer "complications due to the injection of an unidentified liquid into their breasts, lips or cheeks."

Others looking for longer eyelashes end up with infections caused by dangerous implants, according to Nguyen Thang, head of the plastic surgery unit at the Franco-Vietnamese Hospital in Ho Chi Minh.

"Failure to use sterile instruments can also cause hepatitis," he adds.

After decades of war and suffering, women in booming Vietnam are embracing many Western creature comforts, including the right to look better. Beauty treatments, cosmetics and plastic surgery are all the rage.

"My husband and I have a successful business that we are very proud of," Tram says. "Unfortunately, I was not born beautiful and I have turned 50. In the restaurant business, you really need to feel confident and meet people, so I decided to have cosmetic surgery. My husband supports this decision."

Marc Villard, head of operations for the French-based Pierre Fabre pharmaceutical group in Vietnam, says the beauty craze first took off in the early 1990s.

Now women seeking good looks see make-up and surgery as equally viable options and do not think twice about getting a US$300 (HK$2,340) nose job, a US$500 eyelid lift or breast implants for as little as US$2,000 - a fraction of what a woman pays in the West.

While Vietnamese women may want to mimic their counterparts in the West, they do not want Nicole Kidman's nose or Scarlett Johansson's ample bosom, but covet the physical assets of Chinese actresses and local beauty queens.

They also want procedures to be performed as quickly as possible.

"Some come in for a consultation in the morning and want the surgery in the afternoon. Some don't even want a general anesthetic, because they don't want to waste time in the recovery room," Thang notes.

This devil-may-care attitude, coupled with the total lack of regulations in the sector, means a windfall for surgeons - qualified and otherwise.

"In Ho Chi Minh City, at least 200 plastic surgery clinics are in operation, but only 50 or so are accredited by the city health authorities," the doctor says.

Surgeons often train on the job. Some become good doctors. Others instead offer their services to shady beauty salons and spas, where plastic surgery is performed in a back room with only an hour's notice.

The nip-tuck craze has extended from the middle class to the prostitutes of the former Saigon, where an A or B cup may no longer be sufficient to attract high-paying clients in the city's brothels.