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 Copacabana and in a big circus tent, erected metres from one of the world's most famous beaches, hundreds of stylishly dressed delegates crane their necks up 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 Surgery (Isaps), which ended this weekend, is the multibillion-pound industry of cosmetic surgery in action.
That the world's leading cosmetic surgeons have packed into Rio de Janeiro's five-star beachfront hotels this week is no coincidence. For decades Brazil has been considered a thriving centre for cosmetic surgery, and it is now at the heart of a growing wave of surgery tourism, with foreigners jetting in for a few days on the cutting board and a week's recuperation on the beach. After the United States, home to 5,000 registered cosmetic surgeons, Brazil comes in a close second, with around 4,000.
In the dimly lit main hall the delegates, many wearing headsets for translations, gaze up in admiration as a Belgian surgeon explains how best to do-away with dog-ears (a surplus of skin, common with facelift operations). "We are very happy with this," chirps the doctor over a video link from a clinic down the road where, at just after 9am, he is performing the conference's opening facelift live.
Plastic surgery long ago ceased to be taboo in Brazilian society. Celebrities talk openly in the media about their respective facelifts, wrinkle reductions and bum tucks, while several glossy magazines dedicated to the topic appear on newspaper stands across the country.
It is a mega-industry here, as the stream of BMWs and Mercedes which have poured into the conference all week testifies. Its guest of honour, Brazil's superstar surgeon Ivo Pitanguy ("the man who meant you no longer had to whisper about plastic surgery," several delegates explain) boasts his own island off the Rio coast.
Exact figures are hard to come by, with doctors at the conference reluctant to talk about how much the Brazilian market is worth. Americans spent around $12.4bn (£6.5bn) on plastic surgery in 2005, according to the American Society for Aesthetic Plastic Surgery; doctors here say Brazil is not far behind.
At first glance the event seems more like a fashion show, with an abundance of Prada handbags, men's pinstripe suits and designer glasses. Cosmetic surgery has traditionally been seen as the reserve of Brazil's wealthy upper classes.
That, however is changing, according to Joao Carlos Sampaio Goés, one of Brazil's superstar surgeons and the outgoing president of the Isaps. The development of "minimal incision" and "less invasive" operations at walk-in clinics are starting to democratise access to cosmetic treatment, he says, suggesting that private clinics will soon be found in some of the city's shanty towns.
"It's all a question of the market. There are different [options] for high and low income earners," he said.
Irrespective of class, Mr Goés believes Brazil's love affair with what is known here simply as plástica is rooted in three factors: mentality, climate and legislation.
"The mentality of the Brazilian people ... is a very open kind of mentality compared with that of the Europeans. Brazilians have a much greater ease in seeking out plastic surgery," he said. "It is a tropical country, where people enjoy exposing their bodies. This helps stimulate people to have surgery."
Brazil's medical legislation has also paid a considerable part, he says. Silicone breast implants, outlawed in the US for 10 years, have been part of Brazilian life since 1993. This, Mr Goés says, has, in effect, given Brazilian surgeons a 10-year headstart.
Natural beauty seems a distant concept at the Isaps exhibit hall. You are confronted with a mass of stalls, each hawking supposedly pioneering cosmetic surgery techniques, "barbed sutures", "liposelection" and "jet peel" among them. Racks of fluorescent silicone implants adorn many of the stands.
There are "internal bras" (small gauze strips that can be placed beneath the breast's skin); tailor-made compression garments, some of which look scarily like tight-fitting Hannibal Lecter costumes, and "support threads", which can be woven into the inside of the face, holding up one's eyebrows rather like a curtain rail.
"The tendency of Brazilians is the body as they show off their bodies on the beach: [they mainly opt for] liposuction [or] work on the abdomen," says Mr Goés, explaining why Brazilian surgeons remain among the world's best when it comes to barrigas (bellies) or bundas (buttocks).
"These techniques come predominantly from Brazil," he says, while European surgeons rule the roost in terms of wrinkle treatment and facelifts.
The new procedures
Threadlift
The new walk-in answer to a facelift. Making a small incision around the temple with local anaesthetic, the surgeon implants a series of threads, tightening loose skin. The operation takes about an hour and is said to be like having a tiny "umbrella" opened under your skin.
Liposelection
Brother of liposuction, which uses ultrasound to reshape knees, buttocks, hips and "male breasts". The unwanted fat is liquefied and removed causing, it is claimed, "minimal pain, swelling and bruising".
Internal bras
Developed in Brazil since 1988, the internal bra is part of the new wave of "minimal scar" surgery. The surgeon implants a small piece of gauze under the skin, which lifts the breast as if the patient was permanently wearing a bra.
Jet peel skin rejuvenation
Skin rejuvenation promises to "pressure wash" your skin in a series of quick, "virtually painless" sessions. Regular "maintenance" sessions are required so as not to lose "skin clarity" its makers say.
