The Only Way Is Essex is an unlikely TV hit featuring a largely unwatchable group of people (at least to anyone aged over 30) doing unspeakable things to their bodies.
Along the way, it has introduced the nation to the "vajazzle", which a Guardian TV reviewer helpfully defined in 2010 as "sequinned fanny graffiti".
But if its obsession with fake tan and enlarged breasts was a joke three years ago, it has since become big business. Many of the ITV2 show's cast have become the mannequins on which cosmetic surgeons show off their latest procedures.
For some reality TV stars, the enlargement (or uplift) will come cheap – or free – in return for favourable mentions on Twitter or in magazine interviews, or photographs of them leaving the clinic's front door. Bigger stars can even command a fee, with a middle-ranking celebrity reportedly commanding in the region of £50,000.
"If you are a good-looking reality TV star, and you are female, there will be a whole host of beauty treatment representatives on the phone," said Mark Borkowski, an entertainment PR and branding specialist. "The more expensive the treatment, the more likely you are to snare a celebrity."
References to The Only Way Is Essex – or Towie, as it is known to its fans – are legion on the websites of plastic surgery companies, linking to tabloid stories about the latest procedures undertaken by its stars.
Rajiv Grover, president of the British Association of Aesthetic Plastic Surgeons (Baaps), said programmes like The Only Way Is Essex "normalised something that is not normal. I don't think 19-year-olds or 20-year-olds should be having fillers, Botox or breast enlargement as if they were just beauty treatments."
He called for greater transparency when TV stars enter into commercial agreements with clinics.
"We are not saying it should be a nanny state, but there may be sponsorship deals which we are not necessarily aware of because they are not overt," he said.
"If there was a little more transparency, then when people say nice things about these treatments we would be able to take what's being said with a pinch of salt."
Towie is not the draw it once was – it won a Bafta in 2011 – but it remains a big hit among its target 15- to 24-year-old audience, and returned with more than 1 million viewers for its eighth series in February.
It spawned a rash of imitators, including E4's Made in Chelsea, and will be back for a ninth series in the summer.
A spokesman for The Only Way Is Essex said none of the show's current stars had an existing deal with a cosmetic surgery company.
He said: "Towie follows the lives of real people and remains impartial on observing their lifestyles.
"The show never seeks to glamorise plastic surgery, and has indeed on occasion highlighted some dangers, such as documenting Lauren Pope's discovery that she had the PIP implants, and required extra surgery."
Pope, a Towie regular, features on the MYA (Make Yourself Amazing) cosmetic surgery website. Neither Pope nor MYA responded to the Guardian's questions, but Pope previously told the BBC: "These companies need to promote themselves. Why not have us do it? I'm not endorsing a company I haven't dealt with."
"If it got to the stage where girls were going to have these procedures and saying, 'I want it done because of someone off Towie,' that would be a concern. But I don't think that's the case. It's just that we make people aware of what these things are because they are genuinely what we talk about."
