The American dream often conjures visions of white picket fences, puppies lapping a child's face and, for some, the wherewithal to afford plastic surgery.

A new report by the American Society of Plastic Surgeons, a nonprofit organization based in Arlington Heights, Ill., says the number of ethnic patients going under the knife for cosmetic reasons jumped 65 percent from 2004 to last year.

Among minorities seeking plastic surgery, Hispanics lead the way with more than 921,000 procedures (up 67 percent) completed, followed by blacks, who underwent 769,000 operations (up 67 percent). Asian Americans received 437,000 procedures last year, a 58 percent increase.

The groups requested different procedures in different numbers, but the most commonly requested techniques for all three minorities were treatments with Botox or injectable wrinkle fillers and chemical peels.

"The fashions personified by the rock stars or movie stars bring procedures to the forefront," Dr. Corriveau says, citing actress-singer Jennifer Lopez's generous derriere as one example. "Buttocks augmentation didn't exist 10 years ago."

On the surface, helping minority patients receive top-flight health care is a given for any dedicated doctor. However, plastic surgeons who take on minority patients, Dr. Corriveau and others say, must be aware of the cultural nuances of everybody they treat.

"It's the job of a physician to choose the right procedure," Dr. Corriveau says. For example, if a patient's dark skin makes surgical scars more visible, then that must be taken into consideration when choosing surgery.

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