There's no doubt that popularity of television shows like "Extreme Makeover" and "Nip/Tuck" have fueled America's fascination with plastic surgery.

A recent study conducted by the American Society of Plastic Surgeons (ASPS) bears this out.

But plastic surgeons are wary of this connection. Many plastic surgeons like to point out that the definition of plastic isn't "artificial," but "to mold or give form." Plastic surgery entered the mainstream as a way of reconstructing the faces and bodies of soldiers maimed in combat. There are historical accounts of physicians performing skin grafts as far back as 800 B.C. But in recent years, the demand for reconstructive plastic surgery remained relatively flat as the number of cosmetic plastic surgery procedures skyrocketed.

Surgical procedures, such as breast augmentation and liposuction, have increased nearly 100 percent since 1997 and minimally-invasive procedures (such as Botox injections) are up nearly 750 percent over that time period. According to the American Society of Aesthetic Plastic Surgery (ASAPS), 11.5 million cosmetic procedures were performed in the United States last year and Americans spent just under $12.2 billion for the privilege. And that's out-of-pocket. Cosmetic plastic surgery is considered an "elective" surgery, so the patient pays for the procedure, not an insurance company.

Although states like California and Florida are considered the hotbeds for plastic surgery, Georgia is holding its own. This is due in large part to Emory University School of Medicine's Division of Plastic Surgery. The program is internationally recognized, and many of its graduates have elected to stay in Georgia.

"There are more and more plastic surgeons coming to Atlanta every year and most of them are settling in the suburbs," said Dr. T. Roderick Hester Jr., founder of Paces Plastic Surgery and Recovery Center. Hester is also chief of the division of plastic surgery in the department of surgery at Emory University School of Medicine.

Offering the same procedures as larger practices closer to town, residents often opt for convenience.

Of the approximately 6,000 board-certified plastic surgeons in the U.S., about 100 operate in metro Atlanta, according to Georgia Society of Plastic Surgeons (GSPS) records. More than half of these surgeons are within Atlanta's city limits, the rest in outlying suburbs like Marietta, Duluth and Woodstock. The GSPS number does not include board-certified dermatologists or other types of medical doctors who may also legally perform certain surgical procedures considered to be "plastic surgery."

Hester's colleague at Paces Plastic Surgery, Dr. Foad Nahai, is a board-certified plastic surgeon and president elect of the ASAPS. He entered the profession in 1978, and he recalls Atlantans making the trek to New York City or Miami to get a facelift. Not anymore.

"In Atlanta, we have equal to anything done anywhere in the world," he said.

Once relegated to the aging and wealthy, plastic surgery has reached a broader audience. In fact, 35- to 50-year-olds are responsible for nearly 50 percent of all cosmetic plastic surgery done in the U.S. According to the ASPS, the top surgical procedure is breast augmentation, followed by nose reshaping and liposuction. The top minimally-invasive cosmetic procedure is Botox -- more than 4 million procedures were performed in 2006.

By a 9 to 1 margin, women are responsible for most plastic surgery procedures, but the increase in total patients means Georgia's plastic surgeons are seeing more and more men.

"Competition in the workplace has increased, and in areas like sales, where you're meeting the public and the physical appearance component can affect success, men are paying more attention to their appearance," says Dr. E.D. "Dan" DeLoach, the founding associate of Savannah Plastic Surgery and immediate past president of the GSPS. DeLoach noted that most of the procedures men seek are minimally invasive -- like Botox -- but he's also seen a rise in eyelid surgery, neck procedures and liposuction.

In a health-care environment where managed care has brought many physicians' incomes down, the lucrative nature and popularity of plastic surgery has created a bevy of suppliers.

"Everyone is getting into this line of work," said Nahai. He added that the industry is unregulated and patients need to do their homework before going under the knife or the needle.