Unlike the core requirements of food, sleep, shelter and the like, the aesthetic refinement of the body represents more of a hedonistic/indulgent desire . . .a wish to be satisfied only after fulfilling more basic cares.

But as baseline physiological and economic needs are met, aesthetics become much more important. Indeed, as moral scolds are fond of telling us, much of the consumption that drives advanced capitalist economies is want-based rather than need-based. This is precisely because capitalism both satisfies basic needs and rewards economic activity at the margin. In other words, businesses thrive on needs and desires.

It should come as no surprise, then, that over the past five years, as household disposable income increased by at least a quarter and probably as much as a third, the Irish market for cosmetic surgery has more than tripled in size, according to industry estimates.

Although total turnover is still a modest 36m a year for the whole sector, growth exceeds 50% a year.

The market for facial injectables . . .the so-called 'lunchtime lift' . . . has ballooned by 350% to more than 12m in the past five years as wrinkle smoothers such as Botox and Restylane have gone mainstream. The biggest player in Ireland, Advanced Cosmetic Surgery, performs 5,000 procedures a year and has a turnover of 8m.

With numbers like that, it's easy to see why Ailish Carty, managing director of Cosmedico, a start-up cosmetic surgery clinic just beside Avoca Handweavers in Kilmacanogue, Co Wicklow, has placed a 4m bet on bringing something new to the industry. That something new is a high-tech, high-touch approach based around a resident surgeon and Blackrock-level standards of consultation and aftercare.

There is a shortage of cosmetic surgeons in Ireland and clinics make up the shortfall by flying in surgeons from the rest of Europe and North America, so Carty saw an opportunity before and after the procedure: with a resident surgeon, you have continuous medical attention from consult to discharge.

In January 2006 she formed a partnership with Irish-based German surgeon Dr Sammy Malhas and both their spouses and had Cosmedico running by October. Malhas performed the first procedure, a facelift, in December and now the clinic is on track for 500 surgeries in its first year, giving it a projected 3% market share and 800,000 in turnover.

That's the business case. But Carty is an evangelist, too. What propelled her into cosmetic surgery, she testifies, was an earlier missed opportunity in childcare and, later, a "small procedure", which turned out to be a sort of conversion experience.

"I could see all the women my age in the estate in Cabinteely had kids and I said to myself 'there won't always be the lady down the road', " she says. "I missed the boat on creches. I could see it coming because I was in it."

When she next sized up her south Dublin peers, she saw working women whose standards of self-presentation had evolved with the economy.

"It's booming in Ireland right now . . .women are looking after themselves in a way they didn't before, " she says.

"Women in business are going the surgical route because of competition in the workplace, to keep an edge in a competitive marketplace."

In the words of Carty's PR consultant, who mentions some "tasteful procedures" of her own, cosmetic surgery has become "normalised, attainable and destigmatised".

Television has been no small part of the transformation. Apart from the fact the most actors and actresses have undergone aesthetic enhancements of some sort, reality TV is pushing the beauty meme pretty hard, with even "natural beauty" programmes such as Ten Years Younger and Look Good Naked lighting up the Cosmedico switchboard . . . a boon to a company that admits to underestimating its advertising and marketing budget by a factor of three.

"Television has so far been the greatest contributor to our business, " Carty confesses with a wry smile. "After the programmes there's an instant reaction of 'I want it and I want it now'."

And with incomes going up along with the popularity of cosmetic procedures, prices have come within range of many more people . . . they can want it and get it now.

You might expect Cosmedico's business to be concentrated along the Dart line or among the ladies who lunch at nearby Avoca, but Carty says the clinic's location on the N11, not far from the M50 junction, puts it in touch with more clients from Meath and Wexford. It's not just prosperous suburbanites who can stump for an average 1,600 per procedure.

"I don't accept it's a luxury, " Carty says. "It's available to everyone at a relatively reasonable price."

Nonetheless, people are borrowing to get their tummy tucks and breast implants. Carty isn't shy about Cosmedico's relationship with health financing firm Easycare . . . it's on the website and works with the competition, too . . . but she says the clinic's multi-million investment in private hospital level care (state-of-the-art operating theatre, private recovery rooms, tasteful but expensive interior design) is "looking down the road" at coverage approval from health insurers.

Irish private insurers Quinn (nee Bupa) and Vivas don't cover 'aesthetic' treatments, Carty said, but added that this may change. "Vivas is likely to be first, perhaps by the end of the year, " she says.

A spokeswoman for Vivas Health said the company has no plans at the moment to cover cosmetic surgery, though she added that Vivas is the only health insurer in the market to contribute to laser eye surgery and teeth whitening treatments.

The hope of insurance cover has Carty eager for regulation of the market "to get standards up", presumably to the very level Cosmedico has met with its early investment. There are costs as well as benefits to regulatory supervision, Carty admits, but then there are wants and there are needs, too.