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Self-assured and confident, Moss talks about breasts with a clinical distance to keep the conversation comfortable, yet with enough ardour to convince you he’d appreciate a good pair when he saw them.

‘‘The female form is very beautiful with beautiful curves. I certainly think a lot about what looks beautiful, what is in balance. You need to know what looks good . . . so in an operation you know where you’re aiming,’’ he says.

He laughs when asked if his home’s walls are hung with paintings of female nudes. They’re not.

He says the demise of the Baywatch babes’ beach ball breasts and rise of the newer, natural-look enhancements are enticing more women to go up a cup size or three.

But breast-implant surgery, for all the glitz afforded it in flippant mentions by movie stars, for all the in-one-day, out-the-next notions pushed by extreme makeover TV shows, is as involved as a knee reconstruction or a tonsillectomy.

There is no glamour in the process. It’s a hell of a choice to make for bigger breasts. Surgery is surgery and it carries risks — from simple complications to rare but possible death.

BEAUTY isn’t just skin deep, or Emma wouldn’t be lying here, at 4pm on a Wednesday in September, anaesthetised on an operating table. This 22-year-old woman is about to have the most serious medical procedure of her life.

Moss hovers nearby as the anaesthetist and nurses finish preparing his patient for surgery.

Under the theatre spotlight beauty is a clinical notion. This person, whatever her loves, fears and vanities, becomes a body with anatomical planes to separate, with blood vessels to preserve and nerves to mark and avoid.

Carpentry with living tissue.

Emma (not her real name) had a country girl’s quaint twang and a pair of A-cup breasts that to her looked all right on a skinny teenager, but inadequate on her more rounded, early-20s adult body.

On the operating theatre wall is a clutch of photos, varying angles of Emma’s naked upper body. She lies sleeping on the table, her nipples demurely taped flat and black lines drawn to frame her breasts and help guide Moss on his mission.

There are two 4.5cm incisions. The cuts are made at the base of each breast. The skin pulls apart as deeper layers are exposed. Systematically Moss separates the lining from the muscle beneath her breast tissue. A cauteriser — a sharp-pointed instrument like a soldering iron — sizzles during the process. That burnt-flesh smell. It collects at the back of your nose and takes hours to clear.

There is very little blood, a little here and there dabbed away by one of the three nurses on Moss’s team. After 10 minutes the first breast is ready to take the implant. It’s filled with gauze and left. The preparation process is repeated on the other breast.

‘‘Just because I don’t do the acute care car-crash victims need doesn’t make my surgery less important,’’ he says. He defends the mindset of women willing to undergo surgery to look better. People who say they’d be better off seeing a psychiatrist than a surgeon, he says, miss the point.

‘‘I can tell you I look after a lot of psychologists who come here to have surgery. They realise that when the problem is about something physical, a physical remedy is very powerful.

‘‘Some women have literally never taken off their clothes in front of their partners. I might look at them and say ‘you just have small breasts — plenty of women have small breasts and don’t have that concern’. But it’s not about that. It’s about how they perceive their body to be.’’

Emma, a month after the operation, says she’d go through the breast implant surgery 10 times over. Her construction-zone bras have been replaced with C-cup bras that her breasts fill. She buys chicken fillets now to eat rather than to plump up a cleavage. Few people knew how small she actually was, so people don’t notice she has implants. She wasn’t obsessed with having big breasts. She was outgoing and confident. Her parents and boyfriend were ‘‘dead-set against’’ her getting implants, but her friends thought it was a good idea.

‘‘I didn’t care about the negative comments. I was doing it for me, no one else. I wasn’t shy or ashamed. I didn’t have low self-esteem. I just felt my breasts were too small for my hips,’’ Emma says.

She chuckles when she says many friends have since asked to see her new, bigger breasts, to feel them. She’s not shy and happily obliges.

Moss and his colleagues are in the midst of the breast implant season.

When the sun comes out, women want their boobs done. Demand for breast-implant supplies spikes between the start of October and mid-December.

‘‘In that period, we sell every week what we would sell in quieter months the rest of the year,’’ says Nic Steventon of Mentor, one of the bigger implant suppliers in Australia.

His observations are as close to a confirmation of a growing market as you’d get in Australia — no one else has useful figures about breast enhancements. The industry is still relatively young and fragmented.

Steventon says every year 10 per cent more women in Australia have implants. And Melbourne is going with that trend. He says 10,000 to 13,000 Australian women are having the procedure each year.

And that doesn’t take into account the number of women having breast reductions.

It should be of no surprise. Steventon says Australia spends more on cosmetics — from cosmeceuticals and hair products to breast augmentation and facelifts — per head of population than any other country.

Women in booming mining communities in Western Australia and Queensland are pumping up their bust lines much faster than the national average. There’s a lot of spare money there — and it costs $8000 to $12,000 on average.

In confirmation of what southerners always suspected, Gold Coast implant patients choose bigger cup sizes.

‘‘Melbourne is very conservative in its sizes. The Gold Coast is not. Our largest implant is 700ml — we sell them all the time on the Gold Coast. I don’t recall selling any in Melbourne.’’

But, he says, across the board, the average implant size has gone from 275-300ml to 325-350ml.

In general, the bigger the implant, the greater the potential for complications such as reduced breast sensitivity, which Moss says good surgeons can keep to a 1 to 2 per cent occurrence.

HE SAYS partners regularly attend consultations, but it’s never they who push for surgery.

‘‘Men tread very carefully when talking about breast implants, generally,’’ Moss says with a wry smile. ‘‘Occasionally husbands try to keep the size a bit smaller than what the woman wants.’’

That’s comforting for the women and wise of the men.

Moss may have moved to new digs as economic times get tougher, but as long as women see other women with better breasts filling off-the-rack dresses, they’ll keep beating a path to his door.