All of the women in Iranian model Azadeh's family have had nose surgeries, each feeling the pressure to conform with Western beauty standards in a country where female bodies are heavily policed.

To Azadeh, smoothing out the bump in what Iranians would call the "Persian nose" she was born with proved a lucrative investment.

Since the 1979 Islamic revolution, Iranian women have been required to dress modestly and cover their hair, and the beauty industry has become almost entirely centred on the face.

Having rhinoplasty - a nose job - can make a major difference, Azadeh said.

"After the operation, not only have I earned myself a modelling job with better social standing but I'm also earning three times more and I'm more respected by clients," she said.

Azadeh, 29, asked that her surname be withheld because women models can face social pressure in Iran.

According to the US-based International Society of Aesthetic Plastic Surgery (ISAPS), more than 264 000 cosmetic operations were performed in Iran in 2023, with rhinoplasty being the most common.

Across Tehran and other Iranian cities, brightly coloured billboards advertise beauty clinics and cosmetic procedures, offering promises of sculpted noses, flawless skin and perfect teeth.

Many people with bandaged noses can be seen on the streets, a testament to the popularity of rhinoplasty.

"It has become more of a cultural trend," said rhinoplasty surgeon Hamidreza Hosnani who performs up to 20 operations a week at his well-equipped clinic in the capital.

And that trend has evolved, becoming more and more tied to social identity and status, especially as more women have defied the strict dress code.

Such defiance became more marked following the mass protests sparked by the 2022 death in custody of 22-year-old Iranian Kurd Mahsa Amini.

In Iran, where the minimum wage is around $100, basic rhinoplasty costs up to $1 000 - significantly cheaper than in other countries, Hosnani said.

Millions of Iranians have long struggled with soaring prices and a plunging currency, driven in part by years of international sanctions.

"I even had to borrow the money required for the operation from my friends and family, but the money was well spent, and it was completely worth it," Azadeh said.

Reyhaneh Khoshhali, a 28-year-old surgical assistant, had the operation four years ago, and regrets not having it sooner.

"My nose really did not look good aesthetically and I wanted to be more beautiful," she said.

"If I could go back, I would have had the operation earlier."

For years, Iran has hosted highly advanced medical centres, even becoming a destination for foreigners seeking high-quality and affordable cosmetic surgery.

However, the procedures can also come with risks.

The Iranian authorities have repeatedly warned about the growing number of unauthorised clinics performing cosmetic procedures.

In February, a dozen unlicenced practitioners were arrested and several operating theatres in Tehran's Apadana Hospital were closed because of unauthorised cosmetic procedures, the health ministry said.

In 2023, three women died in a single day - November 7 - during cosmetic surgery in three separate incidents in Tehran, media reported at the time.

Ava Goli has yet to undergo her rhinoplasty operation, and said that finding a reliable doctor involved some research.

"I saw some people whose nose job did not look good... and yeah, it really made me scared at times," the 23-year-old said.

Yet the demand for cosmetic surgery in Iran remains high - and the pressure to keep up is not limited to women.

Bahador Sayyadi, a 33-year-old accountant, said he had to borrow money so he could have a hair transplant.

"My financial situation isn't great, but thanks to a loan I got recently, I will be doing the procedure just in time before my wedding," he said.

"Men should also take care of themselves these days, just like women." | AFP