Once upon a time cosmetic surgery was taboo; reserved for the rich or the vain. If you'd had it, you didn't admit it and you certainly never questioned your flat-chested colleague who came back from "visiting the relatives" with ample double Ds.

Things have definitely progressed over the past 10 years. Okay, so maybe it's hardly frowned upon (because our facial muscles won't allow it) and a quick nip-tuck is nearly as normal as getting your roots done at the hairdresser. But why?

A revealing survey by Rouge beauty website found that more than half of Australian women would contemplate having cosmetic surgery. The number-one reason for going under the knife? Low self-esteem. Followed closely by a fear of ageing.

Vote for which cosmetic surgery procedure you would have by clicking on the Vote button to the right.

A similar survey commissioned by the Lifestyle Channel showed a massive eight out of 10 Australians would have cosmetic surgery if money was no problem. Are we really that vain? Or are there other issues at play here?

Let's take a look:

Self-esteem

With such emphasis placed on physical beauty, a huge nose or flapping ears can totally destroy self-confidence. Being able to fix a "flaw" relatively easily can change someone's life.

Often though, we're never satisfied by just one procedure because issues are so deep rooted. Just look at reality star Heidi Montag and her sad obsession with perfection. It took 10 procedures in one day to transform her into the Barbie doll of her dreams but it left her desperately unhappy, not to mention in agonising pain.

Ageing

In a society where youth and beauty go hand in hand, women naturally fear growing old and being replaced.

In the UK, a BBC presenter was recently awarded damages after being unfairly sacked due to her age. With the sexist double standard that sees an abundance of men over-50 in high-profile jobs, is it any wonder women feel under pressure to resort to drastic measures?

Medical issues

Of course sometimes it's necessary to have work done for health reasons like alleviating breathing problems through a nose job, à la Cameron Diaz.

Birth defects in children, burns victims and women who've suffered mastectomies can all benefit from the emotional and physical healing cosmetic surgery can provide too.

It seems that whatever the circumstance, be it medical or aesthetic, the underlying reason for cosmetic surgery is often self-confidence.

While we can understand why, just where has this modern acceptance of cosmetic surgery sprung from?

The age of celebrity

There's no doubt that we live in a celebrity-dominated culture. And with superstardom comes the pressure to look young in order to keep your job, your man and your fans. With paparazzi out to get "stars without make-up" shots, it's no surprise there's a perfection obsession in Hollywood.

In fact it's unusual to find a star that hasn't had a cosmetic procedure these days, with many willing to talk about it. While Sharon Osbourne famously gushed about her love for cosmetic surgery, sitcom star Patricia Heaton was honest about her reasons for surgery after becoming a mother: "Vanity. I mean it, vanity... and I feel fine about saying I did it."

Even the younger Hollywood generation have succumbed to the craze, believing cheek implants and Botox are a necessary part of their day job.

If stunning actresses like Megan Fox aren't happy with their gorgeous faces, should we be so content with ours?

Media coverage

The Lifestyle Channel survey reports that one in five people think media coverage of celebrity surgeries has helped make it more socially acceptable. This may be true, but the influx of reality makeover shows on regular people in the mid-2000s showed that massive transformations weren't just for the rich and famous.

The positive slant that Extreme Makeover and How to Look Younger in 10 Days adopted took acceptance to a whole new level, perhaps contributing to the rise in cosmetic procedures in the US from 14.8 million in 2004 to 16.2 million in 2006.

Medical developments

Technological advancements in cosmetic surgery have seen more people prepared to get work done. With results looking more natural and subtle than 20 years ago, minimally invasive techniques mean little pain, faster recovery and much less risk than ever before too.

A quick Restylane shot in your lunchbreak is not such big deal. Some bigger procedures can mean you're in and out over a weekend which is revolutionary.

With more "have they or haven't they" stories dominating weekly magazines and TV coverage, cosmetic surgery is on everyone's plumped up lips. And while it's a great testament to how far the industry has come, it's also a worrying testament to our state of mind.

Your say: Have you had cosmetic surgery or are you considering it? If you have, was it a good experience? Share your stories and thoughts below.