Women have liposuction on their shoulders for the 'Keira look'

You've had your face lifted, your boobs enlarged and your tummy tucked, but money is still burning a hole in your designer clutch bag.

So where do you go next for cosmetic surgery? The answer, it seems, is your shoulders.

Surgeons in New York have reported a rise in the number of women undergoing shoulder liposuction in the hope of looking like slender stars such as Keira Knightley and Madonna.

Keira Knightley's off-the-shoulder gown inspires off-the-shoulder surgery

They say women have started asking for fat to be stripped from their shoulder areas to give them a more toned and sinewy appearance.

And they predict it is only a matter of time before the craze arrives in the UK.

Dr Douglas Steinbrech, a plastic surgeon based in Manhattan, said a growing number of clients from the UK are now asking for the procedure.

It costs between £2,000 and £5,000 a time, and works by injecting the shoulder area with a local anaesthetic.

Incisions no wider than five millimetres are made in the natural creases and shadows of the shoulders. The fat is then vacuumed out with curved suction wands.

Some surgeons use laser treatments to break up and melt the fat cells before sucking them out.

Madonna leaves the gym after another workout: Her figure is said to have influenced women to have shoulder liposuction

Many of my patients are now requesting shoulders like Madonna and Keira Knightley,' said Dr Steinbrech.

'This procedure is for people who are usually already in great shape and are very trim.

They maybe go to the gym three or five days a week but there are a few areas that the gym can't reach, such as their shoulders, knees and ankles. It is not a procedure I perform on obese women.'

Dr Steinbrech said shoulder liposuction is relatively pain-free and patients can return to work after a few days.

'I often perform the operation on a Thursday or Friday and they recover all weekend with anti-inflammatories and painkillers and go back to work on Monday,' he said.

'Around 80 per cent of the swelling goes down within two weeks and the bruising disappears within ten days.'

Barbara Jemec, consultant plastic surgeon at the Chelsea and Westminster Hospital, said: 'I hope we don't see shoulder liposuction over here.

'It sounds a bit extreme. There are other places where fat is much more visible on women's bodies and shoulders can scar easily.

'The likes of Keira Knightley and Madonna have skinny shoulders because they are skinny all over. I think in this country we are moving away from women having to be stick-thin. A woman who looks normal and healthy is much better.'