The number of plastic surgeries is rising as more young people look to change their appearance and prospects, as Xin Wen reports.

In the West, plastic surgery is usually the preserve of older people hoping to retain or regain a youthful appearance. In China, the reverse is true, with young women the most likely to go under the cosmetic surgeon's scalpel.

At age 29, Gan Yuqian (not her real name) has already had four operations to give her double eyelids. Her fourth surgery came after she visited a cosmetic clinic at the Beijing Hospital to consult a surgeon about changing the shape of her eyes, and spoke honestly about her three previous procedures.

In the past 10 years, the Beijing native had attended several private clinics to "improve" her features. Despite undergoing numerous procedures, she still felt her eye shape wasn't a good fit for her face so she recently paid her first visit to a public hospital in search of a solution.

Gan was one of 9 million Chinese women to change their appearance in 2015, according to a report by Zero2ipo Research, which showed that people in their 20s and early 30s are the biggest spenders on physical makeovers.

She has already spent 100,000 yuan ($15,000) on cosmetics operations. "Plastic surgery can help people, but it can also harm them," she said. "And it hurt me."

Gan first had surgery to produce double eyelids when she was age 19. "It looked pretty good at the time," she said. "I was always naturally beautiful, and boys thought I was pretty and wanted to marry me. But I was kind of lost and thought a better man was waiting for me in the future."

In 2009, having turned down a marriage proposal, she underwent further procedures to alter her appearance. After several shots of hyaluronic acid in her nose and jaw to make her features more aquiline, she looked like a Barbie doll and could barely display emotions.

"It actually ached a lot," she said.

Young beauty miracle

Many young Chinese have had multiple cosmetic surgeries and the number continues to grow, according to a report published in August by Soyoung, a cosmetic surgery social networking app with 20 million users, 92 percent of whom buy beauty products from it every three to six months.

"The industry in China is currently in its first peak development period," said Jin Xing, Soyoung's CEO. "So it's no surprise that a growing number of consumers regularly buy aesthetic medicine products."

The plastic surgery trend first appeared in the United States about 30 years ago. The phenomenon was chronicled by Naomi Wolf in The Beauty Myth which showed the influence of advertising and magazine photo shoots in the growing pressure on women to attempt to conform to unrealistic ideas of beauty. The rising financial and social status of women in the West also helped to accelerate the growth of the industry.

In China, the awakening of self-awareness has accelerated the consumption of aesthetic medicines, while the demands of work and the desire to attract a partner is playing an increasingly important role in prompting younger people to opt for cosmetic surgery.

Ma Zhiguo, a senior psychologist in Tianjin, recalled how surprised he was the first time a man who was not satisfied with his appearance, despite having several operations on his face, asked him for help. That was about 10 years ago.

According to Soyoung's estimates, the market for aesthetic medicine and surgery has risen by 42 percent so far this year, and its growth has provided consumers with greater choice and prompted them to undergo multiple procedures.

Jin, the CEO, is convinced that the value of China's cosmetic medicine market will rise to 2 to 3 trillion yuan within the next 10 years.

Three years ago, Xue Li (not her real name) visited a private clinic in Beijing to undergo a procedure to produce embedded double eyelids. While she was on the operating table, the doctor suggested that she should have the fat in her lower eyelids removed by filling in the lacrimal groove.

Although she felt pressurized, Xue agreed to the procedure. "I felt as though they were advertising while I was undergoing surgery," the 28-year-old said, adding that the original fee of 5,000 yuan eventually rose to 10,000 yuan.

Public hospital plight

Zhao Hongyi, head of the plastic surgery department at the Beijing Hospital who has worked in the sector for 22 years, is noted for performing surgery to produce double eyelids.

He said cosmetic surgery first rose to prominence in the 1950s, but at the time the focus was on reconstructive procedures, and it was only in the 1990s that "aesthetic medicine" began to develop and become a consumer item.

He agreed with the conclusions of the Zero2ipo report, noting that China has the third-highest number of cosmetic surgeons in the world, and that the younger generation - people ages 18 to 30 account for 58 percent of patients in the sector - is the driving force.

"Social competition and the influence of online celebrities have helped to accelerate the pursuit of beauty among young women," he said. "Meanwhile, a nouveau riche mentality has helped to foster a psychological bias."

More important, the market has expanded to such an extent that the number of patients outstrips qualified practitioners, he added.

That is creating a problem because the public hospital system isn't attuned to the needs of customers, and a growing number of private companies are attempting to exploit the potential of the immature market via massive advertising campaigns.

"It's kind of pathetic to work as a plastic surgeon in a public hospital," Zhao said, referring to the low rates of payment, and the fact that fees are fixed and easily ascertained.

However, prices in private clinics - where the operations may be performed by the same surgeons as in public establishments - are not as transparent and can be much higher.

In addition, the cost of surgery may fluctuate according to demand, along with agents' fees.

Zhao said the fixed fees at State-run hospitals are hampering the continuous development of cosmetic surgery in the public sector.

"It's a market-oriented industry," he said. "But if you use the nonprofit medical model to control the marketing profession, it definitely raises some issues."

Healthy attitude

Jin, from Soyoung, said society discriminates against cosmetic surgery.

"If you tell a girl that she has had cosmetic surgery, she will feel offended," he said, adding that most female patients believe they were always attractive and the surgery didn't alter their appearance.

"Society's attitude toward cosmetic surgery shows that the market is not mature."

He said an understanding of the appropriate procedures and a healthy mindset can help patients make the right choices and also foster healthy, long-term development in the sector.

"What we've been trying to impress upon patients is that before you have cosmetic surgery, you should ensure that you are mentally prepared."

In China there is no age restriction for plastic surgery, but public hospitals have a duty to consider a patient's mental condition if they request treatment repeatedly. No such considerations apply to private operators.

Gan formed the habit of visiting cosmetic surgery clinics on her travels around the country. She recalls telling one doctor, "I am worried about the shape of my eyes."

He replied, "With regard to your upper eyelids, the problem is a lack of symmetry, but if you think that's okay, we won't need to do any surgery."

Gan then showed him a photo of Fan Bingbing, a Chinese actress who has appeared in a number of Hollywood blockbusters, including X-Men: Days of Future Past and Iron Man 3, and asked him to make her eyes the same shape as Fan's.

Despite everything, she still believes that more plastic surgery will help her meet the man of her dreams, but with one proviso: "After all the clinics and surgeries, harmonious beauty is the most important thing to me, so the plastic surgery should be appropriate."

Contact the writer at xinwen@chinadaily.com.cn

(China Daily 11/10/2017 page6)