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CHINA - BOOM IN PLASTIC SURGERY - WOMEN

A Beijing doctor works on a woman who wanted a new jaw line and chin.

In 2009, China ranked third in the humber of cosmetic surgeries. NY Times

March 21, 2012 - Editor: Sun Xi

A few middle aged women are sitting on a bench outside the observation room at noon in the Medical Center of Plastic Surgery and Cosmetology at a hospital in Beijing. They have bandages wrapped around their foreheads, faces or abdomens.

Unlike most of the other patients in the hospital, the women are there voluntarily and are technically not even patients as most of them are very healthy. But they have each chosen to undergo painful procedures in the name of beauty.

They are part of the new cosmetic surgery craze sweeping China.

In its most recent global survey, the International Society of Aesthetic Plastic Surgery (ISAPS) revealed that China's plastic surgery operations amounted to more than 3.4 million cases from 2009 to 2010. Of them, a mere 1.8 million cases were surgical operations and the rest were non-surgical cosmetic procedures.

According to the New York Times, China ranks third in the world behind the United States and Brazil for the number of plastic surgeries performed.

It is worth noting that South Korea, which has a widespread reputation for being the cosmetic surgery capital of Asia, only ranks seventh. Clearly, the Chinese have become the biggest fans of cosmetic surgeries in Asia.

Chinese Plastic Surgery: A History

The roots of cosmetic surgery in China go back to 1943 when, during the Anti-Japanese War, a medical school student was sent to the University of Pennsylvania to study plastic and reconstructive surgery so that he could bring back advanced treatment techniques for wounded soldiers. His name was Song Ruyao, and he became the founder of plastic surgery in China and its offshoot, cosmetic surgery.

During the Anti-Japanese War (1937-1945) and the War to Resist US Aggression and Aid Korea (1950-1953), China's plastic surgery field made tremendous achievements in burns recovery, facial plastic surgery and reconstruction. The field seemed poised to continue growing.

However the next period of history saw the Cultural Revolution (1966-1976) happen and plastic surgery was denounced for its 'bourgeois' attention to form over function. People were not encouraged to pursue a sense of beauty. Men and women wore the same loose uniforms of gray or dark-blue and any feminine display, such as long hair, makeup or jewelry was strictly forbidden. The industry foundered under such stifling conditions. Aside from deformity correction procedures, plastic surgeries all but disappeared until the reform and opening up phase of the country's history.

In the mid-1980s, cosmetic surgery began to see a revival in the country. The major procedures were skin whitening and smoothing and removal of moles and freckles.

Corrective and surgical procedures were gradually developed. Perhaps reflecting the influence of Western ideals, 'double eyelid' surgery became popular to add an extra fold above the eyes, a naturally occurring characteristic in many races but which occurs in only a minority of Chinese people.

This was followed by nose implants to increase the height of the nose bridge. Breast augmentation was not nearly as popular as in the US, and the average size of the implants was smaller, but it became more popular over time, perhaps due to the influence of Hollywood aesthetic ideals.

Compared to its previous role of providing disfigured war victims with an improved appearance, plastic surgery was like icing on top of the cake for people of the rapidly modernizing China.

Perhaps because of this, many people longed to try but were worried about potential criticism from friends and family.

Xu Hongxia, director of the Laser Cosmetic Surgery Center of People's Liberation Army (PLA) Navy General Hospital, has a deep understanding of society's take on plastic surgery back then. She said: "People were usually very secretive about it. They dared not ask for the doctor's help if something went wrong. The final result was that the entire industry did not see any developments or progress and gradually fell behind."

In the 1990s, plastic surgery gained acceptance but still existed on the fringes of society as people were unable to understand or accept it.

Zhou Xiaolin, director of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences, recounted a story in his book The Magic Plastic Surgery. In the early 1990s, a woman from a county in north China's Hebei Province underwent a nose job in a Beijing hospital where such procedures were routine. But after returning to her home county, she was condemned by her whole family. Her children felt ashamed. Enormous social pressure forced her back to the operating table. She sighed and asked: "When will the spring breeze of modernized life blow through our motherland?"

The industry's spring did not arrive until the 21st century, when entertainers began to get their minor problems 'fixed' and then kept silent about it.

Advances in media eventually led to plastic surgery amongst celebrities coming into the spotlight and people began to feel reassured about it. The general consensus was: If a celebrity can do it, so can we.

The Growth of A Lucrative Industry

In pursuit of beauty, many people have chosen to endure the pain of going under the knife. The industry now offers all sorts of dazzling cosmetic procedures such as skin rejuvenation, wrinkle elimination, eye bag removal and the perennial favorite, breast implants.

In 2010, the value of China's plastic surgery market reached 300 billion yuan (US$48 billion), with the industry employing more than 20 million people. The industry has grown at an average of 40% per year with sales increasing at a rate of 60% per year.

By the end of 2011, mainland China had 34,000 or more cosmetic surgery institutions including beauty salons, clinics, comprehensive plastic surgery departments and hospitals.

The beauty economy has become the fourth largest consumption hot spot following housing, vehicles, and tourism. 

Who Is Getting Nipped and Tucked?

Xu says that the number of people seeking cosmetic surgery is expanding rapidly and now covers all strata of society.

"In the past, people who wanted to be in the entertainment industry such as drama, dance and performing art school students were the main customers due to their career requirements. But now people consider their self-image improvements very seriously and will do it if economic conditions permit," she said.

As for the age range, she says that the majority of those who go under the knife are women in their 40s. "They are facing menopause and beginning to show signs of aging. Coupled with social pressure or family crises, they tend to lose their identity. A variety of factors leads to their desire for beauty," Xu said.

Of them, there are many high income entrepreneurs and housewives who usually have their first cosmetic surgery procedure in their 30s.

In addition to the factors of age, employment is also stimulating the prosperity of the cosmetic surgery market.

Faced with a brutal job market, many female graduates are considering giving more than just their resumes a facelift. In pursuit of an ideal job, many young Chinese women are resorting to medical plastic surgery to gain an edge over their competitors.

Every November is peak season for college senior students getting plastic surgeries as they want to be fully-recovered before the job-hunting season begins in April and May.

While admittedly drastic, the even more extreme cases choose to reshape their bones, electing for cosmetic height increase, also known as limb lengthening procedure. In a country where height is associated with privilege, limb lengthening is a legal procedure. The risks are extremely high as the procedure entails osteotomy—sawing off the leg bones and stretching the legs to allow the bones to grow.

According to relevant findings, college students have become the second largest group of cosmetic surgery customers in China. About 60% underwent cosmetic procedures to enhance their job prospects.

Not Just the Women

It's not only women that are undergoing cosmetic surgery. The percentage in plastic surgery has risen in men as well.

Statistics show that the proportion of men receiving plastic surgery procedures has almost doubled in China. Men account for about 10% of the total plastic surgery procedures performed and more than 90% of them are engaged in client-facing occupations.
While men seem to have tried almost all the female cosmetic surgery procedures on offer, they tend to focus on the chin, nose and under-eye bags as half of those undergoing plastic surgery were fixing their noses and chins.

The male plastic surgery craze can also be traced to the rise of celebrity culture and male beauty culture subverting more traditional gender norms.

The new culture has generated all kinds of popular men's beauty contests, male skin care lines and professional beauty institutions. Regardless if the overall aim is improved job prospects or simply a better physical appearance, men are definitely growing more concerned about their appearance.

In certain countries, male cosmetic surgery has long seen an upsurge. According to media reports in the United States, about 130,000 men received plastic surgery procedures in 2002, an increase of 25% over 2001. In South Korea, 20% of men have undergone cosmetic surgery. In Thailand, male plastic surgery has doubled from 10 years ago. In Japan, people consider plastic surgery as integral a part of image presentation as buying clothes. Many Japanese company chief executives undergo face-lift procedures almost every year. In Latin America, 10 % of people undergoing plastic surgery are men and of them, 30% are Brazilians.

It is common in mainland China for male celebrities to check into hospitals for plastic surgery accompanied by their personal managers. In 2008, there appeared a number of celebrity face imitators. For instance, good-looking Taiwanese singer and actor Nicholas Tse set off a frenzy of men requesting for their plastic surgeons to mould their faces to look like his.

Aside from people in the entertainment industry, many men in their 40s with successful careers and active social lives also go for plastic surgery to remove the bags under their eyes. Such procedures have long been around and have fast recovery rates, boosting their social acceptance.

In addition, like their female counterparts, hopeful male jobseekers are also turning to plastic surgery, especially those seeking client-facing positions. These new-age young men consider it a paving stone to their future.

However, men also tend to differ from women when it comes to cosmetic surgery. Men usually have a clear purpose when it comes to going under the knife. They tend to do it to correct defects and have a good awareness of the risks involved. In contrast, more women tend to undergo enhancing cosmetic surgeries to improve rather than correct their physical features.

The survey also shows that Chinese men hold a more cautious attitude towards cosmetic surgery.

Adopting A Western Aesthetic

Different human races have different facial features and standards of beauty. However, the trends in Chinese cosmetic surgery show a clear tendency to favor the large eyes, high noses and clear-cut chins of the Western beauty ideal.

Professor Kim Yang-woo, from the medical center of Ewha Women's University in South Korea, said that there is no universal standard of beauty as every country and race has its own ideas of what is beautiful.

In his view, the comparative racial diversity in North America as compared to China has led to a parallel diversity in beauty standards. While Chinese people all seem to value the same facial features such as fair skin, large eyes and small, high noses, Americans tend to value a wider variety of features.

"Caucasian facial features tend to be more three-dimensional with double eyelids, deeply set eyes and high noses. Asian features tend to be wider, with single-fold eyelids and flatter noses. Many plastic surgery procedures that are popular in Asia are not necessary in Western countries. Due to the reasons of economic and cultural development, many Asians admire Caucasian facial features. Conversely, many Westerners think that Asian faces are softer and gentler," he said.

As Western countries focus their developmental efforts on equipment, backed by the Industrial Revolution and an emphasis on research and development, Chinese and South Korean cosmetic surgeons have worked on perfecting their surgical technique.

"Using equipment runs a smaller risk but higher cost. And the effect is not as good as surgery. You might have to undergo ten equipment treatments to achieve the effects of one surgery," Xu said.

It is useless to deny that we live in a world that puts a premium on physical beauty. As Russian literary giant Leo Tolstoy once said: "I am sure that nothing has such a decisive influence upon a man's course as his personal appearance, and not so much his appearance as his belief in its attractiveness or unattractiveness."

In this case, a little bit of suffering and a certain amount of money might reap you plenty of life benefits.

(Source: insight.inewsweek.cn/Translated and edited by womenofchina.cn)