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Mirror, mirror on the wall ... - How do you like my wider eyes, higher nose, sculpted cheeks and bigger breasts?

THE summer after high school graduation was a time of big change for 18-year-old Stacy Lin. Apart from losing 15 kilograms and letting her hair grow, she got an eye job.

Now she has what she believes are "shinier," more attractive "double-eyelid" eyes, thanks to a cosmetic surgeon's scalpel.

Her parents approved, of course, and even paid for it - 2,000 yuan (US$293). Prices today range from 900 yuan to 3,500 yuan for double eyelids in a Shanghai public hospital.

"When I look into the mirror, I see shinier eyes," says Lin.

"The three-month vacation was a great time to do it without being noticed," she adds. "When I recovered from the swollen eyes, I would be ready to meet new friends in college with a new look."

Luckily, it only took Lin a week to recover and she was very satisfied with the result.

Lin is one of millions of young women (and some men) - many just finishing high school or just out of college - who want to look better and improve their chances in college admissions and job interviews.

You can get an eye job (double-lids or actual widening), nose job (straightening or building a higher nose bridge), facial sculpting, breast augmentation, body sculpting, liposuction fat removal, high-tech fat cell "melting," Botox injections to smooth your brow, light photon treatment revive your skin and promote growth of collagen and elastin.

And that's just the tip of the iceberg.

Reliable statistics for cosmetic surgery are not available in China or Shanghai, partly because there are many private, uncertified operators.

Doctors and customers (overwhelmingly women) say cosmetic surgery is hot in beauty-conscious Shanghai.

It would seem possible that the economic slowdown might make some people delay cosmetic surgery, just as they put off buying luxury handbags and many other items. Time will tell.

But there has been no recent drop, in fact, there was a big increase over the Spring Festival period, says Dr Lin Jintai, an official of Shanghai Shiguang Plastic Surgery Hospital.

Two years ago the Municipal Health Department issued regulations requiring special certification for facial surgery, Botox and other treatments. Only 10 hospitals, public and private, were approved including Shiguang, he says.

Hospital President Dr Liao Yuhua says the average number of patients was 50 a day for all kinds of surgery in 2006, 2007 and 2008.

From October through December 2008, there was a 32-percent increase over the same period in the previous year, she says. From January until this week, there has been a 40-percent increase from the same period last year.

Seventy patients a day were seen during the Spring Festival period for all kinds of treatments, from surgery to simple Botox, according to Dr Liao.

Lin, like most Chinese, was born with single eyelids, but she preferred the look of double eyelids more common in the West. One of her girlfriends had her eyes "done," and Lin wanted it, too.

There is, of course, a debate about Oriental women who want to change their typical Oriental eyes to look, in their own eyes, more attractive. We leave that issue aside, since everyone these days wants to look better.

If you're not a natural-born beauty and you're not satisfied with the results of going to the gym, spa treatments, the right makeup and hairstyle ?? then maybe cosmetic surgery is an option.

If you decide to do it, first inform yourself about the procedure and choose an established doctor who performs many, many surgeries of the kind you seek. You want a specialist who does facelifts and eye jobs all the time and has lots of practice. Get references, maybe get a second opinion.

With the rapid development of cosmetic surgery techniques ?? and a more open-minded Chinese public ?? plastic surgery is gaining popularity and becoming big business.

More than 1 million people elect to have cosmetic surgery each year in China, according to Dr Jiang Hua, chief of the Plastic Surgery Department at Changzheng Hospital. It was the first professional cosmetic surgery department in Shanghai, opening in the 1950s.

Cosmetic surgery first appeared in China in the 1920s, but only in Shanghai, which was more cosmopolitan and open-minded. And then it was only simple surgery, like creating double-eyelids and nose-straightening.

There was certainly no advance during the "cultural revolution" (1966-76) when individualism and vanity were denounced.

It was not until the end of the 1970s that China began to open up. Once again, it was good to care about personal attractiveness; surgery and beauty treatments became an option.

Back in 1992, Jin Xing was one of the pioneers who got a higher-bridged nose. Her friends noticed she looked different, and she was delighted to tell them. Now she's 53 and still proud of her nose.

"Most of the patients in the 1980s and 1990s were young girls who wanted a more perfect face, but now my clients can be from 16 to 70," says Dr Jiang.

Generally, young women prefer surgery such as double-eyelid, nose- straightening, higher nose bridge and sharper chin and sculpted faced. Middle-aged and older people prefer face-lifts, removal of forehead wrinkles, and liposuction to remove fat.

"The number of male patients has also increased over the years," says Jiang. "Now they represent around 10 percent of the market ?? much more than before."

Young men, too, may want to change their noses and get a higher bridge; older men want eye pouches removed and face-lifts as well as anti-wrinkle surgery.

Cosmetic surgeons and patients say a better, younger look can give people more self-confidence. The pressure of job hunting and university applications also lead many to seek cosmetic surgery, Jiang says.

"Opportunities should be the same for everyone," he says, "but in fact appearance has an undeniable impact on job and school interviews, starting with the first impression." That's why so many high school and college graduates go for surgery.

Chinese people traditionally believe there's a close relationship between one's physiognomy and his or her future.

Wang Ning, 55, has been bothered by her sagging face, wrinkled forehead and eye bags for years, but she hasn't had the courage for surgery.

"The newspaper stories about botched surgeries frightened me," says Wang. "I'm more afraid of an even worse result from a failed surgery. I would rather live with my pouches."

Chen Mei, 50, remembers that her Botox treatment went wrong, but it was temporary. Ten years ago, Chen was convinced to take a bacillus botulinus injection to get rid of the natural wrinkles at the corners of her mouth.

"When I looked in the mirror, the wrinkles were gone, but that was because of weird swelling and stretching at the mouth corners. I looked weird and wish I had never had the injection," she recalls.

Fortunately, Botox is temporary, maybe four to six months. "The swelling was gone in three months and my wrinkles were back again," says Chen. She wouldn't give it another try, though a better doctor would do better. Nowadays, hyaluronic acid injections, not Botox, are used around the mouth.

In 1992, Dr Han Hui opened his private clinic, Han's Plastic Surgery Clinic on Hengshan Road, and he has seen demand skyrocket. He says there are not enough qualified cosmetic surgeons. Some patients also have unrealistic expectations and complain when they don't look perfect. There are failures as well.

Han firmly believes that a good cosmetic surgeon needs a good aesthetic sense as well as perfect skills.

"Plastic surgery is an art," he says. "Big eyes and a straight Roman (high-bridge) nose do not make a perfect face. There must be proportion and balance in the arrangement of facial features. That is even more important."

Han says that some patients may insist on a nose that does not fit with his or her other facial features. A surgeon should give his or her recommendation in advance and encourage second and third-opinions if the patient is uncertain.

After all, a more beautiful face is what both customer and doctor want.

Certified hospitals

Ten Shanghai hospitals, public and private, have been awarded municipal certification as part of Management Regulation on Facial Plastic Surgery Technology. They are:


Shanghai No. 9 People's Hospital

Changzhen Hospital

Zhongshan Hospital

Shanghai Renji Hospital

Shanghai Ren'an Hospital

No. 455 Hospital of Chinese PLA

Shanghai Ruijin Hospital


Shanghai Shiguang Plastic Surgery Hospital

Shanghai Binkai Meizhiyuan Plastic Surgery Hospital

Shanghai Tianda Plastic Surgery Hospital

Cosmetic treatments

Botox injection

Function: Temporarily "smooths" away wrinkles on the forehead, between the eyebrows and at the side of the eye (crow's feet). Not be used under the eye and not advised for the lower face.

Method: Botulionin Toxin Type A, a toxin produced by bacteria, is injected. It makes creases to disappear because it weakens or paralyzes muscles. It cannot remove eyebags. For the lower face, haluronic acid filler is better for lines around the mouth and nose.

Duration: 3-6 months

Warning: Find a good doctor. Facial expression may be too limited if treatment is improper. Some people get headaches at first. Some are allergic. Not for pregnant women.

Hyaluronic acid injection

Function: Treats wrinkles and sunken areas by plumping up and filling in areas. Best in lower face.

Methods: An injection enlarges the volume of collagen fiber and fills in creases and wrinkles.

Duration: 6 months-3 years

Warning: Find an good doctor, lest the result be lumpy or uneven skin surface.

Sculpting chin

Function: Creates a sharper chin and oval face by filing or shaving bones of the lower cheek and jaw.

Duration: Permanent

Warning: Though this technique is quite mature in South Korea, there is also a risk of damaging facial nerves and damaging facial expression.

Higher nose

Function: Creates Roman nose by implanting silica gel or cartilage from the ears into the bridge of the nose.

Duration: Permanent

Warning: Risk of inflammation and tissue rejection.


Function: Tightens skin around face and neck. Sometimes patients also get an eye-lift and eye bags removal, Botox and filler injections.

Methods: An incision is made in front of the ear extending up into the hairline. The skin is separated from the deeper tissues, lifted and redraped; excess skin is removed.

Duration: Years, but aging continues and skin that was tightened will sag because fibers are weakened and gravity takes its toll.

Warning: Scarring, usually hidden in the hair or behind the ears.

Breast enhancement

Function: Creates fuller breasts by implanting silica gel or another substance.

Duration: Permanent

Warning: Risk of inflammation and rejection reaction. Risk of leakage over time.


Function: Slims figure by removing fat from different parts of the body with a tube and suction device.

Duration: Depends on diet and exercise after surgery.

Warning: The amount of fat removed varies, depending on doctor, methods and patient, but it is typically less than five kilograms. Otherwise, odd "lumps" or "dents" appear in "over-suctioned" patients. The more fat removed, the higher the surgical risk.

Note: Always find a doctor with certificate and lots of experience.


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