China's is the world's second largest cosmetic surgery market in the world after the U.S. and is expected to surpass the U.S in the mid 2020s. Since the ban on cosmetic surgery was lifted in 2001 in China, the sector grew at a rate at of more than 30 percent a year until 2015. In 2012, the sector employed more than 20 million employees and around 70 percent of China's cosmetic procedures took place unlicensed salons. Between 2009 and 2010, more than 3.4 million cosmetic surgeries were performed in China. The registered cosmetic surgery market in China was valued at $36.71 billion in 2019. The entire industry is said to be $63 billion. If the unregistered back alley sector and overseas procedures are factored in the value could be over $100 billion. [Source: Oiwan Lam, Global Voices, October 8, 2015; China Daily January 2020]

Cosmetic surgery clinics with names like Dreaming Girl's Fantasy began popping up all over the place in the early 2000s. By one count over 10,000 medical facilities offered cosmetic surgery by 2003. The No. 9 People’s Hospital in Shanghai performed 25,000 cosmetic operations in that year, a 25 percent increase from the year before. This is an extraordinary leap from virtually no cosmetic surgery in the 1980s. At the No. 9 People’s Hospital in Shanghai in the mid 2000s, a double fold operation cost around $360. Breasts implants cost around $2,500. Facelifts and liposuction are also done. A woman who undergoes a Chinese version of an extreme makeover has her jaw slimmed, eyes and nose sculpted and her breasts enlarged and lifted. Customers at the Shanghai hospital flip through pictures of noses, cheeks and breasts and show doctors assistants what they want. The assistants then use plastic models to illustrate what has to be cut, sucked, altered or filled in.

An eyelid operation costs between $300 and $1,200. During 30-minute double slit eyelid surgery, doctors cut, fold and sew the upper eyelids with what looks like a fishhook, to create a crease above the eyelids. One woman who had the operation said, “Bigger eyes make you look more awake, more beautiful.” Double slit operations aim to make the eyes pop out and look rounder and more Caucasian. Many have said this look as well as high noses and model pouts don’t look right on Asian women. These days there is more of an emphasis on enhancing and refining Asian features rather than creating Caucasian ones. Popular procedures at cosmetic surgery clinics in mid 2000s included reducing eyes bags, sculpting noses and shaving the jawbones to produce a softer face. Double slit operations are more subtle, designed to create larger eyes not ones that look Caucasian.

“The pursuit of physical beauty has become big business in China, ” HSBC analysts said in a report. Laurie Burkett wrote in the Wall Street Journal’s China Real Time, An entire Chinese beauty enhancement ecosystem is emerging. Plastic surgery clinics and enhancement parlors — serving as one-stop shops for Botox shots and facial fillers — are popping up all over cities like Beijing and Shanghai. Korean doctors who see the market potential are already starting Korean-Chinese joint ventures in China.“Homegrown Chinese injection makers — like Shanghai Haohai Biological Technology Co. and Bloomage BioTech — are also becoming big businesses, selling to consumers who would rather have a quick lunch-time shot to fill wrinkles than go under the knife, HSBC said. The Chinese market is still largely in its infancy and is filled with smuggled and illegal products, HSBC said. An estimated 50,000-100,000 beauty salons now illegally perform procedures, it said. But the government is expected to step in and heighten regulation as the market grows, HSBC said. [Source: Laurie Burkett, China Real Time, Wall Street Journal, April 5, 2016]

China's Plastic Surgery Boom

According to Deloitte report, the market almost tripled between 2015 and 2019, when it reached $27.3 billion and grew at an annual growth rate of 28.7 percent, well above the global rate of 8.2 percent. The recent boom may have something to do with increased popularity of women in their 20s and 30s, even teens. Waiyee Yip of the BBC wrote: ““While the most popular procedures include those creating "double eyelids" and V-shaped jaw lines, new surgery fads come and go, with the latest being pointy elf ears, according to reports. Members of Gen Z — those born after 1996-are not shy about getting such procedures done despite the topic being seen as taboo in the past. One young woman, who works in fashion retail, told the BBC that her friends "openly talk about getting cosmetic procedures". “"Even if people don't advertise that they have gotten something done, they won't deny it if you ask them about it." [Source: Waiyee Yip, BBC, July 13, 2021]

Cosmetic surgery really started to take off in China in the late 2000s. About 3 million people in China had plastic surgery in 2009, according to an official estimate. At that time China ranked third in the world behind the United States and Brazil for the number of plastic surgeries performed, according to industry officials. But one expert in Shanghai told the Washington Post the 3 million figure "conservative." Li Qingfeng, a plastic surgeon who is also deputy secretary of the Chinese Association of Plastics and Aesthetics, said his hospital alone receives about 100,000 patients each year, and all of Shanghai could receive as many as 300,000 yearly. [Source: Keith B. Richburg, Washington Post, December 23, 2010]

Keith B. Richburg wrote in the Washington Post, “Plastic surgery was extremely rare in China before the country's economic reforms of the 1980s. Xu Shirong, a senior plastic surgeon at Beijing Hospital, said that until that point, people were allowed to have plastic surgery only to correct physical deformities.” "Doctors dared not to perform such operations on their patients because plastic surgery was considered a bourgeois way of life," Xu said. "Although I studied it, I only gave operations for harelip patients. After the opening and reform, the tide of pursuing beauty rose gradually."

Xu told the Washington Post he sees about 20 patients each day, about half of whom elect to have plastic surgery. Most are women in their 20s, he said, and the most popular procedures are eyelid slicing - to make Western-style double-lidded eyes - followed by nose jobs and tummy tucks. "I feel people have a higher standard of beauty right now," Xu said. "I tell many of my patients they score 98 already, and that's good enough, with no need to pursue a perfect 100. But most of my patients still choose to add those two missing points."

Reasons for Getting Cosmetic Surgery in China

In the 1990s, many women wanted features that made them look more Western: wide eyes, full lips, large breasts and long legs. These days many young women try to look like their favorite Hong Kong, Taiwan or Chinese movies stars or pop singers.

Many young women get plastic surgery for economic reasons. One woman told the China Daily, “I’m a salesgirl in a department store. The better I look the more I sell.” Another woman told the Los Angeles Times, “I’m not looking for a sugar daddy, but I hear good looks may boost your salary by 30 percent.”

As to the claim that Chinese are having the double slit operation to look more Western, one woman told the China Daily, “I am not trying to look like some American celebrity I am just trying to look like a better version of myself."

“To us doctors, altering beauty is a very natural thing,” a medical professor told the Los Angeles Times, “When you do sports, you alter your muscles. We do the same thing through surgery.”

People with Cosmetic Surgery in China

When the Beijing Plastic Surgery Hospital began offering cosmetic surgery in the early 1990s, nearly all the patients were actresses or entertainers. Now it estimates they make up a third of their clients. Bar hostess, concubines and mistresses make up one tenth. One fifth to one third are people hoping that an improved appearance will help them land a good job. One fifth seek fat reduction. About 90 percent are women and a third are people between 30 and 40.

Nationwide most of those having cosmetic surgery fell into two groups: women in their 20s hoping to give their careers a lift, and women in their 40s who want to look younger. Mothers sometimes bring their daughters in to have surgery to improve their chances of getting a good job or landing a good husband. Enhanced breasts have become a status symbol not just for the breasts themselves but also for the fact that one has the money to pay for the procedure.

The journalist Hao Lulu became a national celebrity after she had $50,000 of work done for free by a private hospital in exchange for a write up in her magazine. Dozens of changes were made in 16 operations. Her breasts were enlarged. Bags were removed from under her eyes and wrinkles were removed from her neck. Fat was cut out from her thighs, upper legs buttocks and cheeks. The bridge of her nose reshaped. Botox was applied to her skin. After all the work was done she landed a job on the popular Taiwanese drama Meteor Garden. Afterwards she was dubbed the “Artificial Beauty.”

Beijing hosted a Miss Plastic Surgery beauty contest in the mid 2000s. There were 30 contestants. The promoters for the contest, a group called Beijing Culture, got the idea for the contest after a woman who was initially accepted into the Miss Intercontinental Beauty Pageant was disqualified when it was discovered that she had undergone 11 cosmetic surgeries. The contest was like other beauty contests in that it had swimsuit, evening gown, talent and personality sections. Contestants had to show a certificate that they had their work done at a recognized cosmetic surgery hospital.

double eyelid

Visit to Plastic Surgery Hospital in Chengdu in the Late 2010s

Chengdu is regarded as a leading center of plastic surgery in China and Xichan hospital is the largest cosmetic-surgery provider in Sichuan Province. It was founded in 2005 by Zhang Yixiang, a Sichuan native who originally trained in public health but switched to cosmetic surgery when he realized how much money could be made doing it. “I had a doctor friend who told me that the surgeries cost a hundred yuan each but that clients were happy to pay two thousand or more,” he said. “I knew then it was going to be a growing market.” [Source: Jiayang Fan, The New Yorker, December 18, 2017]

Jiayang Fan wrote in The New Yorker: “Ninety-eight percent of Xichan’s patients are women, most of them between the ages of eighteen and thirty-five. Nose jobs and blepharoplasties (which create the double eyelid crease) are the most popular procedures. Zhang said that in the early days, most clients were seeking to hide a scar or a physical deformity; now, he said, “more often than not, it’s very attractive women who are chasing perfection.”

A woman in her early thirties named Xu Xueyi gave me a tour of the premises, which looked like a Versailles-themed Vegas hotel — eight floors of ornate rooms and gilded corridors, shops and spas. A profusion of synthetic flowers, marble, and sparkling chandeliers served to distract from the procedures taking place out of sight. You might be having your jawbone sawed down, in order to give your face a dainty oval shape, but, just across the hallway, you could treat yourself to a jade-inlaid gold necklace, get a perm or a manicure, or pick up some body-slimming lingerie. “We do everything here to make you happy and satisfied,” Xu said brightly, as she led me through a V.I.P. suite with a Jacuzzi. Bandaged women in striped robes passed by, guided by nurses who waved at Xu. The nurses were all notably good-looking, and Xu confided that she’d had several procedures. “I injected my chin with filler to make it pointier but didn’t like it, so I dissolved it two weeks later.”...“You should consider getting some work done, too”.

One of the hospital’s doctors, Li Jun, said she would give me a consultation, but I’d have to wait till the evening; although it was a Sunday, her schedule was packed. Our session lasted half an hour, during which the chalk pen she used to draw on my face was almost never at rest. By the end, my face resembled a military map in the late stages of a long battle. She began with structural problems. My jaw was too square, my cheekbones too broad, and my eyelids too droopy. My nose bowed outward — a “camel hump” — and I had a weak chin. After the half-dozen or so procedures that it would take to ameliorate these flaws, we could move on to smaller things, which could be dealt with by a combination of Botox (for my shrunken forehead, my jaw muscles, and the creeping crow’s-feet around my eyes) and filler (for my temples, the pouches under my eyes, my nasal folds, and my upper lip). The cost would be more than thirty thousand dollars. “There are still other things that could be done,” she said, as I stared at my chalked-up face in the mirror, but she was careful to manage expectations. It was clear that no amount of intervention could transform my face into that of a wang hong.

Plastic Surgery Patients in China in the Late 2010s

Jiayang Fan wrote in The New Yorker:“After the introduction of Meitu, a app which makes you look more beautiful, “a different kind of client has become more common” at Chinese plastic surgery facilities: “young, impressionable women who bring pictures of their idols to his office and ask to be given this or that feature. He smiled and shook his head. “Expectations are higher than ever, and it’s hard to get through to clients about the recovery period and the risk of unforeseen results,” he said. “To change the shape of a face requires cutting into the jawbone” — a procedure that Western doctors are reluctant to perform except in cases of medical need, because of a significant risk of fatal complications — “but on Meitu the transformation is instant and completely controllable.” [Source: Jiayang Fan, The New Yorker, December 18, 2017]

In the afternoon, I met a loyal customer of the hospital named Li Yan. She was thirty and had had more procedures than she could remember, starting in college: double-eyelid creation, eye-corner-opening, nose job, chin implant, lips injected to resemble “parted flower petals.” Almost every feature of her face had been done a few times, but she still felt as if she were a rough draft, in the process of revision. “I don’t think my nose bridge is quite high enough, and the tip doesn’t have the slight upturned arch I want,” she said.

“I asked Li, who works as an administrative assistant in a regional bank, how she managed to afford all the surgery. “It’s how I spend most of my money,” she told me, adding that, over the years, boyfriends had also chipped in. She said with satisfaction that no one who’d known her at school would recognize her now and that she’d destroyed every picture she could find of herself before the surgeries began. “The beauty of photos taken before the digital age is, if you destroy it, it’s gone for good.”

Li was devoted to Meitu, and used the apps to preview surgeries she was considering. Surgery and Meitu, she believed, “clarify each other.” Recently, she’d been approached by a wang hong recruiting agency about developing an online presence, but she worried that the livelihood would be too unstable, and, besides, she couldn’t really sing or dance or act. The recruiter had said that she wouldn’t need any skills, but she still wasn’t convinced. “I could never be as beautiful as a wang hong,” she told me, laughing.

One Chinese Women Has 170 Plastic Surgery Operations

Reporting from Shanghai, Keith B. Richburg wrote in the Washington Post,”Wang Baobao got her first taste of plastic surgery when she was 16. A nip and a tuck led to another nip and another tuck, another after that, and another, and another. There were the follow-up surgeries, and the repairs for the procedures that were botched the first time, and the second time, and the third time.”[Source: Keith B. Richburg, Washington Post, December 23, 2010]

“Wang, now 28, estimates that she has had 170 to 180 operations, usually six or seven at a time, and on “nearly every part of my body.” She had her eyes widened. She had her nose and jaw made narrower, and her chin shaped smaller. Her breasts were enhanced, but "I had to keep having operations to repair them." She had the fat taken out of her hips, thighs, stomach and backside. She even had implants put into the heels of her feet to try to make her taller; it didn't work.”

“It was the pursuit of perfection that led Wang Baobao down her never-ending path of surgeries. She was an aspiring dancer in China's hardscrabble northeastern Heilongjiang province when she decided to have work done on her eyes. "I wanted to make my eyes more beautiful," she recalled. "But the technology wasn't good enough. Their skills weren't good enough. I kept needing repair operations."

“Despite the bad experience, she decided to have her breasts enlarged. But the doctor used polyacrylamide hydrogel, which two years ago was banned for breast implants in China when it was found to cause infection and deformation. Eventually, she said, her friends and neighbors no longer recognized her. Her colleagues at a Shanghai stock brokerage firm laughed behind her back, so she quit and began freelance stock trading from home. Two years ago, her boyfriend became frightened and left.”

Wang runs a Web site about the promise, and perils, of plastic surgery. She told the Washington Post she regrets ever having that first operation. After spending more than $600,000, she said: "The effects are not that good. And all over my body, there are too many scars." She also offers advice for young people considering enhancing their appearance. "Don't get any plastic surgery," she said. "This is a no-end track. You can never turn back."

Medi-Sculpt Face-Altering

Medi-Sculpt is a face-altering procedure popular in China. According to the Medi-Sculpt Aesthetics and Anti-Aging Solutions website: Scientists from the Chinese Academy of Sciences have found that certain facial measurements, such as the distance between the mouth and nose, and the width of the mouth and nose tend to expand with age. This means that with age, even faces that were previously considered symmetrical tend to deviate from the golden ratio. In addition, with age, fat around the eyes, cheekbones, the inner jawline and sides of the face disappears allowing our face to lose volume, leaving patients with a hollowed, sunken appearance. [Source: Dr Anushka Reddy, Medi-Sculpt Aesthetics and Anti-Aging Solutions website.

“The above suggests that allowing aestheticians to restore your proportions closer to your youthful ideal improves your attractiveness and rejuvenates older features. At Medi-Sculpt we achieve this by using FDA approved dermal fillers and botulinum toxin such as Botox to enhance and rejuvenate facial proportions:

“If your face is long and narrow, Dr Reddy uses fillers to enhance the width of the cheekbones or if the lower face is too short, she can enhance the jawline and even extend and add symmetry to the chin using fillers. If the temple area is sunken, Dr Reddy used dermal fillers to restore the volume and add proportion to the eye area. If a too-high forehead is an issue, she can inject botulinum toxin such as Botox to raise the eyebrows. A non-surgical lip augmentation can reduce your lower facial height.

Male Cosmetic Surgery

In the 2000s, a large number of men were getting breast implants to make them look like they have big muscles. The procedure is similar to the one for women except the implants are different shaped and harder. Small cuts are made under the armpits; silicone gel implants are inserted; and stitches are removed after about a week. The cost of the procedure is around $1,200 at Shanghai No. 9 People’s Hospital. Most of those who have had the operation said they had it because they thought a more “brawny” chest would help attract a partner or impress a client or boss. A doctors who performs the male implant surgery told the Times of London, “To be frank, the surgery is unnecessary. Physical exercise can create the same effect and it is safer. These people actually have psychological problems and attribute the unhappiness in their lives to their weak muscles. The surgery in some instances serves as psychological therapy.” A Nanjing man showed up at a hospital and asked to have plastic surgery done on his ears so he could look like an alien. One clinic has a special album called “Deep Emotion” that shows before and after shots of male breast jobs.

Jiayang Fan wrote: I asked if a lot of men use makeup. “Increasingly, yes,” Abner answered. “But of course not everyone does as elaborate a job as me. My situation is a bit special because of all my plastic surgery.” He’d begun reshaping his face when he was fifteen, having become fascinated by the way he could change his face with Meitu’s apps. “They opened up this world where I could literally invent what I looked like,” he said.

“Over the years, using money earned from a part-time job, he had steadily raised the bridge of his nose. He’d undergone double-eyelid surgery, and then he had the outer corners of his eyes extended — a procedure known as lateral canthoplasty. Abner told me that he would have done the inner corners, too, but his doctor had told him he had no extra skin there to cut. In all, he’d had half a dozen procedures on his eyes, and, just a week before the conference, had completed a third remodelling of his nose. “The stitches aren’t even out, and I’m not supposed to travel,” he said, showing me bruising between his nostrils. “But I don’t care. I’m here to meet fellow wang hong, take group selfies, and grow my fan numbers.”

Cosmetic Surgery TV Shows and Social Media in China

jaw work, before

Social media is now widely used to connect people interested in cosmetic surgery. Waiyee Yip of the BBC wrote: “Gengmei, which means "more beautiful" in Chinese, is one of several social networking platforms in China dedicated to cosmetic surgery, where users leave status updates about all things plastic surgery, including liposuction and nose jobs. Since its launch in 2013, Gengmei's users have surged from 1 million to 36 million. More than half are young women in their twenties. “Similarly, cosmetic surgery platform So-Young has seen its monthly active users grow, from1.4 million in 2018 to 8.4 million in 2021. [Source: Waiyee Yip, BBC, July 13, 2021]

Laurie Burkett wrote in the Wall Street Journal’s China Real Time, Selfies are paving the way for a plastic surgery boom in China. According to a new report from HSBC, China’s social media and selfie obsessions are creating a new Chinese vanity craze and a market for cosmetic surgery, with sales to Chinese consumers poised to double to 800 billion yuan ($122 billion) by 2019, up from 400 billion yuan in 2014. The smartphone market is fueling the industry’s growth, HSBC said. In recent years, Chinese consumers have latched onto smartphone apps — like Meiren Xiangji or BeautyPlus — that offer virtual plastic surgery features, such as enhancing photos by plumping cheeks, widening eyes or slimming jawbones. Those have been the gateways to other apps, such as GengMei, that match users to a market of plastic surgeons who can help their doctored pictures come to life. [Source: Laurie Burkett, China Real Time, Wall Street Journal, April 5, 2016]

"Lovely Cinderella" was a Chinese version of Fox TV’s "The Swan". Produced in Hunan Province, it showed patient enduring extreme makeovers. Some of the footage was quite graphic: showing fat being sucked out, scalpels carving up a face and the face swollen during the post-operation recovery. In one episode a women is shown moaning to her husband for more anesthesia while on the operating table and throwing up in her hospital room because she misses her five-year-old son. [Source: AP]

In July 2006, China imposed on ban on television and radio advertising for products that promised breast enhancement, weight loss or increased height. The Beijing news service reported: “Recently some medical organizations have exaggerated the results of treatment provided using experts and previous patients on television commercials to mislead others."

Emulating Lei Feng Through Cosmetic Surgery

Austin Ramzy of the New York Times wrote: “For the poor, the homeless, people down on their luck in the central province of Anhui, Zhang Yidong has often been there to help. He has made a career of raising money and public interest to help the downtrodden. He has also made something of a name for himself in the process, so much so that Chinese media outlets call him a “public welfare celebrity.” He is often compared to Lei Feng, the young People’s Liberation Army soldier trumpeted as a Communist Party icon for his unstinting devotion to his comrades. [Source: Austin Ramzy, Sinosphere Blog, New York Times, February 21, 2014 |=|]

“Mr. Zhang says he considers Lei Feng, the so-called rustless screw of Mao’s revolution, to be a role model. And now he has taken his emulation to the next step. This week he began a series of cosmetic procedures as part of an effort to look like Lei Feng. “No matter how open or developed China becomes, we can’t forget the Lei Feng spirit,” Mr. Zhang said in an interview. “Through this activity I want to tell even more people that to study Lei Feng, we can’t just engage in slogans.” |=|

“Mr. Zhang says that by changing his appearance he hopes to raise public awareness of Lei Feng, whose fame saw a mild resurgence two years ago thanks to a vigorous propaganda push tied to the 50th anniversary of his death. Lei Feng, who died at the age of 22 in 1962 when he was hit by a falling telephone pole, is known in China as a symbol of selflessness and devotion to the cause of communism. He sewed quilts and darned socks for his fellow soldiers, assiduously studied Mao’s writings at night by flashlight and collected weighty loads of cow dung for fertilizer. Those exploits and most of his biography itself have come under close scrutiny in recent years by scholars and average Chinese alike who point to the suspect signs of propaganda: well-lit photos of a supposedly average soldier, a detailed diary full of expressions of loyalty and an all-too-well-honed image. |=|

“Like Lei Feng, Mr. Zhang has at times found his record under question. Last year he participated in an event with Chen Guangbiao, a recycling tycoon and philanthropist known for brazen acts of self-publicity. Mr. Chen wanted to award 800,000 renminbi, about $130,000, to Mr. Zhang to help carry out his charitable work. Mr. Zhang declined, and online many people suggested the exchange was merely a ruse to help boost both men’s profiles. Mr. Zhang says he welcomes the scrutiny, and argues that serving the public interest requires a certain amount of bombast. “I think criticism is good,” he said. “It shows people are paying attention.” |=|

“Mr. Zhang’s makeover, which is being provided free of cost by a hospital in the city of Hefei, began with a series of injections of the dermal filler Restylane. The goal of the process is one that many who visit a plastic surgeon can identify with. “It involves some skin rejuvenation and microsurgery to help my face look like Lei Feng’s,” said Mr. Zhang, who at 32 is 10 years older than his hero at the time of his death. “Lei Feng, he was very young.” |=|

Height Surgery in China

butt work, before

To increase their height some Chinese undergo painful leg extension surgery that can increase their height by nine centimeters but leave them unable to walk for more than six months and cause them to endure a great amount of pain while the procedure is being done. Most of those paying the $6,000 to $10,000 to have the procedure are women.

Using a technique called the Ilizard procedure — named after its inventor, a Russian doctor, who developed the tecnique to help people suffering from dwarfism and uneven limbs — a person’s shinbones are cut in two and attached to a an erector-set-like metal brace with metal pins. The bones are pulled apart about one millimeter everyday with knobs attached to the metal pins, allowing new bone to grow in a gap, thereby lengthening the bone and making a person taller.

The procedure is risky. There have been a number cases of deformities and infections. If the bones are separated too quickly the bone will become too weak and will not be able to bear a person’s weight. It also possible for the limbs to grow to different lengths and the shins to warp, deforming knee and ankle joints. Nerve damage is also common. Some people end up permanently crippled. In November 2006, the Health Ministry banned the procedure except for medical reasons.

Some people have had implants put into their heels to make them taller. Five-foot-five Wang Baobao, the 28-year-old woman who had 170 plastic surgery operations, told the Washington Post that her doctor promised she would be a few extra inches taller after such a procedure and she would recover in a week. She paid about $7,500 and was left on crutches for nearly six months with large scars on her feet. And she didn't get any taller. [Source: Keith B. Richburg, Washington Post, December 23, 2010]

Another patient, Fung Jian, 28, had heel implant surgery after learning about it on Wang's blog. At 4 feet 9 inches, Fung said he had always felt "tortured" by his height. And like Wang, he too paid for the surgery but did not get noticeably taller. Wang and Fung have hired a lawyer and, with a third patient, are trying to take legal action against the doctor. The doctor, when contacted, said that he never makes absolute promises to his patients and that, on average, they get "a little bit taller."

Problems with Chinese Plastic Surgery


There are a number of fly-by-night operators, known as “firemen,” that offer cheap cosmetic surgery but are known for doing shoddy work and often operate illegally out of beauty salons. Nearly a quarter million people have complained to authorities about botched surgery, most of it done by unlicensed or poorly trained firemen.

According to a Global Times report, the country had more than 60,000 unlicensed plastic surgery clinics in 2019. Keith B. Richburg wrote in the Washington Post that many feel China's new and growing obsession with plastic surgery has gone badly awry, as more and more unlicensed, unskilled and unscrupulous practitioners jump into an increasingly lucrative, yet largely unregulated industry. While government-run hospitals adhere to stricter standards with more experienced doctors, the same can't be said of these "black hospitals" and other private facilities, several experts said. "Those private ones make operations secretly, some of the surgeons lack ethics and their only aim is making money," said Zhou Xiaolin, retired chief surgeon of Beijing's Plastic Surgery Hospital. [Source: Keith B. Richburg, Washington Post, December 23, 2010]

In June 2021, China's National Health Commission announced a campaign targeting unlicensed cosmetic surgery providers, including investigating customer complaints more swiftly. "Most of the people don't have surgery at officially regulated hospitals," with many patients going to beauty salons or other unregulated facilities - "and the number is huge," Li told the Washington Post. The problems were highlighted in November 2010 when a promising 24-year-old singer, Wang Bei, died in an operating room in China's central Hubei province while having a facelift.

Botched Cosmetic Surgery in China

According to the Global Times report, unlicensed clinics are responsible for around 40,000 "medical accidents" every year, an average of 110 botched operations per day, the report added. Waiyee Yip of the BBC wrote: “In one of the most high-profile cases, actress Gao Liu shared images online of a cosmetic procedure that left her with necrosis of the nose, meaning the tissue at its tip has died. She said that she will need more surgery to fix it, but the complication has already cost her more than $62,000 in film deals. Meanwhile, her attending physician was suspended for six months, and the hospital fined $7,650. Many internet users said the penalty didn't go far enough. "This is the punishment for crippling someone?" one user wrote as she demanded better regulation of the industry. [Source:Waiyee Yip, BBC, July 13, 2021]

One woman who had a number of procedure to correct a botched operation to get rid of her sagging eyelids told the China Daily, “The first time I had it done at a private home by a local practitioner. One eye ended up bigger than the other. The second time I had it done at a salon. The stitches got infected. This time I went to the hospital and it looks good.”

The China Daily reported that there have been more than 200,000 botched operations between 1993 and 2003 and described the double list operation as the “most popular — and the most dangerous — cosmetic procedure.” Poorly-done eyelid surgery can result in nerve damage, punctures in the eyelid or even blindness.

Plastic surgery has also produced some unique ruling in courts of law. One man divorced his wife and received a $120,000 settlement for “lost opportunities” after his wife gave birth to an “amazingly ugly” baby and it was revealed the wife had hidden her own ugliness with cosmetic surgery.

Botched Breast Implants in China


On average about 20,000 complaints on botched operations are filed annually in China. In April 2006, the government banned a breast-enlarging liquid called Ao Mei Ding — or Amazing Gel — that was injected into 300,000 women over a nine year period and caused some severe problems, including severe pain and breast removal.

One victim interviewed by the Times of London paid $1,062 for the injection of 300 ml of Amazing Gel at a Beijing beauty salon in 2003. The gel formed hard lumps in her breasts that caused infection and migrated around her body . In 2005 she paid doctors at Beijing Union Hospital $1,305 to remove the lumps. “The gel had solidified and stuck to my breasts.” she said. “The doctor had to scrape it out with a spoon. It was white when it was injected and blue-black when they took it out." Doctors told the woman they would never be able to get all of the hardened gel and recommended a body scan to find the thickest concentrations.

Amazing Gel has also been used on face lifts, penis enlargements and operations to narrow the vagina. It originally was imported from Ukraine but when Ukraine suppliers discovered how the gel was being used they halted shipment in the late 1990s. Chinese marketers of Amazing Gel developed their own formula, which was approved after only seven months by officials at the State Food and Drug Supervision Administration, rather than the usual two years, and was done without animal experiments.

Many wonder how Ao Mei Ding — made with a chemical call acrylamide hydrogel — could have been approved to begin with and how people who were not even doctors were allowed to inject it. There are allegations that officials at the State Food and Drug Supervision Administration took bribes.

One Dead, Three Hospitalized after Receiving Hong Kong Cancer "Beauty" Treatment

In October 2012, CBS News reported: “One Hong Kong woman is dead and three more have been hospitalized after they received a "beauty" treatment that is usually reserved for cancer patients. A 60-year-old remains in critical condition, a 56-year-old woman is in serious condition, and a 59-year-old woman is stable, CNN reports. CNN reported that it has not been confirmed whether the deceased 46-year-old woman or any of the victims had been diagnosed with cancer, but the Hong Kong Health Department said in a previous statement that they had been in "good past health." [Source: Michelle Castillo, CBS News, October 10, 2012]

The four women had underwent a DC-CIK intravenous treatment, which was billed as a "platelet rich plasma," at a DR Medical Beauty Group location on Wednesday, China Daily reported. They were taken to the hospital after complaining of deep headaches and diarrhea. It was later determined that they were diagnosed with septic shock, a life-threatening blood infection that causes extremely low blood pressure according to the National Institutes of Health. Their blood samples contained the bacterium Mycobacterium abscessus. While it is normally found in water, soil and dust, the Centers for Disease Control and Prevention report it often contaminates medications and medical products and can cause serious infections.

DC-CIK (cytokine-induced killer cells) is a form of plasma therapy used in metastatic cancer, the Independent reported. The blood transfusion, which the women each paid about $6,450 for, is known to help improve the survival rate of cancer patients after chemotherapy, radiation or surgery. However, the clinic billed the procedure as a way to get rid of wrinkles and revitalize the skin. The company claimed that "growth factors" could be released from the platelets through a laboratory procedure. Patients who underwent the therapy had their blood removed, treated and reinjected into them. "This treatment involves concentration and processing of blood taken from the person, which is subsequently infused back to the patient. According to investigation, the treatment was provided by a registered medical practitioner," a spokesperson for the Hong Kong Health Department said to China Daily.

The DR Group confirmed in a statement to China Daily that the treatment was conducted by certified doctors at an independent clinic affiliated with their organization, and that the women's medical history was checked before they had their blood transfused. They insisted that their version was a beauty treatment, not a medical procedure. Thirty-one out of the 45 patients who underwent the procedure at a DR Group location have been notified. Authorities are urging people who may have undergone something similar to see a doctor if they experience symptoms.

The DR Group also offers a stem cell treatment created from a person's fat tissues that is also injected back into the host. Dermatologist Chung King-lueh told China Daily that these procedures should only be done in a hospital. "No one would do it in a clinic because we know it risks blood contamination by bacteria," Chung said.

Hong Kong's Health Minister, Dr. Ko Wing-man, told the Independent that harsher regulations may need to be put in place. As of now, the Hong Kong's Health Ministry does not have the authority to regulate beauty salons. "I do not rule out the possibility of the need for legislation, or an amendment to the current law to pin down those high-risk medical therapies," he stated. The Regional Crime Unit of Hong Kong Island and the Hong Kong Health Department are investigating both the treatment centers and a laboratory in Tai Po which was supposed to have prepped the patient's blood for the procedure, China Daily reported.

Most Plastic Surgery Tourists in Korea are Chinese

In 2018, seven out of every 10 foreigners who went to South Korea for cosmetic surgery came from China, according to a Chinese newspaper report. Almost a half of all foreigners seeking a nose job, a facelift, a jawbone reduction or a tummy tuck in 2011 were from China. Their number nearly tripled from 1,657 in 2009 to 4,400 in 2010. [Source: AFP, South China Morning Post]

According to the Korea Health Industry Development Institute 118,310 patients from China visited South Korean in 2018, accounting for 31 per cent of all foreign patients who visited the country that year. Of those patients, 21.4 per cent had travelled to South Korea for plastic surgery while 17.8 per cent were for skin treatment. The number of Chinese plastic surgery patients who visited South Korea reached 27,852 in 2018, a 30 per cent jump from 21,477 in 2017. In 2014, as many as 56,000 Chinese tourists visited South Korea for cosmetic surgery. [Source: Park Chan-kyong, South China Morning Post, January 31, 2020]

Image Sources: Xorsyst blog, China Cosmetic surgery

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated October 2021

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