Written by Julie Zaugg, CNN
Contributors Stella Ko, CNN, Natalie Leung, CNN
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Wu Xiaochen said she was 14 when she had her first cosmetic procedure -- liposuction paid for by her mother to reduce fat from her thighs.
At the time, she said she had been diagnosed with an autoimmune disease that required her to take glucocorticoids, a class of steroid hormones.
"I had put on a lot of weight and felt very uncomfortable in my skin," said Wu, now a 30-year-old model and entrepreneur based in Beijing. "I felt so much more confident afterwards."
In the 16 years since that first procedure, Wu claims to have had over 100 surgeries, costing a staggering 4 million yuan (about $574,000).
She is now a well-known advocate of the industry and has opened two beauty clinics offering cosmetic surgery in Beijing.
Wu's potential market is huge.
Wu Xiaochen on the operating table.
Credit: Wu Xiaochen
A growing number of Chinese women are using cosmetic surgery to achieve bigger eyes, high cheekbones, narrow noses and skinny legs. Like Wu, many are seeking to emulate a beauty ideal inspired by elements of Japan's manga comics, South Korea's K-Pop and Western culture.
In 2014, more than 7 million Chinese people had plastic surgery, according to the China Association of Plastics and Aesthetics. Just three years later, data compiled by Shanghai branch of Frost & Sullivan consultants suggested the figure was closer to 16.3 million.
According to experts interviewed by CNN, the surge in plastic surgery in China is in part due to a series of apps like So-Young and GengMei, which allow potential patients to view before and after photos, book surgeries and even apply for credit to pay for them.
"In China, it is very difficult to find reliable information on clinics, especially in smaller cities," explained Tony DeGennaro, co-founder of Dragon Social, a Chinese market intelligence agency. "People no longer trust the search results returned by (search engine) Baidu, following several medical scandals involving the platform, so these new apps have taken over as unofficial directories of surgeons."
'Not pretty enough'
Wu grew up in a middle-class family in Shenyang, a large industrial city in China's northeast. As a teen, she studied art and dreamed of becoming famous. An actress, or maybe a model.
But she thought she wasn't pretty enough and felt insecure about her "small eyes and round face." So after her first successful procedure she said she soon chose to have a facial liposuction -- to make her face look thinner by having some fat removed -- and then facial contouring surgery, to give it a more angular look by having silicone implants put into her cheekbones.
At 16, she said she had her nose bridge elevated, to make it appear taller and longer. This was followed by surgeries to give her jawline more of a V-shape, breast implants and a double eyelid procedure to add creases to her eyelids and make her eyes look larger. "Every two or three years, I have a few more procedures done," she said. "Surgery has become like an addiction for me."
Wu Xiaochen, seen here as a child, a teenager and an adult, has progressively transformed her face and body, having over 100 surgeries in the space of 15 years.
Credit: Wu Xiaochen
Many of the Chinese women having cosmetic surgery are young and living in the country's second and third tier cities, according to a white paper published in 2019 by So-Young, based on analysis of its own data and visits to clinics.
More than half are under the age of 26, the white paper said. To put that into perspective, cosmetic surgery patients under 30 years old make up a mere 6% of the total in the US.
A woman pictured inside Huamei Medical Cosmetology Hospital in Shanghai.
Credit: Chandan Khanna/AFP/Getty Images
For members of China's Generation Z, having cosmetic surgery is a way to stand out in an increasingly crowded dating scene and job market. "China remains a very patriarchal society," said Brenda Alegre, a gender studies lecturer at Hong Kong University who has researched the cosmetic surgery trend. "Being pretty is a way to ensure you will be successful at work and you will find a husband."
The spread of internet culture, with attractive livestreaming hosts and photo apps like Meitu, which allow their users to enhance their selfies by removing imperfections, has also made plastic surgery more desirable. "People seek to replicate in real life the effects they are getting with these apps," said Dr. Stephanie Lam, a plastic surgeon in Hong Kong.
Plastic surgery apps
Apps that match patients to surgeons and clinics are incredibly popular in China.
The largest one, GengMei, has 36 million users and lists almost 20,000 surgeons on its platform, a company spokeswoman confirmed. Tencent backed So-Young has 2.47 million monthly active users and nearly 6,000 surgeons listed, according to a So-Young spokesperson.
These apps provide testimonies of cosmetic surgery patients, with before and after pictures, as well as reviews of
GengMei has an augmented reality feature that can analyze a face and give it a grade out of 100 based on criteria like its liveliness, attractiveness and symmetry. It then makes suggestions for cosmetic surgery improvements, such as having one's eyelids redone or getting fillers.
"Through the GengMei app, we can access all medical information about beauty without even leaving the house," said Wu.
"This is a reflection of our society's development and it's a microcosm of our lifestyle change."
The app even gives users access to micro-loans through Alipay's lending service Huabei to pay for the surgery.
Leaflets in Sanatorium Hospital's Plastic & Reconstructive Surgery Centre show the range of procedures which can be had.
Credit: Julie Zaugg
During the summer holidays, a period when many young women undergo plastic surgeries to give themselves a new look before the school year starts, some clinics offer discounts and special packages, said Alegre, the Hong Kong University lecturer. "Girls will have surgery in groups, to benefit from offers like three procedures for the price of two."
In these clinics, double eyelid surgery can cost as little as 1,000 yuan ($142), according to DeGennaro, from Dragon Social.
Wealthier patients opt to go to clinics in South Korea, Thailand or Hong Kong to have procedures done, said Lam. "They believe the doctors are more trustworthy abroad," she added.
One such clinic is high up in One Pacific Place, an office block built above a luxury mall in central Hong Kong. Decked out with beige sofas, avant-garde art and huge windows offering sprawling views onto the harbor, it looks more like a high-end spa than a clinic. But it is an outpost of Hong Kong Sanitorium & Hospital, one of the city's private medical facilities.
"We get many patients from mainland China," said Dr. Gordon Ma, who heads the hospital's Plastic & Reconstructive Surgery Centre. Among the younger ones, double eyelid surgery is the most popular procedure, he said.
"Some of these customers want to go as far as possible," he added. "They don't just want to enhance their natural beauty, they want to alter their appearance in a noticeable and obvious manner."
Gordon Ma heads the Sanatorium Hospital's Plastic & Reconstructive Surgery Centre, a clinic nestled above a luxury mall in Hong Kong. He gets many patients from mainland China.
Credit: Julie Zaugg
Finding a new look
With her big eyes, long straight nose and pouty mouth, Wu looks nothing like the shy teen seen in old family photos.
"For a long time, I was trying to copy Angelababy's face," she said, referring to a famous Chinese actress and model. "But I progressively moved away from this template and began to develop my own look, by mixing and matching features that suit my personality and face."
A photo of Wu Xiaochen just after one of her multiple nose surgeries.
Credit: Wu Xiaochen
Now when she looks at herself in the mirror, she says she sees "a better version of herself."
The faces of Angelababy and Chinese actress Fan Bingbing have traditionally been used as references for young cosmetic surgery devotees.
Wu said it's because they embody the "three courts and five eyes" rule, which denotes that perfectly proportioned faces have a width of five eyes, and a length of three equal "courts": from the forehead to the brow, from brow to the nose tip, then nose tip to chin.
To get the look, some women may need surgery. Others turn to cheap and easy to reverse hyaluronic acid fillers.
"They can be used to plump up cheekbones, make a chin pointier or even heighten a nose, a procedure known as a liquid nose job," said Lam, the plastic surgeon.
Some women take it further and undergo major operations, such as using some of their rib or hip bones to make their noses sharper and longer, according to Lam.
Several popular looks (from left to right): Chinese actress Angelababy, the "M shaped" lip of Korean actress Yoon Eun-hye, Korean actress Ku Hye-sun's "baby face," Chinese model Liu Wen's single eyelids.
Credit: Getty Images
But some Chinese cosmetic surgery patients have started to move away from these celebrity beauty ideals. "They seek out more individualistic looks, for example a face with elf-like features or even a world-weary face with a lived-in quality to it," said DeGennaro.
Many of these new trends are apparent on GengMei. Among the most popular looks discussed on the app is an M-shaped lip, meaning a lower lip with a dimple in the middle.
One user said she decided to have hyaluronic acid injected into her lips to copy "the M-shaped mouths" of South Korean stars Yoon Eun-hye and Lee Sung-kyung.
Another sought-after look is described as a "baby face." It involves a full, round face with a smooth contour, a short chin, a prominent forehead, big eyes and a small button nose, according to descriptions posted on the app. Facial fillers, as well as eye and nose surgeries, are recommended to obtain the look.
Another popular topic on GengMei is how to make single eyelids more attractive, instead of resorting to double eyelid surgery. This can be achieved by elongating the upper eyelid and making sure they're not saggy or excessively thick, writes one user, referencing the single eyelids of Chinese model Liu Wen and Taiwanese star Jacklyn Wu Chien-lien. Some skin is removed from the inner and outer part of the eyelid, a procedure called canthoplasty.
But not all surgeries are successful.
Chinese media regularly reports of cases of surgery patients who have suffered adverse effects or even died on the operating table. Cases of medical malpractice often occur in small unlicensed clinics lacking the required permits to carry out surgery.
"Some of these clinics use substandard fillers and anti-aging injectables with contaminants or fewer active parts than they should have," said Lam. She recalled a spate of cases in 2016 where Hong Kong patients went to China to have anti-aging injections and came back with botulism -- an illness caused by the botulinum toxin -- and ended up in intensive care with breathing difficulties.
Ma of the Hong Kong Sanitorium & Hospital regularly sees patients needing corrective surgery after going under the knife overseas, including in China. "They will for example come in with an eye that can no longer close properly because of a botched double eyelid surgery," he said.
Beijing has started to crack down on unlicensed and unqualified clinics.
China's National Health Commission identified 2,772 cases of illegal plastic surgery, during a year-long operation that started in May 2017. This led to more than 1,200 criminal prosecutions, according to a government release. The commission is considering establishing a blacklist of dangerous surgeons, it said.
Wu Xiaochen credits her physical transformation with her ability to become a model for international brands.
Credit: Wu Xiaochen
Wu has also had several bad experiences. "One clinic in Beijing used an L-shaped mold to reshape my nose, but my skin was so stretched after the procedure that I could see light through it," she said. She said she had to have corrective surgery afterward.
Despite the risks, China is quickly catching up to the United States in terms of the total number of cosmetic procedures performed.
By 2023, total revenue is expected to exceed 360 billion yuan ($52 million), according to So-Young's prospectus, which cites numbers from consultants Frost & Sullivan.
For Wu, the evidence of the industry's growth is all around her.
"Ten years ago it was difficult to find a person who had done plastic surgery but nowadays it's hard to find someone who hasn't done it," she said.
Aedit App Lets You Try On Cosmetic Procedures like Rhinoplasty and Botox — Review, Photos | Allure.
Plastic surgery is no longer seen as taboo in Chinese culture. Rather than being limited to reconstructive procedures to restore the appearance of patients with disfiguring injuries, many Chinese people now embrace the aesthetic benefits of elective cosmetic plastic surgery.
Sometimes called the “Cosmetic Surgery Capital of the World,” South Korea currently performs 24% of all cosmetic surgeries . South Korea's ethno-historical context, societal pressures, economic opportunities, and cultural beliefs have all contributed to the popularity and growth in this field.
South Korea: The plastic surgery capital of the world.
Fortunately, it is possible to visualize your results with the help of a board-certified plastic surgeon. Plastic surgeons have advanced training in facial anatomy and specialize in accentuating each person's unique features through meticulously performed procedures.
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Market distribution of facial reconstruction procedures in China as of July 2019, by type.
The modern pursuit of beauty is unprecedented in China – about 1.05 million people underwent plastic surgeries in 2020, and a majority of them were females under 30 years old.
Skin and beauty expert Nurse Jamie and plastic surgeon Dr. Sheila Nazarian use the latest procedures to bring out their clients' best selves. Watch all you want.
Switzerland has for many years been known to be a country that provides world-class cosmetic surgery. It also boasts of having some of the best plastic surgeons in the world.
While some discomfort is likely to be felt following plastic surgery, it should be very manageable and any pain is likely to fade very quickly during the recovery process. The level of pain is also subjective, as there are a variety of different factors that can influence the amount of discomfort post-surgery.
V-line is a specialized cosmetic procedure that combines chin surgery to achieve a slimmer chin, and jaw surgery to create a more feminine jawline. It's commonly requested by women of Asian descent who wish to soften the lower portion of their face to achieve a more beautiful and balanced overall look.
For plastic surgery overseas, Brazil, Thailand and Malaysia take the top spots. To ensure you'll receive the safest care when getting plastic surgery overseas, stick with the countries that have been ranked as the best for their hospitals and facilities, as well as their medical professionals.
RealSelf checked into the density of plastic surgeons and found the number one city to be… Miami, Florida with 3.90 plastic surgeons for every 100,000 residents. Who knew?
40-54 year olds make up the majority of cosmetic procedures, 49% of the total in the world.
Plastic surgeons learn how to take quality clinical photographs in medical school. The main purpose of the photos is for the surgeons to assess their own work. In medical school, surgeons also receive training on how to counsel nervous patients.
“When an area of the face is frozen with absolutely no wrinkles, you can assume the person has had a date with a needle.” "When you look at a photo and see an area of the face that is extremely smooth and shiny," Rusher says, "that can be an indicator that the person may have had Botox."
The shape of your nose is primarily determined by your bone and cartilage and can't be changed without surgery. If you're unhappy with your nose, the cheapest and easiest option is to use makeup to contour it.
Only Rhinoplasty Can Change a Nose's Shape. You can't alter your nose's shape by merely pressing on it or pinching or pushing it.
Apply 2 drops of olive oil on your nose. Using the tip of your finger, massage in a circular motion. Start from the area around the bridge and move towards the sides of your nose. Do this daily for 3-5 minutes to get the desired results.
The Mentor® Breast Implant Simulator is a tool designed to help you visualizing your desired outcome which can be discussed with your surgeon. Simply upload (or capture) your own body photo and use the Mentor® Breast Simulator to manipulate your breast image to your desired look.
If you're considering a nose job or rhinoplasty, then you may find it beneficial to upload your photo to a nose job simulation program such as FaceTouchUp. With this tool, you can reshape parts of your nose to experiment and see what your ideal nose may look like.
Either upload your picture to the tool on the Botox cosmetic website or using the free iPad app, then watch the wrinkles disappear. The end result is definitely interesting giving you a digital picture of what you look like after a Botox treatment. Try out the Botox Cosmetic iVisaulizer Tool at botoxcosmetic.com.
Typically, there will be some loose skin (the larger the implant, the more stretched, loose skin), loss of fullness in the upper part of the breast, and usually, some sagging where the remaining breast tissue sits too low on the chest.
Popular implant size – The most popular size for breast implants is between 350 to 400 cc. For most patients, this would look like a small to a large C cup. In fact, all of the top 5 most popular sizes are between 350 to 500 cc.
How to Make Breast Implant Rice Sizers - Colorado Plastic ... - YouTube
Is rhinoplasty painful? Not for most people. One day after surgery, most people rate their pain between 0 and 4 out of 10.
YouCam Makeup is the best nose shape editing app you can find, and it's free to download and use. You can find it in the Apple Store or Google Play. The app gives you hyper-realistic and natural-looking edits, so no one will know you made any changes to your face.
According to research, a button nose is considered to be the female perfect nose. This type of nose is lifted at the tip of the nose and has a smaller nasal bridge. A button nose is a type of nose that is small and round, similar to the shape of a button.
“Pillow face” is a direct play on the puffy, unattractive result of using too much facial filler or transferred fat. Another term often used to describe this overfilled look is “chipmunky.”
"Your skin is going to look smoother, but you're going to look like yourself, just more refreshed," says Dr. Rabach. In my experience, I simply looked more awake, and my skin looked much smoother all over.
The botox filter on Instagram, which is also referred to as 'Pillow Face,' 'Platic surgery,' or 'lip filler' filter, became popular after several celebrities started using it.
Many patients suggest that the Brazilian butt lift is the most painful surgery. This is followed by the tummy tuck, breast implants, liposuction, breast lifts and reductions, and jaw surgery. Dental implants can also cause much pain, as you still need to eat in the healing process.
Pain. There is usually very little actual pain following a facelift, but you may experience a deep bruised sensation as a result of the swelling, and your face may seem heavy. The bandage you will wear the first night may seem quite snug under your chin.
Patients should also abstain from drinking alcohol about 72 hours before the day of their surgery, as it can affect your immune system. Of course, do not take aspirin or aspirin products for 2 weeks before your procedure, as these medications can thin the blood and heighten your risk for excessive bleeding.