When an 8-year-old asks for a face-lift

If you think plastic surgery is the preserve of the middle-aged and older pampered rich keen on having a few wrinkles ironed out or sagging skin tightened, think again.

The notion that you can change the course of your future by changing the way your face looks is attracting more and more young people, and even middle school students. Especially in job-hunting season, some graduates regard micro plastic surgery as a great investment that will make them more competitive.

Just how popular cosmetic surgery has become among young people was illustrated last year in a China Central Television program, First Time, which told of all 32 students in a high school class in Chengdu, Sichuan province, having undergone cosmetic surgery.

"All the girls had double eyelids cut, as did several boys," said Xiao Zeng, a member of the class, and a second-year student at the high school.

"Now there are only seven or eight single eyelids left in the class."

In the summer just gone, Xiao said he had "fulfilled his wish" by joining the ranks of those with cut eyelids.

In fact, during the summer holidays, double eyelid surgery become very popular among students. The top five cosmetic surgery procedures performed in China last year included breast implants, liposuction, eyelid lifts, nose jobs and stomach tucks, the International Society of Aesthetic Plastic Surgery says.

The medical cosmetology department of Huai'an First People's Hospital in Jiangsu province said recently that after the college entrance examination in July, high school students flocked to it for double-eyelid surgery. The chief physician, Wan Neng, said that since the summer holiday in July there have been three or four times more consultations than usual.

Wang Chuanying, director of the beauty department of Huai'an Maternity and Child Health Care Hospital, says: "In consultations for plastic surgery this year there has been a trend toward younger people. Middle school graduates account for a certain proportion. Many children have surgery at the suggestion of their parents. The youngest person who has consulted us was 8."

In August, a mother in Jiangsu took her 15-year-old daughter who just graduated from middle school for plastic surgery, on the grounds that "she wants her daughter to learn art in high school, and hopes that she will be more beautiful and enjoys the smooth road afterward".

Wang suggests plastic surgery should be performed when someone is aged 16 to 18, by which time bones have properly developed.

Be that as it may, the internet is replete with news stories that tell of children as young as 10 or 11 having cosmetic surgery, and a video that did the rounds of the internet a few years ago purported to show a 7-year-old girl cutting her own eyelids.

In fact so inured have the media and, seemingly, the public, become to young people having such surgery that these days only a child of elementary school age would make the cut as a story in most Chinese news outlets.

"In all fairness, everyone's in search of beauty," says Jiang Wenxiu of the Department of Psychiatry at Zhongda Hospital of Southeast University in Jiangsu.

"Unless their personal tastes are extremely unusual, most people still like handsome men and beautiful women. A good appearance can bring pride and glory to many good-looking people but upset those who are not so good looking.

"In social space, working environments or even in the media, the advantages in being physically attractive are obvious. As a kind of image capital, appearance is an objective fact. This is also the motivation for many people who feel that their looks are not perfect and madly want to change themselves."

A medical beauty industry white paper by iResearch Global said there are nearly 20 million medical beauty consumers in China. Among every 100 medical beauty consumers, there are 64 post-1990s and 19 post-2000s. The post-90s have become the absolute main force in plastic surgery, while the post-00s have a stronger momentum for medical beauty consumption than the post-90s.

Overemphasis on appearance

However, there can be devastating side effects to plastic surgery on young people. Minors have not matured in all ways physically, and the results of anything that goes wrong can even be fatal.

It is not uncommon to see cases where cosmetic surgery fails. A quick search on the internet with the keywords "medical malpractice" reveals a total of 540 documents that describe prevalent and alarming problems such as illegal business operation, operating errors, temporary blindness of the eyes and blood vessel embolism.

According to the white paper, illegal production in the medical beauty and plastic surgery industry is still rampant, and there are still more than 80,000 beauty shops across the country that illegally carry out medical beauty practices. Statistics from the China Plastic Surgery Association shows that in 2019 there were at least 100,000 illegal practitioners in the beauty industry.

Even if the cosmetic surgery is successful physically, there can be mental and psychological problems after plastic surgery, seriously affecting healthy growth.

In practical terms cosmetic surgery may lead to large discrepancies between a person's face and their photo identification on official documents that can produce life-long hassles.

An overemphasis on appearance is reflected in all aspects of Chinese society. Many job recruitment advertisements refer to personal appearance, underlining how, for many, looks really do matter.

That last point, Jiang says, is the kernel of a societal problem, and those who perform plastic surgery merely amplify it.

"Young people having plastic surgery is the result of a value system in which looks are paramount. You can see this in every job ad that says 'Good image and good temperament' or in the sentiment 'If you aren't beautiful, you don't deserve to be happy', and in the wide support for these problematic values or the indifference to them.

"If these things don't change there will be no way to talk about a healthy and diverse aesthetic or to have rational ideas about plastic surgery. It's not going too far to say that if we are to stop young people having plastic surgery we have to first eliminate these distorted ideas relating to looks and employment."