Mirror, please

In the current economic climate, one might assume that luxury industries like cosmetic medical services would see a decline in demand. However, Chinese hospitals continue to open expensive cosmetic surgery wings.

Bioscor, a cosmetic surgery clinic in Shanghai, has recently seen a slight downturn in clientele, but still expects a 30% growth rate next year. Zhuyan Plastic Surgery Medical Clinic in Chengdu has seen a sharper downturn, but still anticipates 20% growth. In years past, many Chinese went to Korea for surgey, but now Chinese clinics have begun to take back the business.

The sector is beginning to attract more and more patients from middle-class backgrounds. "Cosmetic surgery in China is no longer more a luxury than a Prada handbag," said Dr Tony Prochazaka, a surgeon and consultant at Bioscor’s Shanghai office. He notes, however, that while more people are going under the knife, most spend a long time saving up for it. Even at clinics catering mainly to local patients, a single nose job can cost up to RMB10,000 (US$1,450).

The sector’s success here is informed by a cultural difference. In China, cosmetic surgery does not entail the social stigma it does in some Western countries and those who undergo such surgery need not be embarrassed. China annually holds a Miss Plastic Surgery pageant.

In addition, physical appearance is a career advantage, and not just for models. Companies often advertise for candidates with certain facial and body features and require photos in résumé packages. While surveys have shown that the tall and good-looking tend to earn more than the short and ugly in Western countries too, most Westerners still consider overtly hiring based on looks a violation of meritocracy. Chinese employers, on the other hand, consider physical appearance a "merit" like any other resume point, especially for women.

"For women, cosmetic surgery is especially advantageous," said Dr Liu, a cosmetic surgeon at Zhuyan. There is little sense that cosmetic surgery is a form of cheating. 

This Chinese ambivalence towards physical enhancement filters into the Western expatriate market. Expatriates, far from their domestic peer groups, seem to be more comfortable getting cosmetic surgery in China, said Prochazaka. While the number of men undergoing cosmetic procecures is rising in Western countries too, Prochazaka said his Shanghai clinic sees an even higher percentage of men compared to his clientèle in Australia.

At the same time, the growth of the sector drives demand for supplies, many of which are imported. 3M’s Shanghai branch, for example, supplies many local clinics with their cosmetic dentistry needs and anticipates continued growth from those product lines.

Hack jobs

Cosmetic surgery has its share of quality-control issues. There is no certification for cosmetic surgery; surgeons need merely to join an association. Cosmetic dentistry lacks even that requirement. There have already been 200,000 lawsuits brought against cosmetic clinics for malpractice. Liu often finds himself repairing other surgeons shoddy work.

Dr Ben Ian, one of a handful of Chinese cosmetic dentists who has trained overseas, frequently has to reconstruct entire teeth destroyed during a patient’s original procedure. "There are a lot of dentists who have no idea how to do cosmetic dentistry but want to offer the service because it’s very lucrative," he said. "My seminars attract 300-400 dentists per session. They all want to join the profession but they lack expertise."

Despite these setbacks, the cosmetic surgery and dentistry sectors continue to develop. "There are definitely differences in the medical systems and regulations here," said Prochazaka, "but I still feel like I’m at the forefront of the cosmetic surgery wave."