Zhao Hongyi, head of the plastic surgery department at the Beijing Hospital, assesses the features of a patient in the consulting room.[Photo by Zou Hong/China Daily]

Public hospital plight

Zhao Hongyi, head of the plastic surgery department at the Beijing Hospital who has worked in the sector for 22 years, is noted for performing surgery to produce double eyelids.

He said cosmetic surgery first rose to prominence in the 1950s, but at the time the focus was on reconstructive procedures, and it was only in the 1990s that "aesthetic medicine" began to develop and become a consumer item.

He agreed with the conclusions of the Zero2ipo report, noting that China has the third-highest number of cosmetic surgeons in the world, and that the younger generation - people ages 18 to 30 account for 58 percent of patients in the sector - is the driving force.

"Social competition and the influence of online celebrities have helped to accelerate the pursuit of beauty among young women," he said. "Meanwhile, a nouveau riche mentality has helped to foster a psychological bias."

More important, the market has expanded to such an extent that the number of patients outstrips qualified practitioners, he added.

That is creating a problem because the public hospital system isn't attuned to the needs of customers, and a growing number of private companies are attempting to exploit the potential of the immature market via massive advertising campaigns.

"It's kind of pathetic to work as a plastic surgeon in a public hospital," Zhao said, referring to the low rates of payment, and the fact that fees are fixed and easily ascertained.

However, prices in private clinics - where the operations may be performed by the same surgeons as in public establishments - are not as transparent and can be much higher.

In addition, the cost of surgery may fluctuate according to demand, along with agents' fees.

Zhao said the fixed fees at State-run hospitals are hampering the continuous development of cosmetic surgery in the public sector.

"It's a market-oriented industry," he said. "But if you use the nonprofit medical model to control the marketing profession, it definitely raises some issues."

Healthy attitude

Jin, from Soyoung, said society discriminates against cosmetic surgery.

"If you tell a girl that she has had cosmetic surgery, she will feel offended," he said, adding that most female patients believe they were always attractive and the surgery didn't alter their appearance.

"Society's attitude toward cosmetic surgery shows that the market is not mature."

He said an understanding of the appropriate procedures and a healthy mindset can help patients make the right choices and also foster healthy, long-term development in the sector.

"What we've been trying to impress upon patients is that before you have cosmetic surgery, you should ensure that you are mentally prepared."

In China there is no age restriction for plastic surgery, but public hospitals have a duty to consider a patient's mental condition if they request treatment repeatedly. No such considerations apply to private operators.

Gan formed the habit of visiting cosmetic surgery clinics on her travels around the country. She recalls telling one doctor, "I am worried about the shape of my eyes."

He replied, "With regard to your upper eyelids, the problem is a lack of symmetry, but if you think that's okay, we won't need to do any surgery."

Gan then showed him a photo of Fan Bingbing, a Chinese actress who has appeared in a number of Hollywood blockbusters, including X-Men: Days of Future Past and Iron Man 3, and asked him to make her eyes the same shape as Fan's.

Despite everything, she still believes that more plastic surgery will help her meet the man of her dreams, but with one proviso: "After all the clinics and surgeries, harmonious beauty is the most important thing to me, so the plastic surgery should be appropriate."