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(Note: This piece ran on 11/23/03 on the FRONT PAGE of the Sunday San Francisco Chronicle in a different form. This is the Globe version.)


Nov. 9, 2003 * Nov. 23, 2003

In China, cosmetic surgery on the rise


BEIJING -- Hao Lulu was, at least by most accounts, reasonably pretty to begin with. At a news conference in July to announce her plans to undergo a head-to-buttocks series of cosmetic procedures, a photojournalist who didn't understand that the operations hadn't taken place remarked, "Boy, she's gorgeous now, isn't she?"

Hao, a 24-year-old aspiring actress, apparently didn't think so. She had been told she was "plain" by her friend, Bao Huai, the new publicist for a Beijing cosmetic surgery clinic called Evercare. Bao recruited her to become the free recipient of at least four rounds of plastic surgery with the promise that her improved looks and the publicity would boost her career.

Bao's so-called Beauty Dreamworks Project has made a momentary celebrity of Hao, but it also has put a very public, very altered face on the increasing popularity of cosmetic surgery in China.

There are no official figures on how many cosmetic surgeries are being performed annually, but dozens of clinics like Evercare have sprung up. Dr. Xie Hong Bin, who is performing some of Hao's procedures, says he typically performs as many as five a day for as much as $2,500 per operation.

Hao's extreme makeover may be the exception, but thousands of Chinese women, and some men, are turning to surgeons for cosmetic enhancements they can now afford thanks to a prosperous economy that expanded by at least 7 percent a year even during the global slump in 2001 and 2002.

"Many people have the money now," Bao said. "Why shouldn't they do it?"

Analysts see the rise in cosmetic surgery as yet another example of how the once cloistered nation has opened up to Western businesses -- and influences. Starbucks franchises dot most major Chinese cities and new housing subdivisions bear American names like "Orange County" and "Palm Springs," so specialists figured it was only a matter of time before obsession with appearance became another import.

American doctors frequently visit China to teach various procedures, and Xie himself will spend six months next year at the University of California at San Diego studying the latest technology.

"This is related to the influx of corporations like Avon in Asia and other makeup companies, all the same kinds of corporations that make a lot of money off women in the US changing their bodies," said Allaine Cerwonka, an assistant professor of women's studies and political science at Georgia State University in Atlanta, who teaches a course called "Globalization and Gender."

"We have a culture that makes women feel bad about themselves in order to make money. . . . Now they have a global market for it," Cerwonka said.

She noted that the most popular surgeries in China -- and part of Hao's first round -- are to create "double eyelids" and to narrow the nose, a reflection of a Western notion of beauty. For Asian women in the United States, double-eyelid surgery, in which a crease is added to the upper lid, is also a top cosmetic operation because many say they believe "single eyelids" make them look sleepy, Cerwonka said.

Hao insists her reasons are all her own. With two operations down, she now has had her eyelids and nose done, calves and buttocks reshaped, and breasts enlarged. Still to come are liposuction, hairline correction, and wrinkle and eyebag removal.

She says that she is so excited about the changes that from now on she will celebrate two birthdays: her real one and the date of her first surgery.

"Before, a lot of men liked my personality and character, but I lost a lot of guys who were overly concerned about a woman's appearance," said Hao, who is unemployed and says she's been dating a Chinese-American man. "Now, all kinds of guys will like me no matter if they're interested in appearance or character."

Although such comments might shock Western feminists, there appears to be little public hand-wringing over them here.

Nowhere in the Chinese media has there been a debate about the surgeries. The state-run, English-language China Daily cited critics of the publicity stunt but also wrote warmly of the "crack team" of doctors working on Hao.

Dr. Xie is not embarrassed, for example, to say that while sometimes he performs cosmetic surgeries on victims of car accidents, burns, or violent crime, he prefers doing elective cosmetic surgeries because "I love to create things of beauty. It is a gift to the world."

Ironically, one of the few people who admits to being alarmed by Hao's impact is Doris Hu, an editor at the Chinese edition of Cosmopolitan, a magazine that showcases images of beautiful women to whom Hao says she compares herself. Chinese Cosmo, now in its 10th year, sells more than 100,000 copies a month across the country, Hu said.

"This might mislead teen girls to think that to be successful, you need to have cosmetic surgery," Hu said recently. "Some Chinese people will believe that beauty is power, beauty is money."

Beauty and publicity mean money for Evercare. Hao is now a minor celebrity whose progress is documented religiously by the state-run China Central Television and who has been the subject of two reports on CNN International.

Bao said he believes the positive press is largely due to his clever timing, giving a "happy" story to the media after months of depressing news about SARS. The clinic, which opened in May, is now so profitable that it will soon open branches in other Chinese cities, he said.

And Bao is so popular at the clinic that nobody flinched when, during an interview, he reached under the chin of the 47-year-old medical director standing nearby, grabbed a bit of skin and suggested that she would probably be due for some liposuction there soon.

Then again, Bao isn't just the spokesman, he's also a client: The former Peking opera performer had a facelift earlier this year.

Hao said she'll probably be done with plastic surgery once her final two rounds are complete, although Bao said she might need some touch-ups later.

"Everybody wants natural beauty, but nobody is perfect," she said. "Everybody has flaws. But now we can have shortcuts to beauty. I believe I can be more beautiful than any woman in those magazines."


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