In a globalized world, beauty standards tend to merge. While Nordic features and toned bodies are the dominant aesthetic in advertising and show business, in China where Western looks are genetically unattainable, more and more women are nonetheless resorting to going under the scalpel.

Cosmetic surgery is now a US$2.5 billion annual industry in China and one that is growing at a pace of 20 percent a year according to the official Xinhua News Agency. The No. 9 People's Hospital in Shanghai alone handles 25,000 cosmetic operations a year, with women – and men too -- across the country having nearly 2.5 million operations in 2009, landing the country in third place behind the United States and Brazil for attempts at beautification.

The procedure can be a gamble. It is estimated that more than 200,000 lawsuits have been filed against plastic surgeons in the last 10 years, according to the China Quality Daily. Newspapers are filled with stories and pictures of horrific malpractice, with women's noses that are now cavities in their faces, jaws misshapen and other horrors committed by practitioners, some with the barest amount of medical training, who are in it for the money.

In November last year, former TV talent show contestant Wang Bei died as a result of complications on the surgery table. At 24 she was in for a surgical procedure to reshape her jaw. Her death showed the ugly side of Chinese obsession with beauty and sparked a debate in the country.

But it is a gamble that millions of people are willing to take.

"Don't be nervous. The more relaxed you are the faster it will be. First I am going to draw the line on your eyes, then I let you see," Dr Yang Renbao assures a patient he is treating at a Beijing hospital. "Then we will do the anesthetic and only when all is in place we will start the procedure."

Yang is a Beijing surgeon in his 30s. He has worked for five years at the private Evercare hospital, one of the capital's top places to go for plastic surgery. He says the change in his field has been huge over recent years.

"There has been a change in people's level of knowledge –from an uninformed level they are now very aware and ask many specific questions. Every year it becomes more evident that patients have more demands and expect more concrete result. A few years ago, if a patient could get a double eyelid that was pretty, that was good enough," he says.

In the west, cosmetic surgery tends to serve older women who hope to look younger, but in China, it is mostly young women, Yang says.

"Chinese people are very susceptible to fashion. Many people have a certain idea of themselves and they don't want to wait until they are old to realize their aspiration. There are more young people and many of them have worked for one or two years so they have reached a certain economic level and can do it," Yang says.

Sitting on the grass at her university park, 24-year-old Summer Shi recalls the day of her surgery. Shi says she always felt her eyes were too small and every morning she would apply a piece of sticky tape on the upper part of her eyelid to fake an "o" shaped eye look.

Many of her friends have undergone double eyelid surgery which, through incision and suture, adds a crease on the eyelid.

"I started thinking about doing it a year or so before I actually did it," says Shi. "But I could not make up my mind. And then one day, a family friend just took me to do it. I wasn't even prepared. She said she and my mom were waiting in the car and that I should just go with them to do it. So I went."

Shi is happy with the results of her surgery, which cost 800 yuan (US$123.20.)

She had the surgery on the lunar New Year break, away from the eyes of her classmates and in the safe and supportive nest of her family. When she came back to school, friends told her she looked prettier, but they did ask how her eyes became so big all of a sudden.

Support from parents is a common feature in these stories. Susan Feiner, a feminist economist at the University of Maine, says she is not surprised by the fact that parents tend to support their daughters' wish to change their bodies through surgery.

"Parents are caught between a traditional world view and a postmodernist world view. On the traditional side especially, your daughter is your property and potential to social advancement," she says. "On the postmodern side you have this idea that western beauty, this imported beauty ideal, is really a sign of your family's openness to the future. So those two impulses – a very traditional impulse and the more modern neo-liberalism impulse come together at the moment of submitting your own daughter to the knife."

In 2010, Feiner co-authored a paper about the rise of the so-called beauty economy in China. She says that Chinese women – much like their counterparts in the West – are submitting to an impossible standard of beauty and success.

"On one hand we have all of this acceptance and even approval for women to become doctors and lawyers and political leaders and at the same time what's been held up to women is this Walt Disney notion of our lives. That really even if you are a doctor or a lawyer or a political leader the best you can really do is to be beautiful and get some wealthy rich man to take care of you, so the best possible outcome for any women is to be both hugely successful professionally and be knock-down beautiful," she says.

Anna Magnani, an iconic Italian actress from the fifties, once warned a makeup artist not to retouch her wrinkles – because, she said, it took her so long to earn them. In contrast, many young Chinese women may prefer not to even get to that stage, and thanks to a flourishing economy, they have the option not to.

This article was first broadcast on Asia Calling, a regional current affairs radio program produced by Indonesia's independent radio news agency KBR68H and broadcast in local languages in 10 countries across Asia.

Getting Sexy in China

Comments on this post are for paying subscribers