Aspiring singer Wang Bei died during "facial bone-grinding surgery". [Photo/China Daily]

Recent death of plastic surgery patient sends shock waves across growing industry.

The pervasiveness of plastic surgery in China is one of the country's biggest open secrets. Now it is on everyone's lips, following the death of a 24-year-old former talent show contestant during "facial bone-grinding surgery?in mid-November. Wang Bei, an aspiring singer, reportedly went under the knife in the central city of Wuhan, Hubei province, to jump-start a faltering showbiz career. She wanted a more pointed chin, which, along with double eyelids and an aquiline nose, is the modern Chinese ideal of beauty.

Wang was cremated on Sunday without undergoing an autopsy since her family members said they were satisfied with the plastic surgery hospital's compensation and the explanation that her death was due to an "anesthetic accident".

Wang's death has sent shock waves through the country and many Chinese people now fear and distrust an industry that is nevertheless growing significantly.

Surgical and non-surgical cosmetic procedures are one of China's major consumer category next to homes, cars and travel, figures from the Chinese Ministry of Health show. The industry makes 15 billion yuan (1.73 billion euros) a year from about 3 million procedures and business is expected to grow 20 percent annually.

"I didn't know that surgery to narrow the face can be lethal," a woman in Shanghai posted on her Sina Weibo micro blog. "Now I know, and my dream of having a narrower face is smashed."

A survey of reactions to developments after Wang's death, conducted by Tencent, which runs China's most popular instant-messaging service, received at least 22,000 responses as of Wednesday afternoon. Forty percent of those polled advised young people to think twice about their dreams of movie stardom; 38 percent said it is lamentable that Wang's family did not take action against the hospital; and 5 percent were angry that the hospital was able to "evade responsibility". About 16 percent felt sad that the cause of Wang's death will never be known.

A common thread of the online discussion of the issue questions why someone who is considered beautiful remained dissatisfied with her looks. Some netizens said Wang became a victim of society's unrealistic ideal of beauty, one modeled after Western celebrities. Others said her death underscores the limits to which people will go to achieve fame and fortune.

The Ministry of Health stepped in on Nov 27, calling on health authorities nationwide to increase supervision of the medical cosmetology industry. It also instructed the Hubei health department to investigate Wang's death and "to make the results of the investigation public as soon as possible".

As the wealthy and middle-class segments of the Chinese population expand - and as celebrity culture takes an even firmer hold - people are becoming more conscious of their looks and are willing to go to great lengths to enhance them. The example of seniors is illustrative.

"Nowadays, people are living longer and better. But the effects of aging on their appearance affect their mood and confidence in having an active and healthy lifestyle," said Ye Xinhai, a doctor with the plastic surgery department of the Shanghai No 10 People's Hospital, which reported a 20 percent increase in older patients in the past two years. "Many older women want to look as young and as beautiful as those high-profile older actresses in TV dramas or South Korean soap operas and are happy to spend money on their appearance."

Young people, on the other hand, see cosmetic surgery as the key to wealth and love. "They want to improve their appearance to find better opportunities at work and in marriage," said Ding Xiaobang, a plastic surgeon with the Peking Union Medical College Hospital.

"We're living in a highly competitive society. People regard appearance as a weapon and a means of empowerment Most of them tell me, 'I don't care how much I spend, just make me look beautiful'."

In the past decade, Ding said he has seen a growing number of patients, like Wang Bei, who are young and naturally good-looking. The surgeon attributes this trend to people becoming richer, the standards of beauty changing, competition and frustration. "Some are frustrated with life and use surgery as a way to try and recover," he said.

The US-based International Society of Aesthetic Plastic Surgery ranks China first in Asia in terms of the number of procedures performed in 2009. Worldwide, China is third, after Brazil, while the United States is first.

The organization said that the top five surgical procedures performed in China in 2009 were breast augmentation, liposuction, upper or lower eyelid lift, nose reshaping and "tummy tucks". It put the number of Chinese plastic surgeons at 4,250, the second highest in the world after the US.

Their main patients, according to the Chinese Association of Plastics and Aesthetics, are women aged 20 to 45, who represent 64 percent of the industry's clientele. This segment of the population is estimated to be at least 90 million.

Meanwhile, experts say, young and beautiful people who still seek plastic surgery need to cultivate more self-awareness and self-acceptance.

"They've built their identity around the admiration of others and have failed to establish a system to assess themselves," said Zhu Wenbo, a psychologist with Blue Bay Psychological Consulting Center in Chengdu. "People's opinions always change, so this is not a reliable way to evaluate oneself The standard for judging oneself should be one's competence and capabilities."

Zhu pins part of the blame for the plastic surgery craze on false advertising, which "exaggerates the benefits and overlooks or never shows the risks". In his 12 years as a therapist, Zhu himself has become familiar with the consequences of those risks. "I've met several people whose faces were ruined by plastic surgery, and helping them recover is difficult."

The growing demand for plastic surgery in China has resulted in a rise in the number of unauthorized or second-rate business establishments conducting such procedures.

A recent inspection of 11 plastic surgery clinics and hospitals in one provincial capital revealed that fewer than half met government standards, according to the Ministry of Health. And in the past decade at least 200,000 lawsuits have been filed by patients unhappy with the outcome of their surgery, the ministry says.

"There is a lack of well-trained surgeons to keep up with the booming demand," plastic surgeon Ding Xiaobang says.