A doctor at Jiaxing Shuguang Cosmetic Surgery Hospital in Zhejiang province prepares a patient for cosmetic surgery. Provided to China Daily

A growing willingness among Chinese to go under the knife for aesthetic reasons raises questions about the changing national psyche. many are facing the ugly side of the quest for beauty - lack of self-esteem, addiction and disfigurement.

The public has not seen the face of the woman who is perhaps China's most famous cosmetic surgery recipient. That is because the woman, who uses the pseudonym Pink Baby, wears a surgical mask when she appears on TV - not only to protect her identity but also because she says she has been disfigured by more than 200 plastic-surgery operations since she was 16.

The 31-year-old from Jiangsu province has become the public, although unseen, face of an increase in botched cosmetic procedures and plastic surgery addiction in China as modernity poses a stiff challenge to tradition.

More people are going under the knife for aesthetic reasons, influenced by an obsession with entertainment and celebrity, something that runs counter to a long-held taboo against modifying one's body because it is regarded as a shrine to one's parents.

The country ranks first in Asia and third in the world, after the United States and Brazil, in the number of cosmetic procedures - more than 1 million in 2011, the US-based International Society of Aesthetic Plastic Surgery reports.

But the figures include only operations performed by certified professionals. Many Chinese undergo procedures at illegal cosmetology hospitals, clinics and beauty salons.

Some are discovering the ugly side of beauty's pursuit.

While many are concerned about failed procedures, few fathom the possibility of becoming addicted to plastic surgery.

"It's like gambling. When you lose, you want to win it back. And when you win, you want to win more. When a surgery goes wrong, you always think you'll get lucky next time.

"I can't stop," Pink Baby says.

"It's irresistible. I feel compelled to keep getting operations."

Whenever the operations went awry, she would rush to undertake corrective procedures - and entirely new surgeries.

She has undergone virtually every procedure available, she says. Her body has been altered from head to toe but in negative ways, she says.

She cannot lift her eyebrows. Her eyes are so scarred they cannot close.

Pink Baby also says she suffers memory loss from so much anesthesia and heel pain from operations that damaged her foot bones. Some of her implants and fillers pose cancer risks, she says.

This year, she published a book titled Pink Baby: She Has Received Every Plastic Surgery You've Heard Of. She also runs a website. Pink Baby has turned her experience into a business, and offers online consultations and accompanies some patients to the hospital - sometimes for a fee.

Hundreds of people contact her every day, she says."Too many people's bodies and lives have been ruined like mine."

The count is growing in China.

The director of Beijing Tongren Hospital's Plastic Surgery and Beauty Center, Zheng Yongsheng, says most people who receive cosmetic operations are average-looking but seek aesthetic perfection. A decade ago, most were disfigured and hoped to appear normal.

"Rapid economic development, improving living standards and fiercer social competition have generated an obsession with appearance," he says.

"Cosmetic surgery offers a quick fix. Many people get hooked."

Plastic surgeon Ding Xiaobang, who has plied his trade in Beijing for more than 20 years, says up to 80 percent of his patients, mostly women, have multiple procedures.

"Most people get one or two operations and are satisfied," Ding says. "But some crave more and feel anxious until they indulge their urges."

Such people typically struggle with body-image issues and feel ugly, although they look fine or even attractive to others, he says.

The two most susceptible demographics are less attractive individuals in their 20s or 30s and middle-aged people hoping to reclaim the good looks of their youth, Ding says.

Former journalist Huang Wei, who covered the industry for years in Xiamen, Fujian province, before co-founding a private practice in Beijing, says: "It can be especially addictive for people with low self-esteem."

Huang recently denied a nose operation to a 20-year-old mother surnamed Zheng, who had already had a rhinoplasty, in addition to eye-widening surgery and liposuction.

"She's very pretty in others' eyes but not in her own," Huang says. "Her problem is that her husband often indulges in affairs. She believes it's because she's not beautiful."

Zheng's case is not uncommon.

British Anti-aging Academic Society executive vice-chairwoman Yuan Lu, 36, says dozens of her friends get regular skin-filler injections. But only one - a 30-year-old - has had multiple surgeries because her husband frequently strays. She has received a nose operation, an eye-widening operation and jaw-line narrowing.

Zheng Yongsheng, the Beijing Tongren Hospital surgeon, says many patients are women seeking to win back unfaithful husbands' desire. Many feel the urge to repeatedly go under the knife when they are depressed.

Though fewer men undergo plastic surgery, many of those who do get hooked, Zheng says.

He recalls a 37-year-old man who regularly requests operations to remove eye bags.

"A good plastic surgeon knows when to stop patients," Zheng says.

"It puts the patients at risk if the doctor isn't responsible enough to refuse when he should."

Pink Baby's experience shows why.

"It ruined my life," she says. I can't work or date. And I can't tell my family what I've done."

"I was young and ignorant. If I could do it over again, I wouldn't get even one surgery."

But she plans to get several more - mostly in hope of restoring her appearance to "normal".

"And I have to satisfy my cravings," she says.

liuzhihua@chinadaily.com.cn

(China Daily European Weekly 08/30/2013 page24)