Why Cosmetic Surgery Is Booming in China

Source: Photo by Yang Deng on Unsplash

Worldwide, the number of cosmetic surgery procedures is increasing. One of the countries experiencing the most rapid rise is China. As in the rest of the world, about 90% of people who undergo cosmetic surgery in China are women. However, China is unique because the majority of procedures are performed on women who are in high school or college. This is very different from most Western countries, where women who undergo cosmetic surgery are generally middle-aged or older.

Even though cosmetic surgery has become common in China, we know very little about what influences people’s attitudes toward it there. This is important to understand because cosmetic surgery can lead to negative consequences, including health complications and depression. There is also evidence that people may not feel better about their appearance after surgery, and may actually become more preoccupied with their looks.

In light of the rise of cosmetic surgery in China, and the importance of understanding people’s attitudes toward cosmetic surgery, my Ph.D. student Yi Wu, along with myself and my colleague Sandra Mulkens, set out to learn more.

The Research

In our study, nearly 800 Chinese men and women (18-68 years old) completed a questionnaire to measure their attitudes toward cosmetic surgery, called the Acceptance of Cosmetic Surgery Scale (Henderson King & Henderson King, 2005), which we translated to Chinese. The participants also completed questionnaires on other related topics and reported their demographic characteristics.

Using these data, we then looked at the statistical relationships between participants’ scores on the Acceptance of Cosmetic Surgery Scale and the other questionnaires and demographic characteristics.

The key findings were that Chinese women and men who held more positive attitudes toward cosmetic surgery (e.g., they thought that cosmetic surgery is a good thing and considered having cosmetic surgery themselves) were also more concerned about the appearance of their face. They were also more supportive of societal appearance standards with respect to beauty, weight, and muscularity.

We also found that Chinese women reported more positive attitudes toward cosmetic surgery compared to Chinese men. Among Chinese men, those who were older reported more positive attitudes toward cosmetic surgery compared to younger Chinese men. No age differences were found among Chinese women.

Chinese women and men who lived in urban areas had more positive attitudes toward cosmetic surgery compared to those who lived in rural areas.

In this study, we also “validated” our Chinese version of the Acceptance of Cosmetic Surgery Scale; these results are reported in our scientific article (see here).

The Take-Home Message

Several factors were related to more positive attitudes toward cosmetic surgery among Chinese women and men. Many of these relationships reflect interesting features of Chinese culture.

Compared to most Western countries, most cosmetic surgery in China is performed on facial features, and the appearance of the face is viewed as more important than the appearance of the body. This could explain why Chinese people who were more concerned about the appearance of their face also held more positive attitudes toward cosmetic surgery. We also did not find a relationship between attitudes toward cosmetic surgery and Chinese people's feelings about their bodies overall.

The relationship between attitudes toward cosmetic surgery and endorsing societal appearance standards has also been established in other countries. In this study, Chinese women might have had more positive attitudes toward cosmetic surgery compared to Chinese men, because beauty is a key feature of Chinese femininity. Compared to Chinese men, Chinese women are often judged based on their appearance, more than other features like their intelligence. For example, some Chinese employers will only hire women who are tall, thin, and “beautiful.” Of course, these gender differences hold for many Western countries, too.

Chinese men are not immune to appearance concerns, though. In fact, cosmetic surgery has become more popular among Chinese men. The fact that older Chinese men express more positive attitudes toward cosmetic surgery could show that they are also impacted by pressures to remain youthful looking, and youth is valued within Chinese beauty ideals.

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Last, it is interesting that Chinese people in urban areas had more positive attitudes toward cosmetic surgery compared to those in rural areas. A simple explanation is that Chinese people in urban areas are surrounded by more people, so there is more opportunity to compare their appearance to other people's. People in urban areas also see more cosmetic surgery advertisements, which have become common in many cities in China. They are also more likely to know other people who have had cosmetic surgery, and this could cause them to see cosmetic surgery as more acceptable and enticing.

I am extremely proud of the work of my Ph.D. student, Yi Wu. Her findings help to shed much-needed light on attitudes toward cosmetic surgery in China, where cosmetic surgery is rising at an alarming pace. Stay tuned for more of her research on cosmetic surgery in China, which will be published soon.

Note: This blog entry was a joint effort by me and Yi Wu.