Surgeons shoulder huge responsibility, especially with young patients

In the 1990s in China almost everybody who consulted a plastic surgeon did so se eking a remedy for congenital malformations or to repair deformities and scars left by injuries and burns.

Those without such ailments by and large sought cosmetic surgery believing it would help their careers, many of them working in show business or some other high-profile profession.

Moreover, before 2000, if someone who worked for the government wanted to have cosmetic surgery, he or she needed to present to the hospital an introduction and approval letter from his or her danwei, essentially employer, to prove that the cosmetic procedure would contribute to an improved work performance, says Xue Zhiqiang, a senior cosmetic surgeon in Beijing.

Today, as Chinese become more open-minded about such surgery, and as more and more young people have cosmetic procedures done, the industry faces risks, Xue says.

For one thing, even though cosmetic procedures are very safe if performed competently by professionals, there are unlicensed institutions and personnel providing cosmetic procedures that can be highly dangerous. That applies particularly to surgery on the face, on which there are many blood vessels and neuron ends.

Age itself poses risks for those undergoing such procedures. If a patient is too young, for example, a boy under 18 or a girl under 16, it is likely the patient's body has not fully developed, meaning bone structures are unstable, making an operation unwise.

However, the dangers go beyond the physical. In general a very young person will lack the psychological maturity to take full responsibility for his or her decisions, and any dispute as the result of surgery going wrong or a patient simply deciding he or she dislikes it is likely to enter a legal quagmire.

In some countries patients are required to be assessed psychologically and have counseling before and after an operation, but this is not the case in China, where the onus is on the cosmetic surgeon to determine whether the patient is suitable psychologically, Xue says.

Jin Xing, the chief executive officer of SoYoung, an online service in China that puts potential cosmetic surgery patients in contact with the appropriate surgeons, warns that it is important to have cosmetic procedures in licensed institutes by licensed doctors.