SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesLike many of her peers, 23-year-old Ruxin scrolls her social media feed every day, but she is looking for something very specific – updates about cosmetic surgery. Ruxin is planning to have “double eyelid” surgery where the surgeon creates a crease on the eyelid, that she hopes will make her eyes appear bigger. The Guangzhou resident logs on to the Gengmei app regularly to hunt for the most suitable surgeon. “There are so many clinics in the city but I want to make sure I go to a good one. It’s my face we’re talking about,” she told the BBC.Gengmei, which means “more beautiful” in Chinese, is one of several social networking platforms in China dedicated to cosmetic surgery, where users leave status updates about all things plastic surgery, including liposuction and nose jobs. Search results can be filtered by regions, treatments and clinics, among others.image copyrightGengmei/So-youngSince its launch in 2013, Gengmei’s users have surged from 1m to 36m. More than half are young women in their twenties.Similarly, cosmetic surgery platform So-Young has seen its monthly active users grow, from 1.4m in 2018 to 8.4m today.Their popularity is an indication of the changing attitudes towards cosmetic surgery in China, which now performs more operations than any country in the world after the US.According to a Deloitte report, the market in China has almost trebled in value in four years to some 177bn yuan ($27.3bn; £19.7bn) in 2019 – an annual growth rate of 28.7%, well above the global rate of 8.2%. If this continues, China could become the world’s largest cosmetic surgery market by the middle of the decade, according to The Global Times.While the most popular procedures include those creating “double eyelids” and V-shaped jaw lines, new surgery fads come and go, with the latest being pointy elf ears, according to reports. Members of Gen Z – those born after 1996 – are not shy about getting such procedures done despite the topic being seen as taboo in the past. Ruxin, who works in fashion retail, said that her friends “openly talk about getting cosmetic procedures”.”Even if people don’t advertise that they have gotten something done, they won’t deny it if you ask them about it.”More regulation neededHowever, China’s cosmetic surgery boom comes with its drawbacks. According to a Global Times report, the country had more than 60,000 unlicensed plastic surgery clinics in 2019.Those clinics were responsible for around 40,000 “medical accidents” every year, an average of 110 botched operations per day, the report added. In one of the most high-profile cases, actress Gao Liu shared images online of a cosmetic procedure that left her with necrosis of the nose, meaning the tissue at its tip has died.image copyrightWeibo/Gao LiuShe said that she will need more surgery to fix it, but the complication has already cost her more than 400,000 yuan in film deals.Meanwhile, her attending physician was suspended for six months, and the hospital fined 49,000 yuan.Many internet users said the penalty didn’t go far enough.”This is the punishment for crippling someone?” one user wrote as she demanded better regulation of the industry.Last month, China’s National Health Commission announced a campaign targeting unlicensed cosmetic surgery providers, including investigating customer complaints more swiftly.Why take the risk?Many people in China place a great deal of importance on looks and the quest to “be beautiful” is driving the cosmetic surgery trend, experts told the BBC.image copyrightGetty ImagesDr Brenda Alegre, a gender studies professor at the University of Hong Kong, said that “conforming to ideals makes one more desirable, not just for romance, but for jobs”. In China, job applicants are often required to submit a photograph. Some job advertisements also specify physical requirements, especially for women, even if they are not needed to do the job. A 2018 Human Rights Watch report highlighting China’s sexist job ads cited examples including one looking for an “aesthetically pleasing” clothing sales associate, and another for a “fashionable and beautiful” train conductor. And with the internet creating a whole host of new job opportunities – all of which ride heavily on one’s looks – experts say there is a renewed focus on appearance, more than ever before.”To a certain extent, beauty can bring more career opportunities – for example, there is monetisation in live streaming and creating online video content,” Gengmei vice president Wang Jun told the BBC.Gengmei says it only works with licensed practitioners on its platform.image copyrightGetty Images’Prettiest to ugliest’China’s tabloid culture can also be brutal. News publications often criticise celebrities for their appearance.Earlier this year, a Shanghai art gallery promoted an exhibition that ranked images of women from “prettiest to ugliest”.Lu Yufan, a Beijing-based photographer who is working on a book about cosmetic surgery, told the BBC that growing up, people would often be straightforward when it came her looks. Her relatives would tell her that she looked like TV actresses – “not the pretty heroines but the funny side characters”, the 29-year-old recalled. “When I was in middle school, boys also listed who they thought were the ugliest girls in class. They told me I was No. 5.”image copyrightLu YufanMs Lu, who has visited 30 cosmetic surgery clinics as part of her project, added that practitioners never held back when telling her how her face could be “improved”. “They were so persuasive that I found it difficult to say no, except that I didn’t have the money for it,” she said.For Ruxin, the eyelid operation is affordable, costing between $300 and $1,200. But it’s just the first step. “If this goes well, I’ll probably do more. Who doesn’t want to be prettier?” You might also be interested in:In 2016, the BBC visited a private cosmetic surgery clinic in Beijing.

SharecloseShare pageCopy linkAbout sharingimage copyrightXiaohongshuIn the latest fad to rock Chinese social media, women have been flocking to Uniqlo stores to post pictures of themselves trying on clothes – from the children’s section.Platforms such as Xiaohongshu and Weibo – the Chinese equivalent of Instagram and Twitter – have been flooded with selfies of young women in fitting rooms, wearing tiny T-shirts from the popular Japanese retailer. On Weibo alone, the hashtag “adults trying on Uniqlo children’s clothes” has received more than 680 million views.Uniqlo China has yet to respond to BBC queries on the trend, which appears to have been started by netizens in recent weeks.It has sparked widespread debate online – not only because it’s reportedly resulted in ruined T-shirts – but also because it is the latest in a series of Chinese social media trends which observers say illustrate an unhealthy obsession among some Chinese women with looking thin. What is an eating disorder?Parents warned of ‘sharp rise’ in eating disordersBBC Action Line information on eating disordersOther trends which have gone viral in the past include the “belly button challenge”, where women wound their arms around their back to touch their belly button, and the collarbone challenge, which had girls balancing coins behind their collarbones. There was also the “A4 waist challenge”, where women shared photos of waists as wide as the narrow edge of an A4 piece of paper, which measures 21cm (8.2in).’BM Style’In fact, such extreme viral skinny challenges pop up so frequently on Chinese social media that there are even niche categories. The Uniqlo trend is an example of “BM Style”, a teen fashion aesthetic involving crop tops, slim jeans and short skirts. It takes its name from the Italian clothing brand Brandy Melville which mostly stocks one-size-fits-all pieces. Its standard size is comparable to the extra-small size from other brands.The trend started gaining popularity last year, after young Chinese women began sharing pictures of themselves in crop tops and dresses by the brand with the hashtag “test if you can wear the BM style”. One 22-year-old Weibo user who frequently posts such pictures told BBC Chinese that she liked the style as “it looks sexier and sweeter… and it makes one’s legs look longer.”image copyrightXiaohongshuBut the rise in popularity of such trends has sparked concern that they are fuelling pressure for women to be unnaturally thin.There has been criticism of a viral and unverified size chart indicating how much a “BM girl” should weigh according to her height – one example given was that a woman with a height of 160cm should weigh only 43kg.An online body mass index (BMI) calculator provided by Britain’s National Health Service says some of the figures on the chart could mean a person was underweight and advises they consult a doctor.On Weibo, the hashtag “how women should overcome body anxiety” has also received almost 70 million views. “The scary thing about the ‘BM style’ is that everyone knows it is unhealthy, and yet they feel pressured to pursue this aesthetic. Some people overlook their health for this – it’s just not worth it,” said one user.Fears TikTok videos may ‘trigger eating disorders”I was addicted to celebrity diet tea’Why would anyone take the A4 skinny waist challenge?He Jinbo of the Chinese University of Hong Kong, who studies mental health and body image, said his latest research on Chinese adolescents found that the more time a teenager spent on social media, the more likely the teen would be dissatisfied with his or her body.While it is not the only society grappling with this problem, experts have told the BBC that the issue is more fraught in China where notions of body positivity have yet to take root.A 2019 Ipsos online survey on global beauty standards found that out of 27 countries, China came out top in believing that body weight and shape are important attributes in making a woman beautiful. The Chinese were also the second most likely to pick the skinniest body types as “ideal” for women. ‘A good woman cannot weigh over 50kg’Chinese psychologist Ke Han from Singapore’s Nanyang Technological University noted that Chinese media tends to feature “very thin girls” and the public tends to favour waif-like female celebrities.”There is a popular Chinese saying which means ‘a good woman cannot be over 100 jin’ which is about 50kg [110lb],” Dr Ke said. “Women who are heavier than that are then considered lazy and lack self-discipline because they cannot seem to take care of themselves… some women believe this so much that they think it’ll affect their marriage prospects.”Many people still hold a patriarchal view which objectifies women, she said. “Being slim and beautiful implies ‘good value’ as an object.”The ‘punchline queen’ who offended Chinese men’Banshee, shrew’: An angry song wants women to be seenIt is also generally culturally acceptable to be direct when talking about someone’s weight. “The majority of Chinese people have not realised the damage that fat-shaming can have on someone’s well-being,” said Dr He Jinbo.But there are signs of change, and more “are beginning to be influenced by body positivity movements elsewhere… you can start to see some talk online,” said Dr Ke Han. Last year, lingerie brand Neiwai made headlines when it launched a body positive advertising campaign. The brand’s diverse sizing stood out among Chinese retailers which tend to carry items only in limited smaller sizes. Earlier this month, popular Chinese actress Zhang Meng sparked discussion online when she revealed on Weibo that she had to seek medical treatment after attending an awards ceremony, as she had worn a corseted dress that was so tight that it had caused severe pain in her ribs.image copyrightWeiboShe said the incident served as a wake-up call. “Our looks are only one part of us. Instead of complaining every day that we are not thin enough, it’s better to spend that time learning new things, enriching ourselves, and make ourselves more confident!”Many social media users responded with messages of support. Said one commenter: “This is really how it should be. So many women have body anxiety issues, but health is much more important. No matter what we look like, we are all the most beautiful.”If you, or someone you know, has been affected by this story you can get support and advice from BBC Action Line.