The cutting edge
PLASTIC surgery is thriving in our plastic economy. At least 10,000 cosmetic operations are being carried out in Hong Kong every year, estimates The Hong Kong Society of Plastic and Reconstructive Surgeons. However, plastic surgery still carries with it a certain social stigma. Although the subject is regularly discussed at tai-tai teas and girlie get-togethers, no one is willing to stand up and be cosmetically counted.
Hong Kong being the close-knit community that it is, and consequently a veritable breeding ground for gossip, it is difficult to keep such surgery a secret. To avoid being caught out in the post-op period of bandages and bruises, many wealthy women choose to travel overseas for treatment. 'I just tell my friends I'm off to the Maldives or visiting relatives,' says one 31-year-old Chinese woman, who travels to the United States for cosmetic surgery. 'That way no one knows I've had surgery. And if anyone's surprised at how much better I look, I have the holiday to blame it on. In fact, I'm always suspicious of friends who go away on their own. They're either having an affair or having a face-lift!' To date, she has had three procedures done in the US; breast implants, nose augmentation and liposuction on her thighs and abdomen. She estimates that her husband has spent over $200,000 on her treatments including accommodation and air fares. 'It was painful, especially the liposuction, but only for about three weeks. It was definitely worth it because I'm much happier now with the way I look. My nose isn't as flat as it used to be, my breasts are much firmer and bigger and my legs look much better in clothes. And if I'm happier, my husband's much happier too!' Overseas clinics are now targeting Hong Kong, which they see as a potentially lucrative market. 'There are so many shopaholics in Hong Kong, dedicated followers of fashion; they're the one's most interested in cosmetic enhancement and we're trying to appeal to them,' says Pamela Noon, managing director of a beauty clinic based in Queensland. Around a third of Noon's 4,000-strong client base is from Asia, mainly Hong Kong and Taiwan, and she is seeing a growing demand from the region. 'It's definitely becoming more popular in Hong Kong, especially among the ladies-who-lunch,' she says.
'Asians are private people and the subject is still very taboo when compared with Australia. My Hong Kong clients demand confidentiality. My patients come to me because nobody knows they've been here. Penile enlargement patients, for instance, aren't going to tell anyone they're having the operation. Another of my Hong Kong patients is a keen golfer and, as we're in the middle of two golf-courses, he uses it as an excuse as to why he's there.' Some of Noon's clients are so worried about being discovered they even hide it from their nearest and dearest. 'One of my Hong Kong patients is married to a successful businessman who refuses to allow her to have surgery,' she says. 'She has a holiday home in Queensland and is gradually having a little bit done at a time. She waits till he goes away on business for three weeks and by the time he comes back, she's totally recovered. She's had collagen lip injections on her face and lips, three procedures on her nose and liposuction on her hips, thighs and tummy. In fact, the reason I came to Hong Kong was because she said, 'Gosh, if only people in Hong Kong knew about this they'd be rushing over.' ' Noon was in Hong Kong with Dr Colin Moore, the only surgeon in Australia doing penile enlargements. 'A third of the penis is buried inside the body,' says Moore. 'By simply snipping a ligament, up to four centimetres of penis can be pulled out.' Noon is offering penile enlargement packages for $95,000 which includes a round-trip business class air fare, meals, accommodation and all surgical fees. 'We're targeting an upmarket clientele, those who can afford the best, not blue-collar workers, we're too expensive for them. A face-lift package costs $150,000 which is the cost of a Versace dress. For that price we'll give you the body to get into it!' Meanwhile, for those who can't afford Noon's prices, and don't mind recuperating in the Queen Elizabeth hospital rather than Queensland, they can have surgery locally for a mere $40,000. Contrary to popular perception, cosmetic surgery isn't merely the privileged preserve of the rich and shameless. While many procedures are carried out on those for whom $50,000 for a spanking new bottom is peanuts when compared to an $80,000 Hermes handbag, the majority of operations are performed on low- to middle-income earners. With prices starting at $3,000 for lip collagen implants or $15,000 for cheek remodelling, cosmetic surgery is accessible to almost everyone.
Of the plastic surgery procedures being carried out in Hong Kong, around 85 per cent are cosmetic. The rest are reconstructive operations, usually performed in government hospitals, to minimise disfigurement caused by accidents, disease or birth defects, which affect one in every 800 babies. Approximately 80 per cent of procedures are carried out on women, most of whom are in their late 30s or early 40s, although there are four peak age groups. 'The first peak is young children with reconstructive cases, such as cleft lips and palates,' explains Dr Gordon Ma, secretary of The Hong Kong Society of Plastic and Reconstructive Surgeons. 'Then early 20s when people start to make money and can afford to change something they hate, such as an upper eyelid without a fold or flat breasts. The bulk are the insecure group in their late 30s and early 40s, and finally [those in their] late 50s and early 60s when everything needs a lift!' The most popular procedure in Hong Kong is the double eyelid construction that creates a crease when the eye opens. A double eyelid makes the eye appear larger and less 'sleepy' and is considered by Hong Kong Chinese as being far more attractive than a single eyelid. 'Every good-looking person in films, magazines or on television has double eyelids,' says Eunice Lai, a 23-year-old model who recently had cosmetic surgery. 'Few people have single eyelids now because it's not fashionable. I was born with double eyelids so I didn't need it but I was unhappy with the bags under my eyes so I had them cut out. It wasn't as painful as I expected and I only had to wear sunglasses for a fortnight.' Lai believes that many people in the entertainment industry have had cosmetic surgery. 'Lots of models and porn stars have it done. This business is about beauty and the more beautiful you are the more successful you'll be. I don't think it's cheating to have plastic surgery, it's only making the most of what you've got. There's one model at Elite who has definitely had her breasts done. They don't bounce when she's on the catwalk and they stand up when she's lying down but she looks great and is getting lots of work. I can't say whether having my eyes done has affected my work. I don't think anyone's noticed but me.' Augmentation rhinoplasty to build up the bridge of the nose and breast enlargements are other common procedures (in the West, nose and breast reductions are two of the most popular operations). Critics have cited their popularity as indicating an unhealthy aspiration to a Western ideal. 'I think Chinese people do judge beauty by Western standards,' says Lai. 'We like our Chinese characteristics like shiny dark hair and full lips but we also like Western features like big eyes and sharp noses.' However, surgeon Gordon Ma believes changing an Asian feature into a Western one is an impossible request. 'Some people talk about a Westernisation of their eyelids or a Caucasianisation of their noses but I think that's totally illogical. You can't convert an Oriental feature into a Caucasian one. I only believe in beautifying what's been given to you rather than converting to another form.' Is beauty therefore in the eye of the surgeon rather than the beholder? 'Beauty is all in the mind. I don't have a guide to what's beautiful. If you're confident, you're pretty. If you think a straighter nose will give you confidence then I'll give it to you.' Ma selects his patients carefully, turning away 40 per cent of the people who visit him. 'The part of the body they're unhappy with has to be able to be improved surgically. Plastic surgery is unnecessary surgery. There are risks involved and no guarantees. Unless you're positive of getting a good result - don't go for it. Some people ask me what I think they need done. I always say nothing. I don't think I'm in the position to tell people what they should look like. I always force my patients to tell me what they don't like about themselves. Then I simply tell them what kind of surgery is involved, what possible complications could happen, what the recovery period is and what they should expect afterwards.' While face-lifts are popular in the West, requests are rarer in Hong Kong. 'This is possibly because Caucasian skin sags earlier,' says Ma. 'I think it's got something to do with the amount of fat. Caucasian skin is much thinner; the thinner it is the more wrinkles will form. Caucasians start to wrinkle in their late 30s but some Orientals in their 50s don't have wrinkles.' Caucasian skin, however, is far less likely to scar, often healing invisibly. 'Even with a good Oriental scar former, you see a visible scar. With a bad healer you will see a keloid; a very prominent raised scar. Chemical peels are also less popular in Hong Kong as Oriental races and coloured people carry higher risks of developing uneven pigmentation.' For Hong Kong men, mole removal is popular, especially under the eye where they signify bad luck. Eyebag removal is also frequently carried out. 'This is my favourite for men because the results are consistently good,' says Ma. 'But generally I hate performing surgery on men because the recovery period needs camouflage and men can't wear make-up.' Surprisingly few Hong Kong men have penis enlargements. 'I think this is because Chinese women aren't as sexually demanding as women in the West,' comments one local woman doctor, 'therefore men aren't as paranoid about their penis size.' Ma agrees. 'There's not much of a demand,' he says. 'More people seek treatment for impotence and there's an injection available which will give you a good two-hour erection.' With any type of surgery there are risks of infection, haematoma (clots caused by blood leaking into tissues or body cavities) and even death; one operation in every 100,000 leads to anaesthesia-related death. Ironically, the results of cosmetic surgery can leave you looking worse than before. A millimetre or two off the mark can be the difference between a rejuvenated, youthful face and a rabbit-caught-in-the-headlights expression.
Over 100 complaints are made every year to the Consumer Council regarding cosmetic surgery malpractices. The majority of complaints are made against beauty parlours that offer treatments with exaggerated claims of success. Machines that claim to massage away fat or make breasts bigger, or hormone injections that increase height. Often they do no such thing and parlours refuse refunds to disappointed customers. Many complaints involved double eyelid operations such as stitches that didn't come out after surgery, dirty implements which caused eye infections and even a case in which so much skin was cut off the eyelid the patient couldn't close her eyes.
There is a simple solution, says a spokesperson from the Consumer Council. 'Don't go to a beauty parlour if you want cosmetic surgery. You should go to a qualified plastic surgeon. If you go to a beauty parlour for a simple facial, stand firm and don't let them persuade you into having surgery. They'll use strong tactics and make you think you need it when you probably don't. Inevitably you're not as ugly as they'll make you think you are!'
