WHEN, IN NOVEMBER, French doctors grafted a nose, chin and lips onto a woman who'd been savaged by her dog, the beauty world reassessed the potential of new faces.
'I've been watching the face transplant with interest,' says Hong Kong plastic surgeon Daniel Lee. 'With such techniques, it's only a matter of time before it becomes a part of the mainstream.'
According to Xinhua News Agency, more than one million mainlanders had cosmetic surgery in 2004 - three times the number for the previous year.
So popular is the procedure that several competitions on the mainland offer cosmetic surgery to whoever is judged the ugliest competitor. Zhang Di won US$16,000 worth of surgery in Shanghai in 2004. The result was a more western look: her round face was lengthened by pushing back her hairline; her square jaw was trimmed and the bridge of her nose was augmented. 'The overall goal was to make her nose higher, like a westerner's,' said her surgeon.
And it's not only women. Zhang Yinghua, 24, won himself surgery after being judged the ugliest male in the same competition several months later. And another TV cosmetic-surgery show, Lovely Cinderella, attracted more than 30 million viewers for the final, for which 14 contestants had surgery.
Nowadays, cosmetic surgery 'is no big deal', says a 42-year-old Hongkonger who asks to be known only as Samantha. 'I don't plan to grow old gracefully. I'll fight it all the way,' she says. 'If you've got the money, just go ahead and do it.'
Samantha says she had double-eyelid surgery, the most common procedure for Asians, when she was in her 20s. And she says her newly enlarged breasts look amazing in 'plunging ball-gown necklines'. Her daughter, who has just turned 13, is obsessed with her face and wants surgery, too.
Lee says people want to have surgery much younger nowadays. 'I even have parents bringing their teenage kids for eyelid surgery - but I try to persuade them to wait until they're older,' he says.
What's considered beautiful changes all the time, says Bakr Rabie, a specialist orthodontist at the University of Hong Kong. 'The media has a big influence on this,' he says. 'Patients come over with pictures of their favourite model or actress and say, 'I want to look like that'.'
For many Asians seeking cosmetic surgery, the ideal look used to be western. But Singaporean surgeon and ethnic-aesthetics researcher Roland Sim says the ideal is being modified. Although many still want to look less Asian, they don't want to look too western, either, he says. The Eurasian look is increasingly popular.
'Today, we do eyelids that are more compatible to the Asian race, so that surgery is customised according to the harmony of the face,' Sim says.
Samantha says people want to 'enhance what they have, rather than have copycat surgery. There are more ethnic models in magazines and Hollywood, and many people now like individualistic features.'
She had a double-eyelid operation (in which the double-fold lid is removed and to create a single, Caucasian-like version)in her 20s to 'open up my face and to lose the expression of constantly looking puffy eyed and tired'. It had nothing to do with looking western, says Samantha, who was raised in Canada.
Maintaining ethnicity is a challenge, experts say. 'Northern Chinese, the Japanese and Koreans tend to have a relatively flat face, with a protuberant lower jaw,' says Hong Kong plastic surgeon Kenneth Hui. 'Their faces are short and they have strong cheekbones. Northern Chinese and Mongolians have big, bulging eyelids with a lot of fat and smaller eye apertures to shield them from the cold and sunlight.'
So, northern Chinese typically opt for cheekbone and jaw reductions. Surgery is popular in South Korea. Some surveys suggest that as many as one out of two adults has had cosmetic surgery, compared with about 3 per cent of Americans. It's also popular in Japan. 'You can watch Japanese TV series and sometimes you can hardly tell if the stars are ethnic Japanese or Caucasian,' Hui says.
Nose surgery is also popular among Asians - and not only for aesthetic reasons. Prominent nasal bridges are said to signify power and success. Lee says that about 15 per cent of his clients have surgery after consulting fortune tellers.
Work on the chin and jaws can complete the so-called perfect face, because this alters the position of the lips, teeth and smile. Cosmetic surgery to correct large or square Asian jaws usually consists of filing down the bone and adjusting the muscles. Botox injections twice a year offer a quicker, cheaper fix for mildly square jaws.
'People do plastic surgery around here and hide it today, but orthodontics is accepted,' says Rabie. 'These adults have more disposable income. They're used to Versace and Louis Vuitton, and think, 'What can I do now?''
Rabie says big, black eyes, flattened lips and profile, and a stronger nose and chin are Chinese measures of beauty. But many Chinese want to look like mixed races, with softer outlines, he says.
According to the 2001 Hong Kong census, about 78 per cent of mixed race people were under 24 years old. This means that the face of the average Hongkonger is likely to change.
Perceptions of beauty have changed outside Asia, too. In last year's Miss Universe pageant, Miss Denmark was half-Indian and Miss Norway was half-Thai.
A study by the American Academy of Facial Plastic and Reconstructive Surgery from the 1950s to the 90s found a gradual narrowing of the American eyelid, a widening of nasal bridges and fuller nasal tips.
'All these changes reflect an internal average, where Asian, African and Hispanic features are helping to recalibrate norms and reinvent beauty,' says US psychologist and author Nancy Etcoff.
Hui and Rabie say Chinese patients are generally secretive about their surgery. Many go abroad for surgery to mask the inevitable initial bruising, Lee says.
Samantha may say that cosmetic surgery is 'no big deal', but she hasn't yet told her daughter about what she's had done. 'I don't want to disappoint her,' she says. 'She thinks her mother is naturally pretty.'