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On June 7th, Yongfen Zhao celebrated her 87th birthday. She lives in Tiesuo Village, in Yi Autonomous Prefecture, Yunnan Province, China. As one of the women in the village with bound feet, she has never left this small mountain village all her life. In this village, there are six other women like her, who are referred to as the "Last of the Three-Inch Golden Lotus."
"There are six other women in our village who have bound feet like my grandmother, and I find it quite frightening," Rongfan’s grandson Ji Gang says. "Back then, they thought it was beautiful, and without foot binding, they couldn’t get married. Now, you see, they’re old and have difficulty in walking."
Ji Gang explains further: "My grandmother says it doesn’t hurt, but in reality, the pain, foot deformities, and infections last all lifetime. Especially with such small feet, people tend to become hunchbacked. Because of her bound feet and the rough, hilly roads in our village, my grandmother hasn’t seen those women that were with bound feet in nearly ten years. Foot binding is definitely harmful. Otherwise, the practice wouldn’t have been abandoned."
Times have rolled forward, and in the 21st century, beauty standards have changed dramatically. The new trend emphasizes the "white, young, thin" aesthetic, with fair skin, youthful facial features, and a weight under 50KG being the ideals women strive for. On February 7, 2021, the topic "#Mi Yang Talks About the White, Young, Thin Aesthetic#" trended, with 240 million views and 42,000 discussions. Chinese actress Mi Yang, confronted with the notion that women must be "white, young, and thin," candidly admitted that she did not meet this standard.
According to Dr. Ming Yang, a postdoctoral fellow at the School of Management and Marketing at Hong Kong Polytechnic University "Among modern women, the pursuit of the 'white, young, thin' ideal is primarily driven by social media, celebrity culture, and the marketing efforts of the beauty industry." Dr. Yang, who is also a distinguished professor at the School of Economics at Ningbo University of Finance and Economics says, "These factors create feelings of inferiority and low self-esteem in consumers."On May 24, 2023, the official Weibo account of China Newsweek launched a poll titled "#What Intensifies Body Anxiety#". Of the 56,000 netizens who participated, 50 percent believed that the "white, young, thin" aesthetic exacerbates body anxiety, while 22 percent said that body anxiety is influenced by the distorted notion that "the world is more friendly to thin people."
This digital age facilitates self-presentation online. An attractive appearance can bring advantages such as social influence, career advancement, and economic opportunities.
"Whether in film and television or on social media platforms, those girls who achieve greater success in their careers tend to have high attractiveness," Wei Zhu says. She cites the examples of her classmates who became more confident after undergoing cosmetic procedures. "Many girls around me have received cosmetic treatments. Having double eyelid surgery or getting an injection has become very common because an outstanding appearance provides more opportunities in relationships and career advancement. I also want to raise my image through cosmetic procedures to seize the opportunities that rightfully belong to me."
Cosmetic surgery advertisements precisely target individuals like Wei Zhu, conveying a promise: Women can enhance their confidence and appeal through cosmetic procedures, thereby gaining greater opportunities both professionally and personally. The overwhelming advertising campaigns have managed to capture the attention of many female consumers. According to the February 2024 Medical Aesthetics Industry Report by Red Book, women account for 96 percent of the most active users in searching of medical aesthetics. Furthermore, 85 percent of these users fall between the ages of 19 and 35.
Cosmetic surgery has become the primary method for women to achieve the standard of being "white, young, thin." According to the "China Medical Aesthetics Industry 2023 Insight Report," the growth rate of the Chinese medical aesthetics market in 2023 is expected to reach 20 percent, with a market size exceeding 200 billion RMB. Data from Tide News reports that over 20 million users have utilized medical aesthetics services. Notably, more than half of these users have undergone multiple beauty treatments over the past five years.
Bingjie Wang , driven by the desire of being "white, young, thin," invested hundreds of thousands of yuan in eight cosmetic surgeries. "I will continue to undergo more procedures," she declares. However, seven out of her eight surgeries were to repair the unsatisfactory results of her first nose surgery. "It looks more and more unnatural, my skin tissue is damaged, and there is the swelling lasts for over a year..." Throughout this arduous process, Wang has endured considerable physical costs and psychological strain.
Yi Sun, the Associate Chief of Plastic Surgery at Zhejiang Provincial People's Hospital, explaines, "Half of the patients who visit our clinic are here for revision surgeries, especially for double eyelids, rhinoplasty, breast augmentation, and liposuction revision procedures." Therefore, Yi Sun believes that in the next three to five years, the number of revision surgeries might continue to increase. "Many beauty seekers have undergone injections at some unregulated institutions, or their aesthetic preferences have slightly shifted, so they come here for revisions. These issues are actually avoidable."
Yi Sun, the Associate Chief of Plastic Surgery at Zhejiang Provincial People's Hospital, explaines, "Half of the patients who visit our clinic are here for revision surgeries, especially for double eyelids, rhinoplasty, breast augmentation, and liposuction revision procedures." Therefore, Yi Sun believes that in the next three to five years, the number of revision surgeries might continue to increase. "Many beauty seekers have undergone injections at some unregulated institutions, or their aesthetic preferences have slightly shifted, so they come here for revisions. These issues are actually avoidable."
On February 23rd of this year, "Focus Report" aired a segment titled "Medical Aesthetics Live Streaming: Selling Products or Bringing Trouble," exposing the tumultuous state of medical aesthetics live streaming. The program revealed a host of issues, including illegal promotions, deliberate misleading, and consumer fraud. It also exposed the sale of unqualified medical aesthetics products and the practice of making enticing promises online only to deliver subpar services offline. These practices have undermined consumer rights.
The frequent issues in the medical aesthetics industry are nothing new. In Hangzhou, for example, Xiang, the Director of the Hangzhou Health Supervision Center of the Hangzhou Municipal Health Commission, points out that the rapid expansion of the medical aesthetics market has been accompanied by intensifying chaos. In 2023, the rate of complaints surged by 185 percent compared to the previous year.
As mentioned by a staff member from the Market Supervision and Administration Bureau of Xuhui District in Shanghai, "During inspections of beauty salons in our jurisdiction, we found that a beauty injection sold for nearly 2,000 yuan only costs a few cents to produce." The high-profit margins make the medical aesthetics industry a lucrative business that attracts many investors.
As mentioned by a staff member from the Market Supervision and Administration Bureau of Xuhui District in Shanghai, "During inspections of beauty salons in our jurisdiction, we found that a beauty injection sold for nearly 2,000 yuan only costs a few cents to produce." The high-profit margins make the medical aesthetics industry a lucrative business that attracts many investors.
From the initial stages of learning about medical aesthetics to the actual procedures performed in operating rooms, the medical aesthetics industry runs with a well-established "supply chain." "Without these, how could medical aesthetics hospitals survive?" said Jirong Li.
Salespeople play a central role in the first step
In the WeChat group "Integration of Feng Ling Team Wealth Exchange," Feng Ling, a sales director for a Shanghai-based medical aesthetics company, shared the process of "service card sales." She disclosed the specific techniques used in the industry to persuade customers to purchase medical aesthetics service cards through psychological manipulation and interpersonal interactions. This meticulously detailed process starts with understanding the customer's needs, followed by the creation of a sense of urgency using the character "Sister Zhang," and ultimately guiding the customer to make a payment. Beauty salons, nail salons, and hair salons are the downstream entities affected by these sales tactics.
"Customer acquisition is our primary method for attracting clients," explains Haoran Tang, a male sales representative. "Our sales are divided into online and offline channels. Online, we get resources from the hospital and use low-cost projects on social media platforms like Meituan and TikTok to attract customers to our store. For example, a 19.9-yuan annual card allows for one visit per month. Each time the customer comes, they are influenced by the atmosphere, and they are gradually encouraged to consume medical aesthetic services. "
"Offline sales involve targeted social interactions to expand and discover new customer groups. For instance, I often visit bars to meet new friends and learn about their social circles. I then manage to make them my potential clients. This approach is especially effective with influencers. Once they undergo a procedure, those around them ask where they had it done, gradually bringing in more referrals." said Haoran Tang.
The customers attracted by the sales team become clients for "medical aesthetics consultants." These consultants persuade beauty seekers and formulate recommendations for medical aesthetics procedures. They also present the expected post-surgery results to the clients.
In addition to his role as a salesperson, Haoran Tang also works as a "medical aesthetics consultant." He explained: "When a woman enters the medical aesthetics environment, she will see various low-cost water light injection advertisements, and that's when the brainwashing begins. I identify her facial issues and start by using psychological manipulation to arouse insecurity by pointing out flaws in her appearance. We then anchor our solution and try to convince her that the procedure will work and enhance her looks." He futher explains: "Next, we create a vision of her post-procedure appearance and help achieve this process. Once she undergoes an initial procedure and observes some results, we guide her towards more expensive treatments. Essentially, we ensure she spends money before leaving, unless she has a very strong sense of self-awareness. Usually, we can manage to persuade them."
The customers attracted by the sales team become clients for "medical aesthetics consultants." These consultants persuade beauty seekers and formulate recommendations for medical aesthetics procedures. They also present the expected post-surgery results to the clients.
In addition to his role as a salesperson, Haoran Tang also works as a "medical aesthetics consultant." He explained: "When a woman enters the medical aesthetics environment, she will see various low-cost water light injection advertisements, and that's when the brainwashing begins. I identify her facial issues and start by using psychological manipulation to arouse insecurity by pointing out flaws in her appearance. We then anchor our solution and try to convince her that the procedure will work and enhance her looks." He futher explains: "Next, we create a vision of her post-procedure appearance and help achieve this process. Once she undergoes an initial procedure and observes some results, we guide her towards more expensive treatments. Essentially, we ensure she spends money before leaving, unless she has a very strong sense of self-awareness. Usually, we can manage to persuade them."
Next, the hospital receives these successfully persuaded beauty seekers and arranges for them to meet the lead surgeon, who provides the final treatment plan. Nurses handle the paperwork, payment, and medical examinations before scheduling the surgery.
Next, the hospital receives these successfully persuaded beauty seekers and arranges for them to meet the lead surgeon, who provides the final treatment plan. Nurses handle the paperwork, payment, and medical examinations before scheduling the surgery.
As disclosed by a female technician at a foot massage parlor in Fuyang District, Hangzhou: "Many people around me take out loans to undergo cosmetic surgery. Cosmetic surgery hospitals collaborate with banks to provide online loans. This method has left many people with mounting debts." She also mentioned the close cooperation between hospitals and banks, "Bank representatives stay directly at the hospital, with dedicated offices to handle loan matters."
"Top-performing salespeople or consultants can even earn an annual salary of over 2 million yuan," explained Ge Li, a sales representative in the medical aesthetics market in Taicang, Jiangsu Province. "The commission in the medical aesthetics industry is not based on profit but directly on the consumption amount. Typically, 40 percent goes to the salespeople, 10 percent for downstream stores, 40 percent for hospitals, and 10 percent plus a fixed salary for medical aesthetics consultants. Doctors usually have a fixed salary of over 2 million yuan as well."
As disclosed by a female technician at a foot massage parlor in Fuyang District, Hangzhou: "Many people around me take out loans to undergo cosmetic surgery. Cosmetic surgery hospitals collaborate with banks to provide online loans. This method has left many people with mounting debts." She also mentioned the close cooperation between hospitals and banks, "Bank representatives stay directly at the hospital, with dedicated offices to handle loan matters."
"Top-performing salespeople or consultants can even earn an annual salary of over 2 million yuan," explained Ge Li, a sales representative in the medical aesthetics market in Taicang, Jiangsu Province. "The commission in the medical aesthetics industry is not based on profit but directly on the consumption amount. Typically, 40 percent goes to the salespeople, 10 percent for downstream stores, 40 percent for hospitals, and 10 percent plus a fixed salary for medical aesthetics consultants. Doctors usually have a fixed salary of over 2 million yuan as well."
The ultimate driving force behind the ever-thriving industry chain is, after all, the consumers. "Most do it for self-pleasure, but many also do it to please others," remarked Bingjie Wang and others during interviews. They expressed that alignment with the "white, young, thin" aesthetic through cosmetic surgery can help them attain better social status and even improve marriage prospects. This sentiment echoes the reasons why Rongfang Zhao and others chose the three-inch golden lotus.
The ultimate driving force behind the ever-thriving industry chain is, after all, the consumers. "Most do it for self-pleasure, but many also do it to please others," remarked Bingjie Wang and others during interviews. They expressed that alignment with the "white, young, thin" aesthetic through cosmetic surgery can help them attain better social status and even improve marriage prospects. This sentiment echoes the reasons why Rongfang Zhao and others chose the three-inch golden lotus.
A century ago, the practice of foot binding among women was driven by oppressive feudal ethics and a distorted societal pursuit of female beauty. A century later, the fervent chase for cosmetic surgery is similarly propelled by capital marketing and industry promotion. "When women are constantly fed the message that cosmetic surgery is the prerequisite for beauty, confidence, and success, they become prone to short-term satisfaction and long-term psychological pressure from such procedures," says Zurong Liang, a doctoral advisor in sociology at Zhejiang University. "This marketing strategy not only exploits women's desire for beauty but also exacerbates their dissatisfaction and anxiety about their own appearance."
A century ago, the practice of foot binding among women was driven by oppressive feudal ethics and a distorted societal pursuit of female beauty. A century later, the fervent chase for cosmetic surgery is similarly propelled by capital marketing and industry promotion. "When women are constantly fed the message that cosmetic surgery is the prerequisite for beauty, confidence, and success, they become prone to short-term satisfaction and long-term psychological pressure from such procedures," says Zurong Liang, a doctoral advisor in sociology at Zhejiang University. "This marketing strategy not only exploits women's desire for beauty but also exacerbates their dissatisfaction and anxiety about their own appearance."
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