Photos From Inside China’s Cosmetic Surgery Boom

"I had anxiety about my appearance long before this work was made," says 29-year-old Chinese photographer Yufan Lu. She’s discussing her new photo project, Make Me Beautiful – a brutal and devastating deep dive into cosmetic surgery culture in her home country.

"The idea came from popular media, which has little tolerance for anything other than beauty, but also from my own experiences. I’ve received some really harsh comments on my appearance over the years – things like: your eyes are too small, you need to diet – and then the comments I received at cosmetic surgery hospitals actually echoed the ones I’ve received in daily life." This wasn’t too surprising, she says, because their comments only reflect the beauty standards of Chinese society at large.

Lu grew up in Tianjin, an industrial city next to Beijing. Where she’s from, she says, very specific beauty ideals and life choices are thrust upon young people – and young women, especially. "It’s believed that if you look young and beautiful it will be easier for you to get a job, find a good husband (or wife) and marry into a better-off family. The great life pressure in China also deepens people's anxiety: if you don't earn a certain amount of money by a certain age you are a loser; if you try to look for a job over the age of 35 it would be difficult; if you don't get married over the age of 30 you'll be called a 'leftover woman'. All these ‘social norms’ furthermore deepen women's anxiety about their appearances." In China, more than 10 million cosmetic surgery procedures are performed every year.

Make Me Beautiful takes us inside cosmetic clinics in cities including Beijing, Tianjin, Hangzhou and Chengdu, and also in South Korea, where many Chinese people travel to regularly for cosmetic surgery or medical beauty procedures. At each clinic, Lu asked the consultants, known as 'beauty designers', to put together surgery plans for her. The results are a fascinating yet terrifying set of 'diagnoses' picking apart her appearance: passport-style headshots scribbled all over with measurements, simulations of how she could look.

Particular 'types' of faces are most popular, Lu says, reeling them off from memory. "There’s the ‘innocent and pure style’ (which you could also call ‘the easy to get married style’), the internet celebrity style, the high-level style (this is the face that top models usually have), the anego style (which means 'powerful woman') and the group idol style." Lu says she began to notice how narrow the options were when she’d go to clinics and they’d ask what kind of face she wanted to have. And so she began visiting different clinics with different aims in mind, like an experiment. "When I said I wanted to have the face of an internet celebrity, some clinics told me it would be difficult because my face's natural conditions decide that I can't change into that kind of face." That’s because 'that kind of face', she explains, is one with big eyes and wide double eyelids – "otherwise known as European eyes, because people think they are characteristic of Caucasian people, alongside a small nose and a pointed chin," she says. Of course, there were other clinics that told her they could make anything happen, so long as she could pay the money. 

Once she began visiting surgeries, Lu was surprised how easy it is to choose face styles from a shelf, like you would clothes at a shopping mall, and it really opened her eyes to the realities – and injustices – of the industry. "I learned that the people who I consulted with are more like salespeople than medical workers. They have this set of questions and based on your answers they’ll know your economic viability, and then they’ll give you different suggestions accordingly. For example, for richer people wanting a taller nose they’ll offer a rhinoplasty with an imported nasal implant which is higher quality and more expensive, while for those with less money they would offer hyaluronic acid injections."

The surgeries as seen in Lu’s pictures are eerily empty and clinical while still often overtly feminine, which gives them the strange quality of feeling both clinical and commercial. In some clinics, she says, "you can see lace and flower patterns on the sofas and intricate, bright white 'rococo-style' furniture that reminds you of a woman's living room," but you can also see the cold silver of magnifying mirrors, and machines to measure out your imperfections. In one particular photograph, a set of blindingly illuminated white steps disappear into a hole in the ceiling, like something from a sci-fi film. Lu says the consultant at that place nicknamed it the 'time tunnel'. Some clinics really emphasise this sense of future, she says, "partly to show that they have the most advanced equipment and partly to suggest that people become beautiful and young again, as if they’ve stepped into a time machine."

The most bizarre diagnosis experience Lu had, she remembers, was at a clinic in Beijing. "I went to this particular clinic with the aim of becoming beautiful to marry well. At some point, I was taken to the clinic’s director and to my surprise, he started to analyse my physiognomy: ‘Your temples are sunken. Sunken temples mean bad luck in love.’ He also said that I look fierce, which means that I have a bad temper. The way he talked was like he really cared about my mental wellbeing and to be honest I was even moved," she says. "Until he concluded that I need to do a facial fat transfer," she adds, only half laughing. 

Even though she believes our societies should have more diverse beauty standards, Lu also says that this work has helped her to have real empathy and understanding for the people who have cosmetic surgery. "There’s no difference between them and the way I consulted different clinics trying desperately to find a way to liberate myself from my own anxiety," she says truthfully. "I know how helpless it feels to internalise social beauty standards, and people undergoing surgery are courageous." Overall, she says, it’s not about whether surgery is right or wrong but what can and should be done to tolerate different kinds of beauty so that surgery doesn’t always feel like the only remaining option. 

She also says there should be more rigorous supervision of the industry, to protect those using its services. "People are at their most vulnerable when they consult a surgery, and sometimes they can be easily induced by the verbal tricks of the staff. Some people I know were asked to sign operation agreements right before they entered the operating room, giving them little time or comfort to check the terms, and so if problems are encountered it's difficult for them to defend their rights. Not to mention that there are illegal cosmetic surgery clinics, which don't even have a fixed location and just move around China, finding a place to stay for one day or two, to perform surgeries by appointment before moving on. They’re even more risky but they still have customers because they are cheap."

In the end, the image that most stays with Lu is one she took of an 18-year-old girl, just three days after undergoing cosmetic surgery. In the portrait, the girl stares into the lens, blurred city lights behind her, the skin around her eyes glistening and slightly bruised. "She had just graduated from high school and she said her parents and friends all supported her decision of doing the surgery," Lu says. "She also told me she wanted to become an internet celebrity and make money from that career." Becoming beautiful meant the promise of her world opening up and everyone around her agreed. That’s because beauty is currency. Not just in China but everywhere. "Even on social media platforms like TikTok now, people's faces are covered under filters," Lu says. "It’s like we’ve become more and more used to this world of simulacra that we are more and more intolerant of how we really look."

Meanwhile, Lu says, she was able to move past the crippling anxiety she had in regards to her own self-image. "I started working on this project out of curiosity, like an experiment on myself, but for some reason it eventually became a therapy for me." From looking and being looked at so intently, she says, she became capable of resisting the gaze of the outside world and appreciating herself for what she is instead.