WHEN Jackie Chen, 24, received the offer from a first-tier university in Shanghai six years ago, she turned to her parents to ask for the present she had wanted since she was 10 years old — cosmetic surgery for double eyelid.

“I am so glad that I did the eye job. It changes me into a self-confident girl,” she tells Shanghai Daily.

Chen, a clerk at a foreign trading company, is part of a wave of young women and some young men who want to look better and improve their chances in social competition and relationships.

The 2-month summer vacation that started this month is the peak season for students (overwhelmingly women) just finishing high school or just out of college to get plastic surgery.

“They all want the common standards of beauty: big eyes, higher-bridged nose, small face, white and brightening skin,” says Dr Xu Jinghong, deputy director of the Plastic Surgery Department at the First Affiliated Hospital, Zhejiang University.

A Shanghai survey found that about 20 percent of high school graduates and university students plan to have facelifts. Double eyelid and nose reshaping are the most popular procedures, especially for students, as they are considered to have the biggest impact on appearance.

There are two main methods of double eyelid procedure: full incision and buried sutures. Chen did both. The first time, she chose so-called “buried sutures.” It is a non-incision, non-invasive procedure in which small sutures are knotted above the eyes to create the fold.

“I recovered from the swollen eyes about 10 days after the procedure,” says Chen. Her parents paid 12,000 yuan (US$1,950) for it in a private hospital.

Unfortunately, as her eyelid is too thick, her double eyelid went back to its original shape in less than a year, a common issue of buried sutures.

So during the following summer vacation, she underwent the full incision to remove the excessive fat, muscle and skin. The looser the skin is, the deeper the cut.

She also went for a lateral canthus (eyelids on the outside corner) reconstruction so the eyes can appear bigger. The surgery took nearly two hours. After one year of recovery, she finally has what she longed for — “big and shinier” eyes.

“It is a quite painful process, but all worth it,” Chen says, recalling the post-surgery bleary red eyes and severe bruises around the eyelids.

“Once when I was taking the bus, I overheard two people talking about whether I had just suffered domestic violence. After that, I wore my sunglasses pretty much everywhere I went,” Chen recalls.

No matter how tougwh the plastic surgery was, Chen says it got rid of her low self-esteem and she now attributes almost every good thing to her new look — more male friends, success on a job interview at a foreign trade company and even better style taste.

“I loathe the old me who always wore sportswear, no makeup and never tried to eat less and keep fit,” she says, sitting in a trendy restaurant in Shanghai. She wears a yellow printed minidress and light makeup, with shimmering shade on her eye area. Even her nails are polished with tiny crystal ornaments.

Nonetheless, Chen thinks she is not “pretty enough.”

“My face is too big so I am thinking of getting an injection to make it smaller,” she  says.

“I can’t say plastic surgery is something people will be addicted to,  but some people will grown very fond of it,” Dr Xu says. “When you see how it changes you, the pleasure is too huge to outdistance the fear. And the ability to bear pain and risk will become stronger.”

Cosmetic surgery first appeared in China in the 1920s, but only in Shanghai. Back then there was only simple surgery, like double eyelid and nose straightening.

During the “cultural revolution” (1966-76), the development of plastic surgery was ceased since individualism and vanity were denounced.

It was not until the end of the 1970s that China started to open up. Once again, it was good to care about personal appearance. Plastic surgery and beauty treatment became options.

Xu has performed plastic surgery for 23 years, treating more than 20,000 cases. He says the number is increasing every year. Most clients are young women born in the 1980s and 1990s.

Cathy Lao, 23, regularly goes to the plastic surgery clinic and gets a skin-whitening injection once a month, a dermal filler injection for reshaping her nose once every six months, and a BOTOX injection for her face. She has spent more than 150,000 yuan a year on these injections since she was 20.

“I saw my friend’s nose job and face job. It was amazing, so I decided to give it a try. I don’t think I can go back anymore,” Lao says.

For her, life is like a beauty pageant: The prettier you are, the more opportunities you will get.

“You can’t blame them for having thoughts like this,” says Shanghai sociologist Gu Xiaoming from Fudan University. “Who doesn’t want to be beautiful, especially when you are young? Plus beauty hegemony is now raging in the society.”

People sometimes get discriminated against for plain looks. Their social circle, career and marriage all seem related to how they look.

“There is deformity in culture and aesthetics in the society now,” Gu says, citing some celebrities popular among young people who are very pretty but shallow. “They can’t act or sing, barely have any special talents except for their appearance. And that often is artificial. Yet they are rich and successful.”

“I miss my chubby daughter,” says Chen’s father, Roger Chen. “Sure, she is much more confident now and prettier but she cares too much about her look.

“She gets upset gaining 1 kilogram and spends too much time online, shopping for garments,” he adds.

The young Chen used to like Czech writer Milan Kundera and Chinese poems, but now she barely reads anything but fashion magazines and makeup tips, says her father. And she takes selfies many times a day and puts them on the social network.

“The dangerous part of plastic surgery is not how it has changed you physically but how it changed your personality,” says Gu, the sociologist. “It turns a natural person ‘unnatural’ and she/he becomes a copy of some beautiful face prototype.”

Another hot procedure for young women is breast augmentation. But it has safety issues that are always a top concern among both industry insiders and the beauty seeker.

Breast augmentation is done through medical implants using silicon gel or the person’s own fat. The current technique is to use both medical implant material and the patient’s own fat transplanted from her belly and thigh.

People considering plastic surgery should go to qualified, certificated hospitals or clinics, and those with a history of hypertension and diabetes must inform the doctor on the first visit, experts say.

“The medical accident rate of plastic surgery by licensed hospitals is 10 to 20 percent, just like the ordinary medical accident rate, or even lower,” Xu says.

Backstreet beauty parlors should be avoided. They tend to use new, untested medicine and medical implants, which sometimes end up causing cancer. In the first five months of the year, the Shanghai Health Supervision Agency closed six such establishments, none of which was licensed to carry out surgical procedures.

Emotional condition is also very important for people considering plastic surgery.

“People should be clear what they really want,” Xu says. “Don’t rush to a doctor but instead think it over.”

People have high expectations for cosmetic procedures but should be aware that results can vary and may not be as perfect as what they imagine based on posters and advertisements.

“Also, people suffering depression are not advised to do plastic surgery, since they can’t accept even an obscure flaw in the surgery,” he says. “And you have to fully understand the analysis from the doctor before doing the surgery.”