'I've had 100 operations and will never stop' - inside China's cosmetic surgery boom

22 April 2025

Natalia Zuo

BBC Eye, World Service Investigations

Abby Wu, who's had more than 100 operations, is one of China's first cosmetic surgery influencers

BBC A young woman with a surgically-enhanced face, wearing a pink jumper, stares at the camera. White lines have been imposed over her face by a cosmetic surgery app called SoYoung — Abby Wu, who's had more than 100 operations, is one of China's first cosmetic surgery influencers

Abby Wu was just 14 when she had cosmetic surgery for the first time.

After receiving hormone treatment for an illness, Abby's weight increased from 42kg (6 stone 8lbs) to 62kg (9 stone 11lbs) in two months.

The change hadn't gone unnoticed by her drama teacher.

"My teacher said, 'You were our star but now you're too fat. Either give up or lose weight fast,'" recalls Abby, who was preparing for her drama exams at the time.

Abby's mother stepped in, taking her to get liposuction to remove fat from her belly and legs.

Abby re her mother's words as she waited in the clinic in a hospital gown, nervous about the impending operation.

"Just be brave and walk in. You'll become pretty once you're out."

The surgery was traumatic. Abby was only given partial anaesthesia and remained conscious throughout.

"I could see how much fat was extracted from my body and how much blood I was losing," she says.

Abby pictured before she had her first surgery, aged 14

Family handout A teenage girl with shoulder-length hair, dressed in a swimsuit, stands behind a rubber ring, with a beach behind her — Abby pictured before she had her first surgery, aged 14

Now 35, Abby has gone on to have more than 100 procedures, costing half a million dollars.

She co-owns a beauty clinic in central Beijing and has become one of the most recognisable faces of China's plastic surgery boom.

But the surgeries have come at a physical cost.

Sitting in front of a mirror inside her luxury duplex apartment in Beijing, she gently dabs concealer onto bruises from a recent face-slimming injection - a procedure she undergoes monthly to help her face appear "firmer and less chubby" after three jaw reduction surgeries removed too much bone.

But she insists she has no regrets about the surgeries and believes her mother made the right decision all those years ago.

"The surgery worked. I became more confident and happier, day by day. I think my mum made the right call."

Abby documents her cosmetic surgery journey on social media, showing some of the realities of going under the knife

Abby Wu A young woman with a thick brown plaster stretching across almost the entirety of her nose and much of her face. A white bandage is wrapped around the edge of her face, including her chin, and there are signs of bruising and blood on parts of her face. — Abby documents her cosmetic surgery journey on social media, showing some of the realities of going under the knife

Once seen as taboo, plastic surgery has exploded in popularity over the last 20 years in China, fuelled by rising disposable incomes and shifts in social attitudes, in large part driven by social media.

Every year, 20 million Chinese people pay for cosmetic procedures.

Overwhelmingly, it is young women who seek surgery. Eighty per cent of patients are women and the average age of someone receiving surgery is 25.

While appearance has always been important in Chinese culture, particularly for women, beauty standards in the country are changing.

For years, the most sought-after features were a blend of Western ideals, anime fantasy and K-Pop inspiration: The double eyelid, the sculpted jawline, the prominent nose, and the symmetrical face.

But lately, more disturbing procedures are on the rise - chasing an unrealistic, hyper-feminine, almost infantile ideal.

Details of help and with body image concerns are available in the UK at BBC Action Line

Botox is now injected behind the ears to tilt them forward, creating the illusion of a smaller, daintier face.

Lower eyelid surgery, inspired by the glassy gaze of anime heroines, widens the eyes for an innocent, childlike look.

Upper lip shortening narrows the space between lip and nose, thought to signal youth.

But much of this beauty is built for the screen. Under filters and ring lights, the results can look flawless. In real life, the effect is often uncanny - a face not quite human, not quite child.

Toxic beauty standards are being shared on social media in China, distorting what is seen as normal

TikTok Three images of women on social media show various toxic beauty standards. On the left a woman reaches her hand behind her back and touches her tummy button. In the middle image a woman dressed in tiny shorts and a crop-top looks very thin. In the third image, a woman stacks dozens of coins in a gap in her collar bone — Toxic beauty standards are being shared on social media in China, distorting what is seen as normal

An advert by the cosmetic surgery app SoYoung's said a "woman is only complete when she's beautiful"

SoYoung A huge crowd of attractive women in white dresses are stood bare-foot on the soft sands of a beach, staring at the camera — An advert by the cosmetic surgery app SoYoung's said a "woman is only complete when she's beautiful"

Cosmetic surgery apps like SoYoung (New Oxygen) and GengMei (More Beautiful) - claiming to offer algorithm-driven analysis of "facial imperfections" - have been surging in popularity.

After scanning and assessing s' faces, they provide surgery recommendations from nearby clinics, taking a commission from each operation.

These and other beauty trends are shared and promoted by celebrities and influencers on social media, rapidly changing what's considered desirable and normal.

As one of China's earliest cosmetic surgery influencers, Abby has documented her procedures across major social media platforms and ed SoYoung soon after it launched.

Yet despite having undergone more than 100 procedures, when she scans her face using SoYoung's "magic mirror" feature, the app still points out "imperfections" and suggests a long list of recommended surgeries.

"It says I have eye bags. Get a chin augmentation? I've done that."

Abby seems amused.

"Nose-slimming? Should I get another nose surgery":[]}