OPERATIONS in the Plastic Surgery Section of Shanghai Ninth People's Hospital are in full swing and the waiting room is thronged with young people waiting for cosmetic surgery.

Among them is a little girl accompanied by her mother. The mother said her five-year-old daughter is waiting for an operation to create double eyelids and to put two dimples in her cheeks.

Several of the daughter's playmates have had plastic surgery and they now look more beautiful, said the mother. She thought her daughter could look just as beautiful.

Plastic surgery used to be for disfigurement. Then it was favoured by middle-aged women who wanted to conceal traces of ageing. And today, it is burgeoning because an increasing number of teenagers want it and are rushing to have it.

Each day some 70 students - almost half from middle schools - turn up at Shanghai Ninth People's Hospital.

Routine operations

The hospital routinely offers services such as double eyelid creation, pouch resection, and operations on the nose and ears. Each operation costs 1,000 yuan (US$121) on average, a good sum of money for a teenager. But this hasn't slowed down their rush to have some plastic surgery, no matter how minor.

Some students submit themselves for more major surgery - operations on breasts or jaws, which cost more than 2,500 yuan (US$302), almost a month's income for an ordinary family.

"I am to take the senior middle school entrance examination, and you know, face to face interview is required in some schools. Plastic surgery can remedy some of my 'defects' and I will be more confident after the surgery. I hope I can win an edge over others," said a student surnamed Liu from Shanghai Middle School.

His words reflect the thoughts of most operation-seekers. At present, due to tougher competition, some students believe success can only be obtained if competence and ability are combined with a more charming appearance.

"Teenagers are maturing and they care much more about how others think about them. Thus, they'd like to 'keep up with Joneses'. If a boy's classmates or friends have plastic surgery but he doesn't, he will feel ashamed and think he has lost face," said Jiang Weimei, director of Jing'an Psychological Health Guide Centre.

Star struck

She also said teenagers were still emotionally immature, they were easily influenced, by well-known pop stars for example. If they were a fan of some film star, they were likely to dress themselves and try to behave in the same way as the star - some even consummate their worship by trying to become a "copy" of the star.

"Some students come to our hospital with photos of Andy Lau (famous Hong Kong singer and actor) or David Beckham (famous British soccer player) and they ask us to give them Lau's nose and Beckham's eyes," a surgeon in the Plastic Surgery Section in Shanghai Ren'ai Hospital said.

Many students waiting for plastic operations have the backing of their parents.

A mother surnamed Luo waiting in Shanghai Ren'ai Hospital said several children of her colleagues had had plastic surgery, so she thought she should also bring her daughter along for an operation.

The 1,000 yuan (US$120) or so for an operation is not too expensive, and would be money well spent if the daughter becomes more beautiful.

"Actually, parents are the real driving force behind this tide of demand for plastic surgery. They like to make a comparison between their children and those of their colleagues. And they always load their impractical expectations onto their children," Jiang said.

She said a woman took her 12-year-old daughter to have operation on her breasts in the hope that she would win a modelling contest. And another mother had her daughter operated on several times just so she could be accepted into a famous art school.

False hopes

This issue is now arousing widespread concern. Some doubt the useful effects of plastic surgery. They don't think an improved appearance gained on the operating table will really be a big help in competing for a job.

In their opinion, what counts most is one's ability rather than one's looks.

Some students resort to cosmetic surgery on their mouths to help improve their oral English. They think they owe their not-to-fluent English to their big tongues and they believe that an operation on the tongue can solve the problem.

"There isn't any evidence showing that an operation on the tongue can really help. I think some students are misled by the media. I think we should correct the media and give students correct guidance," said Yang Xiong, head of Shanghai Social Academy Teenager Research Institute.

Teenage plastic surgery has other opponents. Surgical experts who oppose it believe that facial tissue and muscle grow at different paces. As teenagers are still growing, the surgery may hinder their facial development.

"Children under 16 are not fit to have plastic surgery because it is harmful to their growth. And it's very hot during summer, germs can propagate very rapidly and the cuts can be easily infected," said Sun Baoshan, chief surgeon in Shanghai Ninth People's Hospital.