Li Fei cannot make up her mind. By turns consulting a small pocket mirror and a hospital pamphlet, the 20-year-old sits with a dozen other women in the plastic surgery department at Shanghai's Ninth People's Hospital, contemplating a future seen through different eyes.

The young college student is considering eyelid reconstruction, the most popular - and most dangerous - cosmetic procedure in China. During the 30-minute surgery, doctors will cut, fold and sew her upper eyelids with what looks like a little fishhook to create a crease above her eyes.

Li Fei believes that creased eyelids will improve her chances of securing a good job and a suitable husband after graduation. "People often make judgements based on one's appearance," she says, peering into the mirror once again. "Bigger eyes make you look more awake, more beautiful."

Women young and old share Li's outlook and are lining up to undergo double eyelid surgery. Whether it's career ambition or a desire to marry well that provides the motivation, the procedure's popularity says a great deal about the shift in China's ideal of beauty. To some, eyelid reconstruction caters to foreign ideals of beauty - the Western caricature of Asians typically focuses on the eyes - and is nothing more than an attempt to 'look Western.' Those undergoing the operation typically deny that Audrey Hepburn is their goal, but it is hard to imagine what, if not the lure of looking a tad more European, makes wider eyes inherently more attractive than smooth lids. The grass is greener, perhaps?

While the daily application of glue or tape can offer a makeshift solution, many women are eyeing the operation, which can cost up to 3,000 yuan, as a more permanent answer.

Li Fei is not worried about the cost. "My parents are paying for it."

Growing numbers of women are convinced that the long-term financial benefits more than compensate for the initial outlay. This May, Li Fei will join six-million other graduates entering the intensely competitive job market. Her parents, fearing that the years of supplementary classes, private tutors, and instruction in the finer arts of music and dance may not guarantee her success, have joined the thousands sacrificing weeks' worth of salary to pay for their children's nips and tucks.

A survey of university graduates in 2002 found that 54.3 per cent of new job seekers identified physical appearance as the defining factor in securing a position. The idea that good looks hold the key to opportunity has prompted Yu Peipei to spend almost two months' salary on plastic surgery in the hope of improving her performance at work. "I'm a salesgirl at a department store," she explains. "The better I look, the more I sell."

Her aunt, Wu Xiuying, fully supports her choice: "It is wonderful that women now have the opportunity to make themselves more beautiful. They should take advantage of it."

And they are. All over the city plastic surgery departments in hospitals and clinics are bustling with patients. In Beijing alone, there are now around 30 accredited clinics, and hundreds of unaccredited ones. Summer is peak season for plastic surgery, and most patients are 25 to 45 year-old women, many of whom are trying to enrol in performing arts schools.

"We're performing two to three surgeries a day on average," says Belinda Wang, marketing manager at Beijing's VIV International Medical Beauty Clinic (some of Shanghai's private clinics report performing 20 to 30 procedures a day to keep up with the growing demand, and the Ninth People's hospital conducted over 26,000 cosmetic surgeries last year, a 40 per cent increase from 2002)

"Liposuctions and eyelid surgery are among our most popular procedures," adds Wang. "I'm very optimistic about the future ... the field is ever-improving and there is a developing 'beauty economy'." Ben Chang, the marketing director at Fu Hua Aesthetics, a private plastic surgery clinic in Shanghai that sees 8,000 patients a year, agrees: "Chinese culture is more accepting and open to plastic surgery ... and people now have money to spend to improve their quality of life."

One young woman's high-profile bid to improve her looks is perhaps responsible for the recent nationwide shift. Last summer, we first reported about Hao Lulu, an unemployed fashion writer from Beijing who completed six months of donated plastic surgery from the capital's Ever Care clinic in a 'live advertisement' for the company. Regular TV updates and splashy tabloid spreads detailed her every alteration for a rapt audience.

Hao's first deficiency - her smooth, creaseless eyelids - was the first to be erased. But she did not stop there. The aspiring actress eventually underwent US$36,000 worth of liposuction, breast implants, nose reconstruction, hairline correction, calf enlargements, and face-narrowing jawline surgery. Her efforts paid off, too. Her glamorous new look landed her a glamorous new job: a starring role in Taiwanese drama Meteor Garden alongside pop pretty boys F-4.

Not that all eyelid reconstruction patients are interested in fame and fortune. Sun Qingmei, an attractive 45-year-old divorcee, says: "I am just looking for an honest man to marry. I need help paying my mortgage and my son's school fees. I want to lift my eyes to look younger." She seems certain the investment will pay off. "It is my decision. I will pay what it costs."

Gao Lingjuan defends her choice with equal conviction. "This is not my fiance's decision," says the 35-year-old, dark glasses hiding bruised and swollen eyes. Gao was operated on a week ago, and she is here for a routine check up. "I trust the doctors here. Nothing went wrong."

Some are not so lucky. Liu Xingmei, a teacher in her 50s, is waiting for her final post-operative care after three separate visits to the operating room. She initially embarked on her surgical saga to solve a lifelong problem of sagging eyelids. "The first time I had it done, at a private home by a local practitioner," she says, "one eye ended up bigger than the other. The second time, I had it done at a salon but the stitches got infected. This time, I went to the hospital and it looks good."

Liu is just one victim of over 200,000 botched operations over the last decade, as untrained practitioners lured unsuspecting patients with promises of an instant new look. Eyelid surgery, if done incorrectly, can cause nerve damage, punctures in the eyelid, or even blindness.

Despite the continuing dangers of a largely unregulated industry, the women wandering the unadorned waiting room defend their choice for a new pair of eyes. Whatever their origins, the women say, double eyelids will bestow confidence and new opportunities.

Li Fei is still unsure but dismisses any suggestion that she is simply conforming to a Western ideal. "I am not trying to look like some American celebrity. I am just trying to be a better version of myself."

(That's Magazine  July 5, 2004)