The real price of beauty

Tram, a restaurant owner in Vietnam's largest city, is not stingy when it comes to being beautiful. She has just had her eyebrows, eyelids, neck and nose done. And that's not all...

"After five operations on my face, as soon as I recover, I will have liposuction on my belly," says the 50-year-old woman, her face swollen and covered in bandages.

Once the bandages come off, Tram could look like a wax model in Madame Tussaud's museum. But at least she feels healthy. Many others having plastic surgery here are not so lucky.

Vietnam, which posted over eight percent economic growth last year, has seen the emergence of a burgeoning middle class, mainly in and around the commercial hub of Ho Chi Minh City and the capital Hanoi.

Serious medical problems
Tom Cuong Nguyen, an Australian-born Vietnamese doctor who runs the "perfect skin" ward at the Columbia Saigon Clinic, says many women suffer "complications due to the injection of an unidentified liquid into their breasts, lips or cheeks".

Others looking for longer eyelashes end up with infections caused by dangerous implants, according to Nguyen Thang, head of the plastic surgery unit at the Franco-Vietnamese Hospital here.

"Failure to use sterile instruments can also cause cases of hepatitis," he adds. After decades of war and suffering, women in booming Vietnam are embracing many Western creature comforts, including the right to look better.

Justifying the right to be beautiful
Beauty treatments, cosmetics and plastic surgery are all the rage here. "My husband and I have a successful business that we are very proud of," Tram says.

"Unfortunately, I was not born beautiful and I have turned 50. In the restaurant business, you really need to feel confident and meet people, so I decided to have cosmetic surgery. My husband supports this decision."

Marc Villard, head of operations for the French-based Pierre Fabre pharmaceutical group in Vietnam, says the beauty craze first took off in the early 1990s.

"Fifteen years ago, Vietnamese women plastered themselves with thick face creams mixed with powder to make their skin whiter," he says.

Now, women see make-up and surgery as equally viable options in the quest for good looks, and most remain ignorant of the risks associated with such operations.

The price to pay for beauty
They don't think twice about getting a 300-dollar nose job, a 500-dollar eyelid lift or breast implants for as little as 2 000 dollars – a fraction of what a woman would pay in the West.

While Vietnamese women may want to mimic their counterparts in the West, they do not want Nicole Kidman's nose or Scarlett Johansson's ample bosom, but covet the physical assets of Chinese actresses and local beauty queens.

They also want procedures to be performed as quickly as possible. "Some come in for a consultation in the morning and want the surgery in the afternoon. Some don't even want a general anesthetic, because they don't want to waste time in the recovery room," Thang notes.

This devil-may-care attitude, coupled with the total lack of regulations in the sector, means a windfall for surgeons – qualified and otherwise.

"In Ho Chi Minh City, at least 200 plastic surgery clinics are in operation, but only 50 or so are accredited by the city health authorities," the doctor adds.

Most practitioners can only operate on the face, with a hospital stay required for procedures done on other parts of the body.

Unauthorised medical practicesNevertheless, most clinics offer breast surgeries and liposuction, using colourful ads, dubious references and certifications that may or may not be authentic. A few weeks ago, a Vietnamese surgeon was barred from practising after performing an unauthorised operation.

A judicial inquiry has been opened. Practitioners say the sector itself needs a face lift. "Only Hanoi University offers a certificate programme in plastic and cosmetic surgery. Vietnam is like France 20 years ago," Nguyen says.

"Most practitioners are certified ear, nose and throat specialists who can perform orthopedic and thoracic surgeries."

Surgeons often train on the job here. Some become good doctors. Others instead offer their services to shady beauty salons and spas, where plastic surgery is performed in a back room with only an hour's notice.

The nip-tuck craze has extended from the middle class to the prostitutes of the former Saigon, where an A or B cup may no longer be sufficient to attract high-paying clients in the city's brothels.

So what about Vietnamese men? They're largely unconvinced, but some have been tempted to go under the knife for surprising reasons.

"When they fail in business, their fortune teller tells them it's because their nose is too flat or they have a mole that is too close to their eyes or nose, which is considered to be a sign of bad luck," Nguyen says. "The day after, they come in for surgery."

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