A young woman undergoes aesthetic treatment. Photo: VCG

The phone glowed in 18-year-old Xiaoyu (pseudonym)'s hand, illuminating a photo of a celebrity's perfectly sculpted eyes. "I want these," she said to a plastic surgeon at a cosmetic hospital in Yangzhou, East China's Jiangsu Province, local media reported.

For Xiaoyu and thousands of fresh high-school graduates, summer marks a frenzied transition from exam halls to operating rooms.

Across China, plastic surgery units hum with this seasonal energy. 

Multiple hospitals estimate a 30 percent spike in aesthetic procedures in summer vacation, with high-school graduates accounting for most of the surge, according to CCTV News.

"Fifteen slots can get snapped up in as little as three seconds," a Zhejiang-based plastic surgeon says, adding that they have upped daily capacity to 35 just to keep up. There are doctors doing seven to eight procedures a day on young people.

At Nanfang Hospital, the number of students seeking to undergo cosmetic procedures also increased from 10 percent to 30 percent compared to regular days, with an extra hundred monthly surgeries booked through July and August, said the report.

Risks behind the hype 

The "must-have" procedures reflect a curated hierarchy of adolescent desires. Double-eyelid surgery dominates the majority of student consultations, branded as van "entry key" to transformation. 

A student surnamed Chen suffered severe acne breakouts during the stressful exam period. Acne scar repair offers much-needed relief and renewed confidence for Chen and other graduates facing the same problem.

"I won't enter university with this face," he resolved, starting laser treatments.  

But the most meteoric rise belongs to slimming injections. Quick, affordable, and requiring low-downtime, slimming injections promise refined jawlines and are remarked as a "remedy" for perceived "square faces" or asymmetry. Over three years, this procedure has dethroned traditional favorites like acne removal and spot lightening among teens.

What surprises clinicians is the number of teens worried about hair loss, the temporary "telogen effluvium" triggered by exam stress, late-night cramming and crash diets.  

Beyond facial treatments, Lu Feng, a plastic surgeon receives daily requests for liposuction from teenagers whose weight could be better managed through diet and exercise. "The real question is whether they are psychologically ready for the consequences," he said, according to CCTV.

Another popular trend among young students is that of tattoos. "Many high school students get tattoos for a few hundred yuan just to look 'cool.' It's only when these students want to join the military after the gaokao that their parents discover the tattoos on their bodies," said another doctor Shi Ge, according to CCTV. 

Removing a tattoo, she explains, is expensive and far from a "one-and-done" process. 

It often requires a treatment cycle of over six months, and may leave visible scars, making them ineligible for military service.  

"We hope that before pursuing beauty, students will first take responsibility for themselves," she said, according to the CCTV report.

Some doctors have stated that certain plastic surgery procedures are not suitable for high school graduates. The results of surgeries like double- eyelid surgery or getting face-slimming injections vary from person to person. 

Generally, plastic surgeons discourage minors from undergoing such treatments, unless there are obvious physical issues that require improvement through medical aesthetic procedures.

During the summer vacation, a doctor based in South China's Guangdong Province said he has managed to turn away three to four minors per day.

"Teens' features aren't mature. Their aesthetic ideals shift. A poor outcome can scar them psychologically," Wang Yongqian, chief physician at the Chinese Academy of Medical Sciences' Plastic Surgery Hospital, told the Global Times, adding that teens are particularly vulnerable to complications. 

"Double-eyelid surgery, for example, can lead to scarring, asymmetry, or even impaired eye function," he notes. "Recovery takes three to six months, and during that time, swelling and scarring can cause anxiety, exactly what these kids are trying to avoid."

Worse, unregulated clinics are exploiting the craze. 

Lured by slogans like "Beauty starts young," some unlicensed centers forge medical records to make teens appear 18 plus, thus bypassing parental consent. 

Others operate out of nail salons or spas, offering cheap injections or lasers, procedures that, in untrained hands, can lead to infections, nerve damage, or even death. 

Cosmetic procedures are, at their core, medical treatments. It is then important to always choose a licensed facility staffed by qualified health professionals. Gambling on bargain prices and wishful thinking can turn a beauty fix into a life-threatening emergency, Wang warned.

Anxiety-driven craze

Chinese social media including the Xiaohongshu buzzes with posts endorsing "cosmetic rewards" for passing the gaokao. 

For many families, the post-gaokao glow-up isn't just about vanity, but a "strategic investment." Parents argue that good looks help socializing, boost job prospects, and even provide better romantic opportunities.

But experts say this mindset masks deeper anxieties.

Yang Lichao, a sociologist at Beijing Normal University, told the Global Times that some parents treat looks as a capital investment in their child's market value within the competitive job and marriage markets, while others project their own unrealized beauty ideals onto the next generation.

This transactional mindset, Yang warns, teaches young people to commodify their bodies, eroding self-worth beyond their appearance.  

The fallout manifests in consultation rooms. 

Zhang Lulu, a psychologist, treated a girl obsessed with replicating a K-pop star's eyes. Three failed surgeries later, she remained trapped in self-loathing. 

Reversing this tide demands systemic effort, Yang pointed out. 

Families should praise non-physical traits and resist conditional compliments. Schools might integrate critical aesthetics into curricula, dissecting how the media purposefully manufacture insecurities. 

On a policy level, society needs clearer bans on lookism in hiring and stricter regulations of click-bait ads that equate success with symmetry, Yang said.