Cut to the bone

When Zhiqing, the last factory producing shoes for bound feet, marked its closure in 1999 by donating eight pairs of wooden lasts (i.e. the models used for repairs) to the Heilongjiang Museum of Ethnography, a page in Chinese women’s history was thought to have turned. With footbinding, the notorious practice that reduced upper-class women’s feet into tiny arched objects, relegated to the past, mothers and daughters would no longer have to subject their bodies to a warped standard of beauty.

But it turns out that modern Chinese women have found another radical way to rearrange their natural form to achieve what they see as an alluring look.

Known as calf neurectomy, the operation involves severing the nerves behind the knees that control the calf muscles. This leads the latter to receive fewer flex signals and atrophy over time. Originating in South Korea to meet the demands of women with muscular calves, calf reduction as a treatment is meant to create slimmer legs that are perceived to look more elegant with dresses, skirts, shorts and boots.

Recently calf neurectomy has drawn widespread attention across China due to the mushrooming of advertisements for the procedure on social media platforms.

Typical promotional material features photos of two pairs of lower legs purportedly before and after the surgery. Below the images: “Mrs Yang from Shanghai, aged 55, lower legs shrunk by 2.5 centimetres 15 days after the operation, with the hard muscles toned down. A recent check-up shows a reduction of 4-5cm. She is ready for another leg straightening treatment in April. [Smiley face emoticon] One can become pretty, regardless of age [another smiley face emoticon].”

On Sina Weibo the discussion chains about calf neurectomy have surpassed 350 million, making it one of the top trending topics. Netizens’ responses range from disbelief to downright abhorrence.

“It’s not the legs that need fixing, but the human brain,” commented one weibo user, referring to the people who are attempting the treatment.

“Mutilating yourself in order to look good? This sounds freaking awful,” remarked another.

While advocates say calf neurectomy can create more lasting results than other methods to slim down the legs such as botox injections, the flip side is that the damage it can do to the legs is irreversible.

“Without that calf muscle supporting surrounding ligaments and bones, the burden of basic movements such as walking will be shifted to one’s ankles, knee joints and even hip joints, creating back pain,” Yang Tieyi, a professor at the medical school of Shanghai University, told Phoenix TV (which has recently produced a feature dedicated to the subject). “Besides, you’ll have trouble standing for even just a short while, as well as climbing. That would make life very difficult. Neither can you walk briskly,” he added.

What makes calf neurectomy even more counter-productive is that it might trigger hypertrophy or other compensatory responses from surrounding muscles or fat, causing the post-operative legs to grow in size again.

Yang said such “destructive” surgery was not supposed to be available at any public hospitals in China. A report by Beijing Youth Daily on May 24, however, noted that calf neurectomy was among the 10 most searched subjects on So-Young, a digital platform that specialises in selling cosmetic surgery packages. For instance, a Beijing-based medical institution has sold 80 such surgeries, costing as much as Rmb60,000 ($9,406) each, so far this year.

Positive mentions of calf neurectomy have been choked off since various state media including The People’s Daily strongly criticised the practice. The debate has put the spotlight on appearance anxiety, a growing social malaise in China.

In an op-ed entitled “Wake up please, stop wasting money on self-injury,” the People’s Daily highlighted concepts such as a “palm-sized face”,“A4-paper waist” and “birdie legs” and admonished them as setting a “stifling” standard of beauty. The fact that they have become so mainstream has put undue pressure on impressionable youngsters, it added, many of whom are struggling with their body image and self-esteem.

“A distorted sense of beauty is, of course, to be blamed for the popularity of damaging plastic surgeries. But service providers that over-emphasise the value of physical beauty while fanning appearance anxiety are equally alarming. Quite a lot of people suffering from such pressure end up on operating tables undertaking makeovers that are potentially risky and come with complications,” lambasted the newspaper.

Last year a 22 year-old man from Jiangsu province, looking to increase his height to 1.8 metres, went abroad for surgery that claimed it could make him taller. The result was severe bone and leg infections that robbed him of his ability to walk.

Other bizarre surgeries include creating “elven ears” by injecting hyaluronic acid (see page 12) into the pinnas, and injecting bone cement (or polymethyl methacrylate, widely used for implant fixation in orthopaedic and trauma operations) into the skull to create a peaked head shape.

According to So-Young, which went public on Nasdaq in 2019, the number of people that had underwent plastic surgery in mainland China reached 15.2 million last year. That represented a compound annual growth rate of 53% since 2018. A majority were women aged between 20 and 35. Nose jobs were the most popular treatment.

Last year China’s plastic surgery market reached Rmb197.5 billion ($30.5 billion) in sales, accounting for 17% of the world’s total, China Daily reported.

Deloitte, a leading professional services firm, expects the number to reach $48 billion by 2023.

That doesn’t look an outlandish prediction: 3.6% of Chinese had a cosmetic procedure in 2019, versus 20.5% in South Korea and 16.6% in the US.

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