The Clinical Quest for Beauty

Skin care clinics have existed in Thailand for over twenty years, but the popularity of beauty clinics that offered more aesthetic treatments only began in the last five years.

By | Fri 29 Jul 2011

When eighteen year-old Filipino pop sensation Charice Pempengco received a Botox injection and thermage treatment prior to her appearance on the TV show Glee, she was met with public outrage. From infamous celeb critic Perez Hilton’s vehement pronouncement of the treatment as “sick” to one Filipino newspaper running the headline “Charice’s Botox apocalypse,” many media outlets were scathingly skeptical of her representatives’ claims that the treatments were merely for non-cosmetic purposes. It seemed that once again, another young and talented teen had submitted to the social pressures of beauty, conforming to the ever growing teen cosmetic trend.

Yet Ms. Pempengco’s foray with Botox is hardly the exception; many other stories of teens (or children even younger) undergoing similar treatments abound. In March, Kerry Campbell turned heads when authorities discovered she had been giving her eight year-old daughter Botox and filler injections on a regular basis. A few months later, Sarah Burge stole the spotlight in the UK when newspapers reported that she had given her seven year-old daughter a voucher for breast surgery to be redeemed when she turned eighteen.

All these articles and incidents seemed to act as a springboard for commentators to disparage the woes of preemptive ‘modifications’ to one’s looks. Insecurity, one commentator said, was surely what drove teens like Charice to seek the beautifying needle at such a young age.

Yet does this scornful attitude actually reflect the culture of beauty today?

Socially accepted or not, statistics suggest that the popularity of surgical and nonsurgical aesthetic procedures is on the rise. According to a global survey conducted by the International Society of Aesthetic Plastic Surgery (ISAPS) in 2009, “the number of non surgical cosmetic procedures performed by plastic surgeons actually topped surgical procedures.” In the most recent survey conducted by the American Society of Plastic Surgeons, Botox was injected into Americans ages 13 to 19 nearly 12,000 times, representing a two percent increase from 2008.

Perhaps it’s not that unexpected that Thailand, even for its size, finds its way into ISAPS’ survey as one of the top twenty-five countries with the most surgical and nonsurgical cosmetic procedures performed each year. Walk around a mall and you’re bound to find a number of beauty clinics nestled amongst the shiny storefronts, usually with a photo of a slim, clear-faced man or woman gracing its windows. Botox injections, laser treatments, and plastic surgery among celebrities are frequent and almost expected, with tabloids regularly highlighting any significant ‘changes’ that occur on their bodies and faces.

Sitting at lunch one day, one of my co-workers flipped through a magazine and in no more than half a minute, announced all the procedures each celebrity had received, from Botox injections to nose jobs, jaw reductions and breast implants. Some celebrities are open about their various treatments (one even openly sued a clinic for failed laser treatments), oftentimes acting as the ‘face’ of the clinics they visit. Wuttisak Clinic, one of the most popular skin care clinics in Thailand, advertises itself as the number one clinic for Thai celebrities, with a slogan that goes, “Because beauty can’t wait.”

Thus it’s possible that here in Thailand, statistics and public opinion are in tune – instead of outcry and disdain, public reaction is tolerant and almost encouraging. Gossip notwithstanding, there’s an underlying understanding that yes, people get these treatments, and if it isn’t harmful, well, it’s okay.

The Beauty Business

Skin care clinics have existed in Thailand for over twenty years, but the popularity of beauty clinics that offered more aesthetic treatments only began in the last five years. Dr. Saringa Watcharachan, whose Chiang Mai clinic opened its doors in 1996, says that beauty clinics have become popular because advances in technology have allowed a more ‘natural’ path towards beauty. Instead of worrying about long recovery periods from plastic surgery or bearing the brunt of gossip from changes that may be too obvious, people can get treatments that take at most two hours and ‘enhance’ their features rather than alter them.

“Nowadays people take care of themselves more,” Saringa added. “They need to start going to work, interacting with a lot of people. A lot of older people have come to realise that expensive, over-the-counter cosmetics just don’t work as well as going into the clinic.”

Chayootkhan ‘Hart’ Phongjirakhorn of the Bangkok-based Tanaporn Clinic says, “It’s becoming very normal for people, both men and women, to go to beauty clinics nowadays. Everyone places importance on their skin and appearance, so it’s not strange that everyone, at any age, would go to a beauty clinic.” Beauty clinics are becoming increasingly present, he adds, comparing their growth to the number of 7-11 stores in Thailand: “Walk in a mall and you’ll find more beauty clinics than furniture stores and banks.”

However, the competitiveness of the beauty clinic business can pose some dangers. Hart notes that there are many clinics that do not actually offer the quality that they advertise. “There are many brands that say they use the latest technology in skin care and beauty, but in fact, use equipment that has not met the standards of the Thai Food and Drug Administration, or are fake products from China,” he said. “Since these don’t require a lot of investment, it’s easy for these clinics to expand into hundreds of branches around Thailand in a short period of time.” He also adds that many clinics will use celebrities to lure customers when in fact, these celebrities had never used their services at all.

Dr. Chartchai Kwangsukstith, an associate professor of dermatology at Chiang Mai University, says that like in any kind of procedure, there can be a number of risks and complications if treatments are not administered properly. Infections from Botox or filler injections can leave red spots that last from six months to a year, while clumsy technique can cause eyelids to droop or lopsided mouths. He advises that anyone who is interested in going to a skin care clinic thoroughly do their research before going.

Some people interviewed also noted that while beauty clinics did help treat their problems, they were also commercial businesses. One phenomenon commonly associated to beauty clinics is ‘liang kai’. Roughly translated as “feeding the fever,” ‘liang kai’ describes the process of doctors deliberately prescribing lengthy treatments to draw out money from their customers. Some beauty clinics openly advertise against ‘liang kai’ in their clinics, while others flatly deny that it exists.

Despite these potential risks and concerns, the future of beauty clinics looks as bright as the treatments they offer. Especially with continuing advances in technology and increasing demand, many agree that clinics will continue to be widely successful for at least the next five to ten years _ after all, the quest for beauty is a never ending one. “As long as people are interested in the exterior, there are going to be skin care clinics, just as there have always been cosmetics,” says Titiya Hongsawong, a clinical pharmacist at Holistica Clinic.

For some, the issue isn’t a matter of whether beauty clinics are socially accepted – it’s about looking good, and needing to look good. “Many occupations require their personnel to appear clean, smart, and show that they take good care of themselves. And what can be a better choice than going to a skincare clinic and getting someone to deal with your condition?” says Piriyapa ‘Eve’ Putsongkram, 20.

“Almost all of my friends go to skin care clinics and actually, most of them get plastic surgery too,” says Sineenard ‘Bow’ Poomsanga, 29. “Everyone is doing it – some guys do it even more than girls! It’s what society’s like. It’s almost like a requirement.”


Another underlying factor that may drive customers to beauty clinics is, rather simply, that looking good makes us feel good too. A study conducted by economists at the University of Texas at Austin in March 2011, “‘Beauty is the Promise of Happiness’?” concludes that personal beauty can lead to higher levels of happiness. Results from a survey group of over 25,000 people worldwide revealed that the most attractive people were 10 percent happier than those who were less attractive.

Part of this extra happiness was due to economic benefit. “The majority of beauty’s effect on happiness works through its impact on economic outcomes,” says Daniel Hamermesh, one of the authors of the study. His research seems to confirm what many of us may have suspected all along – better-looking people generally earn more money and marry similarly attractive people with higher salaries.

Surprisingly, and perhaps encouragingly, many of the people I interviewed, including doctors at the beauty clinics themselves, didn’t necessarily connect beauty with happiness. Titiya says that patients shouldn’t expect miracle makeovers or think that their lives will completely change for the better once they go to a beauty clinic. “Beauty gives us more opportunities in life,” she says, “but at the same time, we have to understand how to be satisfied and know that things are enough.”

“I still believe that instead of striving to have a beautiful outer shell, it is more essential to spend more time and effort in improving the inner-self,” says Eve. “And this can be done simply just by believing in yourself and accepting that you are flawed, just like everybody else. Just be confident in things you do and what you say, and your true self will make its way to shine through and impress people, even if you might not have the perfect skin and body.”

So, skin care, beauty clinics, plastic surgery, a new face, new clothes, new car – we’re all told that these could lead us to happiness, clear skin could lead to beauty. But what defines happiness, and what defines beauty, after all? In the future, we may be buying home laser treatment systems and visiting the beauty clinic once a week, but those questions probably won’t lose relevance any time soon.