Despite its late entry into the Asian cosmetic surgery arena, China may turn out to be the region's predominant player in not too many years.

Until 2001, plastic surgery undertaken in China for purely cosmetic reasons was banned, presumably with the intent of preserving traditional appearances and styles. Illegal, however, did not mean unavailable.

Without formal regulation, trained Chinese reconstructive plastic surgeons as well as untrained lay practitioners offered cosmetic procedures to eager patients behind closed doors.

Lacking good education, experience, facilities, and supervision, results were not first-rate and horror stories abound. Many patients maimed by the untrained suffered not just serious deformity but death.

Times have changed, and cosmetic plastic surgery in China has undergone a bold transformation. Today, delivery of cosmetic services is an approved discipline with strict training requirements, formal certification, and official licensing.

While the "underground" trade still persists more in China than in most other East and Southeast Asian countries, it is much diminished and should no longer factor into the worlds' perception of the quality of Chinese cosmetic plastic surgery.