The history of cosmetic and reconstructive practice in China can be traced through early medical records and archaeological discoveries that reveal both therapeutic and aesthetic concerns. One of the earliest detailed accounts of cleft-lip repair appears in historical material from the Jin dynasty period. The biography of Wei Yongzhi (~390AD) describes himself as a patient born with a cleft lip who sought treatment from a skilled healer. He was told that the cleft lip could be “cut and mended, but you must eat porridge for 100 days with no laughing or speaking.” This case is widely regarded as one of the earliest recorded descriptions of cleft-lip repair in Chinese history and demonstrates an advanced understanding of postoperative care and tissue healing in early China.

Archaeological evidence also reveals a long tradition of cosmetic skin care. A bronze jar excavated from the tomb of an aristocratic male at Liujiawa in Shaanxi province and dating to approximately 700–640 BC contained the remains of a prepared cream. Scientific analysis showed that the substance consisted of animal fat mixed with a white substance known as “moonmilk.” Moonmilk is a mineral deposit commonly found in limestone and stalactites. It was thought that the combination of animal fat and moonmilk formed a paste that functioned as an emollient and could produce a whitening effect. The formulation closely corresponds to prescriptions recorded in early Chinese medical texts, indicating that it formed part of an established medical-cosmetic tradition. Skin whitening in this context likely served as a marker of elite status by distinguishing aristocrats from laborers exposed to outdoor work and may also have had ritual significance. Prior to this discovery, the earliest physical evidence of cosmetic use in China came from a 3rd-century AD tomb where cosmetics were found. By comparison, the use of cosmetics in ancient Egypt dates back to 6000–3150 BC.

Evidence for aesthetic body modification in China extends into prehistory. The Sanxingdui site in Sichuan, dated to approximately 3,800–4,800 years ago (1700-1050 BC), yielded bronze human heads and masks with distinctive facial features and large perforated earlobes designed for ornaments. These artifacts indicate that ear piercing and decorative body modification were practiced in ancient China.

Modern plastic surgery in China developed through international medical exchange in the early twentieth century. In 1929, Ni Baochun, who is often considered a founding figure of modern Chinese plastic surgery, established one of the earliest plastic surgery units at St. John’s hospital in Shanghai after training at Johns Hopkins University. In 1948, the American surgeon Jerome P. Webster introduced formal systematic plastic-surgery training at Zhongshan Hospital in Shanghai, now affiliated with Fudan University. During the Second World War period, the Chinese surgeons were sent to the United States for specialist training and later returned to help establish major reconstructive centers in Beijing and Shanghai.

In contemporary China, the growth of the middle class has become a major driver of the cosmetic surgery industry. Rising disposable income, urbanization, and competitive labor markets have increased the perceived value of physical appearance. Social media, beauty competitions, and the influence of Korean popular culture have further reshaped aesthetic ideals and normalized both surgical and non-surgical enhancement.

 

Wang, W., Lin, X., Zhang, Y., & Li, Q. (2021). The practice of China’s cosmetic medicine dated back to 3,800–4,800 years ago. Chinese Journal of Plastic and Reconstructive Surgery, 3(2), 109–112. https://doi.org/10.1016/S2096-6911(21)00092-3

Davis-Marks, I. (2021, February 10). This 2,700-year-old Chinese face cream combined animal fat and “moonmilk.” Smithsonian Magazine. https://www.smithsonianmag.com/smart-news/archaeologists-find-2700-year-old-facial-cream-180976973/