'Before and after' photos from Nguyen Du's brochure show the result of 'skin-tightening' and eye, lip and nose surgery.

Chem Lin, 23, is a walking advertisement for the surgical skills of her boss Nguyen

Du. Squinting through puffy eyes, she explains that she has just had her second round

of cosmetic treatment - Cambodian style.

This time the beauty shop assistant has had a thick rope of eyeliner tattooed around

her eyes, but two years ago she went under the knife to get what she calls a "Western

style" nose. Thin, sharp, and only slightly off-center, she displays the nose

she received in the beauty parlor's backroom surgery with pride.

"My nose was not beautiful," she says. "The nose of the Khmer is flat,

not high like the foreigner. I am very happy and my husband thinks I am more beautiful

than before."

At first she says, her new nose felt strange "like artificial teeth" but

now it feels normal and she feels more attractive.

Lin works at one of Phnom Penh's numerous beauty parlors that practice a little surgical

enhancement on the side. Along with many other clinics, Nguyen Du's parlor, which

is licensed by the Ministry of Health (MoH), can soon expect a visit from the health

authorities as part of a crackdown on illegal cosmetic surgery. The visits are set

to begin this month following a new sub-decree on beauty parlor control issued by

the MoH.

Ung Phirun, undersecretary of state at the MoH, said most of the clinics in Phnom

Penh are operating illegally, but have not yet been closed because of a lack of appropriate

regulations. The ministry has never sought to regulate the surgical free-for-all

and Phirun says it is difficult to tell how many surgeons are working, and whether

or not they are qualified doctors.

"The majority of beauty clinics are illegal, because they have not registered

with the ministry," says Phirun. "They will be required to get a license

from the ministry and if they don't have one we will cooperate with the local authorities

to close them down."

Beginning mid-October the MoH will begin to educate clinics about the new law. If

they continue to defy the decree, operators will face legal action and closure. Under

the new regulations all clinics will need to be licensed and surgeons will be required

to have appropriate qualifications.

But the new regulations could prove unpopular with the thousands of Cambodians who

seek out cosmetic surgery every year. A little eye work is close to compulsory for

Cambodia's young karaoke starlets, and the wives of the wealthy frequent the clinics

as well.

"Some Excellencies' wives come to our clinic but they just wear normal clothes

so no one knows if they are really Lok Chumteav," says Lin.

Around Phnom

Chhim Vattey, director of a Phnom Penh beauty salon, regularly deals with the after-effects of poorly performed cosmetic surgery.

Penh almost every aspect of nature can be improved upon and any type of operation

can be had. Eyes can be rounded or a fold placed in the eyelid for between $300 and

$600; noses can be raised and narrowed for anything from $100 to $250; liposuction,

chin implants and breast enlargements are also available.

Nguyen's clinic has been operating on Monivong Boulevard for more than a decade.

He has no shortage of competitors, some in the back of gleaming new beauty parlors,

others - like Salina Salon on Charles de Gaulle Boulevard - are in small rooms atop

filthy stairwells or are located in first floor apartments up back alleys.

Salina's owner Bo Na says that a nose operation takes a mere 15 to 20 minutes to

complete and costs between $100 and $150. Operations are conducted under local anesthetic.

"We cut inside the nose so there is no scar then we insert the piece of plastic

from France or Japan," he says of the popular operation. He admits that he assists

in operations though he is not personally a qualified doctor. Na says he employs

a Thai-trained Cambodian doctor, although he would not provide contact details.

According to the staff at Nguyen Du's clinic the Vietnamese doctor was trained in

the United States while his daughter, who also performs operations, says she trained

in Hanoi for one year "and also learned from my father".

Staff say the clinic attracts Khmers living overseas, as well as local Chinese and

Cambodians. By way of example they point to a large framed photograph of a 72 year-old

Khmer-American who flew in to have her eyes done in August.

"We have customers coming every day, both young and old. The Khmers have good

eyes but bad noses and the Chinese have good noses but they don't have beautiful

eyes," says one staff member of the favored operations.

Nguyen is confident enough of his techniques to employ them on his own family. A

row of photographs in the parlor's anteroom show his post-operative and very straight-nosed

daughters.

And the range of surgery available goes well beyond a nose job. According to the

parlor's brochure, staff can add dimples to the cheeks and clefts to the chin, perform

face-lifts, and redden the nipples. It even boasts that a woman's genitals can be

restored to their virginal appearance, even after childbirth. But to get breast enlargement,

says Lin, they will refer you to Vietnam.

Chhim Vattey, director of the Samangkar Salon on Norodom Boulevard, sees a regular

stream of clients who have had botched surgery in the many illegal parlors.

Vattey refers clients to a Japanese doctor with 38 years of experience. Her clients

include acid attack victims, children with cleft lips and "anyone concerned

with their beauty". Wealth is not important, she says, and her clients include

many low-paid garment factory workers. However at $2,700 for breast enlargement the

garment workers tend to stick to the simpler operations.

Some customers, though, are beyond help she says. One woman recently came in with

a serious infection after she had had collagen injected in her cheeks and around

her collarbones. Vattey could do nothing for her.

The injections, which typically cost about $120 and the effects of which last about

six to eight months, are popular with men and women who want to conform to the Cambodian

ideal of looking plump and healthy.

 

A more tragic case, says Vattey, was a typist from Pursat province who wanted

her hands to be smooth and her fingers long and tapered to a point "like thorns".

 

Bungled hand surgery. The patient later died.

The woman saw a local "plastic surgeon" who injected a liquid into her

hands. Instead of the desired result her hands became hugely swollen. Vattey says

that there was little anyone could do. The doctor fled the province and the woman

returned to Pursat and died six months later. Vattey blames the bungled surgery.

Vattey produces folders filled with "before and after" photographs, a gruesome

catalog of surgical mistakes. One photograph shows a woman who was advised to remove

a facial mole using acid.

Another displays the scabrous and bloodied eyelid of a woman who had a mole removed

in a market by a "doctor". He tied off the mole with cotton, and then pulled.

She welcomes the intervention of the MoH as a way of reforming an industry that has

been allowed to operate unconstrained for too long. "This is the best thing

they can do," says Vattey. "I've proposed to the ministry that [it regulate

the industry] for some time. Plastic surgery is not a simple thing - it is very dangerous

to do."