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Image: Shutterstock

Image: Shutterstock

China’s medical aesthetic services platforms face both opportunities and challenges with the rise of Generation Z

According to a survey by China's official state-run media Xinhua News Agency, for about 54% of young people born after 1995, the new dream job is online celebrity. Young people have grown up in a world where beautiful people who post photos online can convert traffic into revenue. Even for those with other career plans, studies have shown that perceived attractiveness helps candidates land job interviews.

In 2018, China’s cosmetic surgery market exceeded US$121.7bn. 18.81% of plastic surgery customers are below age 19, and 40.1% are aged 20 to 25.

Parental support has contributed to the increase in Gen Z plastic surgery procedures. "Many mothers offer to pay for their daughter's double eyelid surgery as a college graduation gift," said Zhao Hongyi, director of the cosmetic surgery department at Beijing Hospital. 

Since apps and O2O platforms for medical aesthetic services made their debut in 2012 and 2013, VCs have been lining up to fund them. Among the early birds, Gengmei raised US$50m in a Series D1 funding round in 2018, and So-Young went public on Nasdaq in May 2019 after completing six funding rounds in six years. According to Gengmei CEO Liu Di, only 5% of transactions in the cosmetic surgery market are completed via online platforms, leaving ample room for future growth.

More transparency

Acting as a bridge between consumers and cosmetic surgery providers, medical aesthetic services such as So-Young use the model of social commerce to solve the unique predicament facing the cosmetic surgery industry.

"Normally when Chinese people visit public hospitals, they know which one is better. The government categorizes state-owned hospitals into different tiers based on ability to provide good medical care," Jin explained. "However, assessment standards are missing in China's cosmetic surgery market, where private institutions account for 80% of service providers."

Additionally, there are a number of illegal beauty clinics that operate without certificates and hire unqualified surgeons. They employ false advertising and lower prices to trick consumers into buying their services.

The So-Young app provides users with the information they need to make careful decisions about whether and where to pursue plastic surgery. Patients can use the app's diary feature to educate others considering plastic surgery about the process via before and after photos, commentary on hospitals, doctors and the recovery process, etc.

These apps have built platforms where true stories serve as a valuable reference. Customers can compare prices and communicate with others who have undergone the same procedures. These features are especially appealing to Chinese members of Gen Z, who are used to doing online research before making purchases.

Lower customer acquisition cost

Cosmetic surgery providers benefit from the social commerce model as well. The lack of assessment standards has led to fierce competition, which squeezes the profit of cosmetic surgery institutions. Low material cost means the gross profit of cosmetic surgery institutions could reach 70%. However, due to the high cost of customer acquisition (around RMB 6,000 per customer), a shortage of qualified surgeons, among other reasons, net profit is usually less than 10%.

According to Frost & Sullivan, in 2018, China's cosmetic surgery providers spent around US$4.6bn on customer acquisition, which accounts for 25.8% of total revenue generated by the sector. Baidu, China's largest search engine, earns one-sixth of its advertisement revenue from cosmetic surgery providers.

"The big institutions throw tens, even hundreds of millions, of RMB to get their ads on the first page or above the search results, making it hard for smaller institutions to compete," said Ma Ke, dean of Beijing Xuanmei Cosmetic Surgery Hospital. "Acquiring a customer means paying Baidu RMB 7,000-8,000."

For cosmetic surgery institutions, opening an e-shop on a medical aesthetic services app such as So-Young means a lower user acquisition cost and a more targeted audience. Many apps allow providers to join for free and only charge them commission and advertising fees.

If app users are satisfied with their surgeries, the free word-of-mouth advertising can be a windfall. "One diary mentioning a particular surgeon could bring the doctor at least ten interested customers," said Liu.

Challenges

According to a Gengmei survey, China has about 9,500 legal beauty clinics and 60,000 illegal ones. There are as many as 150,000 practicing unlicensed cosmetic surgeons, nine times the number of licensed surgeons. And some medical aesthetic service apps have been caught promoting unlicensed institutions or surgeons on their platforms.

Users have accused companies of posting fake reviews on their apps to trap prospects. On Zhihu.com, China's Quora-like website, one user commented, "Maybe at the early stage all the stories shared on [So-Young] were real, but now most reviews read like feedback from a robot."

False reviews can have disastrous, even fatal, results. "I tend to trust friends' recommendations and then go on So-Young to see comments," a young woman who had eyelid surgery told a tech reporter at SINA. "Positive reviews are not 100% trustworthy, but I do use negative ones as a reference."

Many cosmetic surgery apps have started to address the mistrust. Yuemei and Meidaila, among other platforms, are trying to build their own offline cosmetic surgery hospitals to control the business loop. So-Young, which closed its own offline hospitals in 2018 without explanation, is now prioritizing the fight against fake content. In August, it became the first platform to employ facial recognition to verify diary photos came from a real user. It is unclear whether these efforts are changing public opinion.

In addition, rivals with serious clout are entering the cosmetic surgery market. Internet-enabled platforms such as Meituan Dianping and Tmall, Alibaba's B2C e-marketplace, have started promoting cosmetic surgery products on their platforms by giving out deep discounts.

In June 2019, Meituan Dianping announced that, during its 618 Mid-year Shopping Festival, a promotional campaign that runs from June 1-18, 4m users purchased RMB 670m worth of medical aesthetic products on its platform. 45% of customers were under 25.

So-Young's Jin still believes medical aesthetic services platforms have an edge: "Any platform needs a long time to accumulate the same amount of [user-generated content]. Besides, in the medical industry, users tend to trust the vertical platforms more."

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Edited by Wendy Lovinger, Wang Xiao'e

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