Officials often choose plastic surgery for two reasons. First, they are concerned that their aging face will harm their public image. An official once told his surgeon, "When I turned 40, I didn't want my leaders to think I'm old, and I didn't want my colleagues to think I'm slow in thought. I wanted to still look capable." Other officials have admitted, "I'm spending all of this money and suffering all of this pain just to leave a good impression on others."

Another reason officials go under the knife is that plastic surgery will enhance their self-confidence and make them more welcomed by the public. A plastic surgery expert in Guangzhou said, "Today, many Chinese officials have studied abroad. They are more intelligent and more open, and image is also important to them. A better-looking face after plastic surgery will boost their self-confidence and make them more welcomed by the public." Today, you can often read news about a "beautiful mayor" and "hot president" having tens of millions of fans. It is obvious that the public tends to have a more affectionate feeling to officials who look competent and handsome.

Chen commented, "In the past two years, senior officials have had more chances of meeting ordinary people and going abroad. It is acceptable that they want to undergo plastic surgery to portray a younger, more confident and more active image to others. After all, they don't just represent themselves—they also represent their city and country."

However, public opinion differs greatly from surgeons when it comes to officials having plastic surgery. In November 2008, a Chinese BBS poll asked, "Can you accept officials undergoing plastic surgery?" About 75 percent of the respondents chose yes, while the rest responded that "fewer efforts should be made on such 'vanity projects' and more measures should be taken to prevent bribery cases involving plastic surgery."