When the Global Times visited Hu Juan at a local plastic surgery hospital in Shanghai last week, she was still recovering from her third round of face-lift surgery.

Her face was still swollen, and the skin was so tight that she could barely smile. Sometime in the next four months she will undergo another round of surgery.

The reason for her surgery is not vanity, but rather a rare disease she contracted in 2004, which caused the face of the then 19-year-old to appear to age, giving her the countenance of a 60-year-old.

Hu Juan has endured a decade of having a face that made her appear older than her years.

Born in 1985 in a small village in Zhumadian, Henan Province, Hu Juan married her husband Zhu Jichao early. She gave birth to her son in 2003, when she was 18 years old. After the birth of her son, Hu began to notice that the skin on her face and her neck was loosening. At first, she thought it was a temporary condition caused by the stresses of childbirth. However, in late 2004, her look changed dramatically. The skin on her neck sagged, wrinkles developed on her face, and her eyelids became droopy. By 2005, she looked like a woman 40 years her senior. However, the rest of her body was unaffected, including her voice.

Hu quit her job at a factory in Guangzhou and returned to Henan Province to seek medical help. A series of examinations at local clinics and hospitals indicated her body functioned well, although doctors could not explain her condition. Finally, the First Affiliated Hospital of Zhengzhou University diagnosed Hu as having a very rare disease called cutis laxa, which causes the skin to lose its firmness and hang loosely, especially on the face. However, it is a genetic condition, the gene for which Hu lacks.

Hu Juan receives cosmetic surgery at a local hospital in Shanghai.

The struggle

Why Hu developed the disease is still a mystery.

"I cannot describe how I felt at that time," Hu told the Global Times. "Compared with this, breakup or divorce would be nothing. There are solutions for those kinds of problems, but I can never get rid of this."

She said people's reactions were also hard to deal with. While friends and family felt sorry for her, dealing with strangers was more difficult, for example, shop attendants would assume that Hu was Zhu's mother rather than his wife.

Hu wanted to return to work, but when interviewers saw her, they could not believe that she was born in 1985. Hu had to show them her identity card to convince them.

"Most did not listen to my explanations about my disease. Those who did still did not hire me," Hu said. As a result, she hasn't had a stable job since 2005, occasionally earning cash in seasonal jobs such as picking tea leaves or cotton.

Hu tried folk medicine, and even sought help from fortunetellers. When nothing helped, she became suicidal, trying to take her life twice - both times her husband intervened to save her. She asked Zhu to divorce her, thinking he could find a "younger" wife and take good care of their son. But Zhu refused.

"My conscience told me that I cannot leave her. I cannot imagine how she will live if I leave her," Zhu said in a TV interview.

In 2012, the couple had their second child, a daughter. The little girl gave Hu new hope.

"She used to stay at home everyday without talking to anybody. But after our daughter was born, her mood changed a lot. She is more willing to go outside and communicate with people," Zhu told the Global Times.

Hu Juan's husband Zhu Jichao attends to her after another round of face-lift surgery in Shanghai. Photos: Courtesy of Shanghai Elikeme Medical Cosmetology Hospital

Cosmetic surgery

Hu's story was reported in the media in 2012, which prompted hospitals to offer her free cosmetic surgery.

"Other girls my age could work in factories, but I had to stay with people of 40 or 50 years old and pick tea leaves. If I accept the surgery, I can look better and find a better job. I do it for me, and also for my family," Hu said.

In early 2013, Hu received two rounds of surgery, and then in June that year appeared on the TV talk show A Date with Lu Yu, which detailed her story and further raised her profile in the media.

"They tell me the more surgery I have, the better I will look. But I do not expect much. I know the disease that I have. The elastic fibers on my face broke due to the disease. I know that it is impossible for me to look exactly how I looked before. I accept whatever outcome the surgery may have," Hu said.

Considering the risk and the pain involved, Hu's husband did not want her to undergo more surgery. He was also concerned that the related medicines Hu had to take would impact her health.

As such, after the next scheduled round, Hu has resolved not to have any more surgery.

After enduring a decade of having to present to the world a face that does not fit her age, Hu is happy that she has a husband who cares about her and their two lovely children.