KOREAS PLASTIC SURGERY CRAZE 1

Uncovering South Koreas Plastic Surgery Phenomenon

Sojung Judy Moon

Seoul International School

KOREAS PLASTIC SURGERY CRAZE 2

Abstract

The purpose of this study is to evaluate the prevalence and growing acceptance of plastic

surgery in South Korea over the past decade, and how cosmetic procedures have seeped into the

everyday lives of South Koreans. Unhappiness with appearance is de rigueur for most teenagers

around the globe, but for South Koreans, this seemingly normal teenage thought is increasingly

being addressed with artificial pursuits of beauty. For years, it has been assumed that the South

Korean population possesses the highest rate of surgery for the pursuit of beauty. Such

presumptions have fostered undue cultural stereotyping, and as a result, a lack of emphasis upon

important historical and societal causes that have contributed to the rise of cosmetic surgery rates

in the nation. This study strives to tackle the reasons as to how and why South Korean culture

has come to embrace cosmetic surgery as a norm, where it is no longer considered taboo to admit

to having undergone major cosmetic transformations.

Keywords: cosmetic surgery, pursuit of beauty, cultural stereotyping

KOREAS PLASTIC SURGERY CRAZE 3

Uncovering South Koreas Plastic Surgery Phenomenon

The origins of Korean plastic surgery date around 50 years ago to an American plastic

surgery pioneer, Dr. Ralph Millard, who was stationed in Seoul from 1950 to 1953 to perform

reconstructive surgery for those wounded on the battlefield (Baer, 2015). The popular double

eyelid surgery originated in South Korea during the year-long Korean War, when Dr. Millard

began performing double eyelid surgeries for Korean soldiers who requested to change oriental

to occidental eyes (Millard, 1964, p. 646). According to a 1964 edition of the American Journal

of Ophthalmology, Dr. Millard recorded that "the absence of the puerperal fold produces a

passive expression which seems to epitomize the stoical and unemotional manner of the

oriental," accounting for the cosmetic reasons of those wanting to pursue the procedure from a

historical perspective. He further added that his first double eyelid procedure was operated on "a

slant-eyed Korean interpreter, speaking excellent English, [who] came in requesting to be made

into a 'round-eye,'" (Baer, 2015). While Dr. Millards accounts from history seem to corroborate

the widely-believed theory that the origins of plastic surgery stem from the desire of most

Koreans to adopt Western features, in the modern era, Koreans undergo these surgical

procedures to create a natural crease on the eye suited for Asian features and to assimilate into

the homogenized beauty standards in such small of a peninsula, where fads, trends, and styles

are often standardized (Diller, 2011).

Within South Koreas present day society, cosmetic surgery is generally perceived as a

worthwhile and understandable investment in ones body rather than a sign of vanity.

Furthermore, it has been confirmed by recent reports from the International Society of Aesthetic

Plastic Surgery (ISAPS) that South Korea is indeed the country with the worlds highest per
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capita rate of cosmetic plastic surgery (ISAPS, 2015). The nation ranked fourth in the total

number of cosmetic procedures with 445,144 cases, but once this number was divided by the

countrys total population, it significantly topped the United States (ranked first in world

rankings in total number of cosmetic procedures) in per capita rate with 87 out of every 10,000

people having undergone invasive plastic surgery in the same year (The World Bank, 2017).

Such a phenomenon may have resulted from several factors, which can be explained through a

cultural and sociological lens.

ISAPS International Survey on Aesthetic/Cosmetic, Procedures Performed in 2015

As portrayed in most mass media, it is difficult to argue that appearance does not play a

significant role in first impressions. Likewise, cosmetic surgery is often sought as a means to

maximize womens chances of success in marriage and the economy (Holliday &

Elfving-Hwang, 2012, p. 66). Thus, it makes sense that the surge in cosmetic surgery rates

among South Koreans can be understood as an investment to enhance an individuals social and

economic position (Swami, Hwang, Jung, 2012). Compared to that of other East Asian nations,

South Koreas greater political, social, and economic power of contemporary women may also
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account for the greater latitude in choosing to enhance their appearance (Swami, Hwang, Jung,

2012).

Not only are there social reasons to explain the cosmetic surgery trends in South Korea,

but also it is often argued that the pressure to conform to Western beauty standards plays a role

in the increased rates of plastic surgery. Since the liberalization of South Koreas media in the

1990s, Western celebrities and models have been frequently used to sell beauty products and

services. Korean pop culture idols share Westernized characteristics, such as being tall and thin

and having big eyes, a perfectly angled nose, a small chin, and long legs. Such a phenomenon

has invited an array of attention, discussions, and debates from news media to many Western

academic scholars. In fact, a large number of media reports attribute Koreans craze for beauty to

its pursuit of Caucasian features, and overlooks certain important historical and societal causes

that have contributed to the rise of the cosmetic surgery obsession in South Korea (Wang,

2015).

During one 2011 CNN report, journalist Kyung Lah reported that Chinese and Korean

patients are seeking to have a westernized face, high profile nose, slender nice cheekbone and

mandible bone, (Lah, 2011). In addition, Lah includes a quote from Korean plastic surgeon Dr.

Kim Byung-gun, stating that the definition of pretty, explains their plastic surgeon, is not the

standard Asian face, but closer to a Caucasian face (Lah, 2011). However, as NYU professor

Sharon Heijin Lee claims, "often times when Asian American women opt to get surgery, people

automatically assume it's because they want to look white, but often you find the pressure to

engage in these surgeries coming from their own families, from their connections abroad," thus

debunking the previous assertion from Lahs report (Stone, 2013). In addition, Dr. Hyuenong
KOREAS PLASTIC SURGERY CRAZE 6

Park, a surgeon at the OZ Cosmetic Clinic in Korea, agrees to Lees statement, explaining that

"even though many Caucasians have small and slim faces, it doesn't mean Asians want to look

like Caucasians If you inspect some Caucasian celebrities, you find many examples of

prominent jaws and high cheekbones. But if you inspect Asian celebrities, they all have small

jaws and cheekbones" (Stone, 2013). Granted, such media observations hold some validity to the

shift of Asian cultural perception of beauty that may be influenced by western fashion. Yet, there

is an underlying view conveyed by theories that western countries are the ones holding the

definition of beauty and that Koreans are imitating Caucasian facial features.

Rather than a Korean-take on a westernized beauty standard, South Koreas plastic

surgery fever may be attributed to the psychopathological trend of appearance dissatisfaction

amongst South Koreans (Swami, Hwang, Jung, 2012). In fact, a 2011 study from Jeju National

University analyzing the prevalence of distorted body image in 1024-year-old Koreans and

[determining] its relationship with sex, age, body weight status, and disordered eating behaviors

found the following:

... body image distortion was present in approximately 50% of a sample of young

Koreans aged 1024 years. The prevalence was noticeably higher during adolescence

than during early adulthood, and the highest value (55.3%) was reported in female

elementary school students. Additionally, more than 40% of young adults aged 1824

years demonstrated body image distortion; it was particularly common among those with

abnormal body weight. Distorted body image was significantly associated with an

abnormal body weight status and disordered eating behaviors. These findings emphasize
KOREAS PLASTIC SURGERY CRAZE 7

the importance of early intervention to manage and prevent a distorted body image in

young people (Hong, Jung, Kim, Lee, Hyun, Bahk, Yoon, Lee, 2011).

As a result, the increasing number of plastic surgery procedures, such as nose and double eyelid

jobs, among Koreans, including teenage girls, may be attributed to the desire to imitate their

idols appearance, in order to earn others acceptance and admiration (Wang, 2015). Not only is

the increasing idolization of stars becoming a prevalent practice, but also the pursuit of artificial

beauty is rapidly expanding to younger generations. In fact, [parents] give their children surgery

as a gift for graduation or for passing major exams, a practice which may contribute to the

normalization of surgery among such age groups. Surgeon Park Hyun-cheol, a doctor at OZ

Cosmetic Clinic in Seoul, points out that as many as 20% of his patients are under

the age of 20 (Wang, 2015). As confirmed by DSM-5 (the Diagnostic and Statistical Manual of

Mental Disorders, 5th ed) criteria, distorted body image is a core and often persistent symptom

in eating disorders, . may play a crucial role in the development of disordered eating behaviors

(excess dieting, purging, and binge eating) and lead to serious psychological and medical

conditions (Hong et al., 2011). As a result, such prevalence of appearance dissatisfaction can

inevitably drive many young teenagers to resort to artificial methods (i.e. cosmetic

transformations) to alleviate their stress upon body and facial dissatisfaction.

In recent years, the exacerbation of the rates of appearance dissatisfaction amongst

adolescents and young adults can be attributed to the popularity of domestic media, specifically

K-pop and K-dramas. Influence of the glamorized kkonminam (translated as beautiful flower

boys) looks in the highly popular TV drama series Boys Over Flowers (broadcast on KBS,

2009) is often looked upon as the turning point in the nations standards for a handsome Korean
KOREAS PLASTIC SURGERY CRAZE 8

male figure. As epitomized by many K-dramas, the soft image of these men includes a less

angular jaw, double eyelids, and a prominent nose tip, while augmented pectoral and bicep

muscles give their bodies definition (Holliday & Elfving-Hwang, 2012, p. 61). The goal of

this soft image is to create a muscular but smooth body by inserting implants into the biceps,

chest, or even forehead to obtain similar looks to those glamorized in such TV shows. On the

other hand, females are subjected more to the influence of K-pop (Stone, 2013). The ubiquitous

perfect facial features (i.e. big eyes, white skin, high-bridged noses, and sharp V-shaped chins)

that almost every girl group possesses has created a completely new, artificial beauty aesthetic

that nods to Caucasian features but doesn't replicate them (Stone, 2013). K-Pop has grown

tremendously in both domestic and international markets, and taking into consideration the

small, crowded, and overpopulated nature of South Korea, it is inevitable for beauty standards

and trends to be uniform across the entire nation. Every country has a unique standard of beauty,

but in a society (i.e. South Korea) that glorifies those with bigger eyes, sharper jaw lines, and

high-bridged noses and rewards them with better job opportunities, cosmetic surgery is often

valued as a necessity to survive in the highly competitive culture (Stone, 2013).

Although the medias traditional role seeks to reflect the social reality and norms of

society, media can also create socially acceptable ideals. Exposure to thin models through

magazines and entertainment shows (e.g. movies, TV shows) contributes to body dissatisfaction,

decreased self-esteem and confidence, and negative feelings of guilt, anxiety, shame, and

depression (Holliday & Elfving-Hwang, 2012, p. 62). In addition to clinic websites [playing]

down the negative after-effects, and [highlighting] the positive benefits with before and after

photos, sanitized representations of facial and body transformations through films encourage
KOREAS PLASTIC SURGERY CRAZE 9

viewers to participate in the same dramatic transformations (Holliday & Elfving-Hwang, 2012,

p. 62). Popular movies such as The 200 Pound Beauty (Kim, 2006) and comedy drama series

Before and After Cosmetic Surgery Clinic (MBC, 2008) serve to romanticize the practice with

extremely rare references to procedures gone wrong or the painful recoveries, although the

dangers and devastating aftermaths of cosmetic procedures are still occasionally reported in the

news (Holliday & Elfving-Hwang, 2012, p. 62).

While the number of plastic surgery seeking patients within South Korea have

continuously increased over the past few years, the popularity of various types of cosmetic

procedures has remained relatively consistent over the past decade (ISAPS, 2015). For example,

blepharoplasty refers to the creation of a visible palpebral fold to the eyelid where one is not

already visible (Sheng, 2000), but it also refers to the general widening of the eye to make it

look more round and plump. The most popular procedure amongst South Koreans, the double

eyelid procedure, also known as the Asian eyelid surgery, is aimed to give the upper eyelid a

visible crease or fold when the eye is open, thus giving the eye a more natural, wider gaze

(Asian Eyelid Surgery, 2017). As one of the cheapest operations, between $1,000 to $3,000,

with little to no invasive procedures, over 1.43 million people had the procedure done in 2014,

according to a 2015 report conducted by the International Society of Aesthetic Plastic Surgery

(ISAPS, 2015). In addition, the second most popular surgery is the rhinoplasty, a procedure

requiring implanting silicone, autogenous cartilages, or bone harvested from the septum or rib,

to augment the tip and dorsum of the nose for a more pointy look for the nose (Holliday &

Elfving-Hwang, 2012, p. 60). Other popular procedures include facial fat grafting, breast
KOREAS PLASTIC SURGERY CRAZE 10

augmentation, liposuction, facelift, brow lift, facial bone contouring, breast mastopexy, and hair

transplantation (Martin, 2017).

In Seoul, South Koreas capital, the Gangnam district has a dedicated street for plastic

surgery clinics, with more than 300 accredited hospitals (Wang, 2015). These surgery clinics

cater to both domestic and international patients. In specific, the number of foreigners travelling

to South Korea to obtain aesthetic treatment has been increasing by an average of 37% per year

since 2009 and totaled more than 210,000 in 2013 (Wang, 2015). An estimate of 150,000

medical tourists had visited South Korea for cosmetic procedures in 2015, according to Kim Min

Ji, a member of the medical tourism department at the Korea Tourism Organization (MacLeod,

2011). In the KTOs official report, officials claimed that South Korea was expected to have its

medical tourist numbers reach close to 998,000 in 2020 (Wang, 2015).

While South Korea appears to benefit from immense economic profit from its plastic

surgery industry, the cultural and historical reasons as to why Koreans have grown to accept

cosmetic procedures as a norm in todays society cannot be ignored. Dating back centuries, the

foundation of all important principles within Korean society has been predominated by

Confucian values, such as the traditional outlook of femininity as associated with virtue and

modesty (Wang, 2015). Confucian philosophy and practices still retain a considerable influence

in everyday life. According to these values, men are superior to women and women are bound to

the home, thereby creating a strongly patriarchal society. Thus, it is not surprising to note that

Korean advertisements portray women more stereotypically and objectify women to a greater

degree compared to advertisements in the United States. In addition, the Asian Financial Crisis,

an economic drought for South Koreans in the 1990s, brought even more fierce competition
KOREAS PLASTIC SURGERY CRAZE 11

among job seekers with heavy layoff rates and fewer job openings, and thus sparked South

Koreas notorious intrusive hiring practices requiring physical appearance as one of the

selective conditions for hiring a candidate (Wang, 2015). This practice, considered highly

discriminatory and illegal in most developed countries including the United States, Canada and

the United Kingdom (Jung, 2015), requires job candidates to attach professional headshot

photos to the top corner of job application forms (Wang, 2015). According to a 2015 news

article from The Korea Times, 75.7% of Korean employers said job applicants' photos affect

their chances of getting interviews. Therefore, by submitting a more attractive photo,

applicants are more likely to be selected through the interview and gain more favor from

employers. Amongst surveyed job-seekers in a study conducted by Saramin, an online

recruitment website, 68.3% of [applicants] said that they photoshopped their resume photos,

while 28.5% said they were even willing to get cosmetic surgery if it would help them land a

job (Jung, 2015).

Due to the heavy emphasis upon physical appearance in evaluating success, achievement,

and skills, the attitude towards plastic surgery within the Korean peninsula is very unique.

Translated from Korean, , means reform surgery, in which the word reform entails a

positive connotation, highlighting South Koreas unique perspective towards the subject; instead

of exerting a more common, negative connotation, such as artificial beauty, Koreans refer to

such surgeries as a betterment for ones future, as a transformation to improve the quality of

ones life. In a nation where attractiveness translates to more opportunities, it isnt surprising that

many teenagers and young adults look upon plastic surgery as a path to improve ones quality of

life socially, romantically, and economically.

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