A version of this article appeared in print in The Korea Times on 3/15/2013 with the headline “Plastic Island.”

By Kim Young-jin, Jung Min-ho

“I have a complex,” explains Won Hee, a petite 27-year-old office worker as she points to her chin, which she says is unshapely. “This surgery is for me. It’s to improve my self-confidence.”

Won is sitting in the courtyard of a medical complex in Apgujeong-dong, southern Seoul ― the nexus of the nation’s plastic surgery boom. She has just consulted with a doctor about a procedure to shave her jawbone into the narrower “V-shape” favored among Koreans.

From where she sits, one looks up and sees six floors of clinics specializing in the full range of procedures from the popular double-eyelid surgery, which makes the eye appear bigger; to tummy tucks and nose jobs, to the more invasive jaw reduction that Won wants.

While the procedure is ostensibly to boost her self esteem, Won also believes it will change how others view her. “Appearance is very important in Korea,” she says. “I’m still relatively young; I still have to meet people in work and social life. This will help me remarry.”

Korea is gaining notoriety for being at the vanguard of the worldwide surge in plastic surgery. According to recent data from the International Society of Aesthetic Plastic Surgeons (ISAPS), the country led the globe in such cosmetic procedures in 2011 on a per capita basis with a total of nearly 650,000. An estimated one in ten Koreans have undergone some type of cosmetic procedure.

The ISAPS figures include medical tourists as well as non-invasive procedures such as laser skin therapy. Still, the lengths many Koreans are willing to go to for beauty, continue to raise the question of whether Korea has become too superficial.

While a fixation on appearance is not unique to Korea, scholars say it is intensified due to a history of rapid economic development and an ultracompetitive society. A better understanding of the phenomenon, they say, could pave the way for developing a wider concept of beauty, success and happiness.

Premium on beauty

Lee, a 29-year-old teacher, was unhappy with her cheeks, which she felt were too thin. In search of the “egg-shaped” head that is sought after here, she consulted with 10 plastic surgeons before deciding to get an autologous fat injection to make her face fuller. During the process, she was convinced to alter her eyes as well.

“I had never thought about getting a double-eyelid surgery, but six of the doctors recommended that I get it, saying I would look much better,” Lee said. “Friends around also told me it would be nice.”

Such experiences, observers say, point to societal pressure ― particularly on women ― to achieve an ideal of beauty. A growing number of men are also seeking procedures.

Scholars link the fixation with appearance to Korea’s relatively homogenous and racially distinct society, which has, historically, has put forth narrow ideals of beauty. Divergences from the norm are often scrutinized and seen as weaknesses.

“In other societies where people are more diverse, having one agreed upon standard is much more difficult,” said Kim Min-zee, a professor of sociology at Ewha Womans University. “But here people have the perception that (achieving a particular standard) is more or less easily achievable, especially with the availability of plastic surgery.”

The current look favors features such as a double-eyelid, a small face with a rounded forehead and narrow jaw, and a high nose bridge.

Park Jin-seok, an Apgujeong doctor specializing in breast enlargement said the vast majority of his clients were “not seeking large breasts but rather normal-sized breasts.

“They face a lot of pressure to blend in. They want to be able to go to the public bath without shame. We help them,” he said.

Koreans say there is enormous pressure to marry at a young age to a partner of high social standing, and that cosmetic surgery can help them tie the knot. Appearance is also important in landing a job.

Cosmetic surgery on the peninsula can be traced back to the work of a U.S. military surgeon named D. Ralph Millard during the 1950-53 Korean War.

Better known for his pioneering work on cleft palate repair, Millard took interest helping prospective immigrants to the United States adjust to Western norms. In his writings, Mallard said the “folds that were exotic in Pusan (Busan) or Kyoto will be strangely foreign to the Main Street of a Midwestern town.” To address this, he introduced what is now known as double-eyelid surgery.

Pressure cooker society

The pursuit of better looks, some suggest, is symptomatic of problems lingering from Korea’s rapid economic development. “Because so much that has happened to Korea has been really fast-paced, plastic surgery is part of a construction of reality that is about always having to be moving to a point of improvement, refinement and perfection,” said Nadia Kim, an associate professor of sociology at Loyola Marymount University.

Scholars say the nationalized development push, which saw the country rise from the fratricidal war to a top 15 economy, has translated to an overly competitive society. This is perhaps best exemplified by a highly-competitive education system in which often students attend hours of afterschool academies with the hope of entering one of the nation’s top universities.

“We don’t have a lot of time for self-reflection or a lot of time to learn to express ourselves,” Ewha student Song Sae-un said. “I think that a lot of people see appearance as a relatively fast and easy form of expression.”

Seoul-based psychiatrist Park Jin-seng said the competition often translates to feelings of inferiority.

“If students study very hard, they can get a high position. With plastic surgery, they can marry well and get high status. But if they fail, there is a lot of frustration,” he said, adding that competition has also driven Korea’s soaring suicide rate.

Normalization

The most immediate factor pushing the trend, however, is the accessibility ― and acceptability ― of cosmetic surgery.

The medical system lends itself to the proliferation of clinics: Cosmetic surgery, unlike non-voluntary procedures, is not covered by national insurance. Doctors flock to plastic surgery in order to charge higher fees. “Nowadays, many excellent medical students are interested in dermatology or plastic surgery,” Dr. Park said. Meanwhile, advanced technology and cheaper prices have driven demand from medical tourists.

Experts also point to the media’s role in “normalizing” plastic surgery among the public.

In the TV show, “Let Me In,” participants are given “extreme makeovers” at no cost. On the heels of the show’s launch last year, some viewers reacted virulently, saying it encourages surgery as a cure-all solution. Nevertheless, the show has been a hit.

While some stars keep mum about rumors over their plastic surgery, others, including Hyun Young and Kang Ye-bin, have been outspoken about the empowering effect it can have.

“The media definitely plays a big part in encouraging some of my friends to have plastic surgery,” a 24-year-old college student, who refused to be named, said at a cafe in Apgujeong-dong.

The concerns about media become an issue when new stars come into the spotlight. When the public turns its eyes to a new starlet, the student said her friends clamor to achieve the look.

Looks and happiness

Lee, the teacher, was happy with the results of her procedures. Later, she tried botox injections, but didn’t like the result, and also is unlikely to have a major procedure in the future.

“I wasn’t happy with the way I looked; that’s why I chose surgery. Now I feel a bit more confident and happy,” she said.

Lee’s case is one that psychologists here would deem “healthy” because she had a clear motivation for the seeking the procedure, it was within her financial means and she was satisfied with the results. Unhealthy cases, said Dr. Park, continue to show a high level of concern about their appearance and are not satisfied even after a successful surgery.

Some experts, such as Park Jong-hi, a physician at Kangwon National University Hospital and director of the Korea Suicide Prevention Center, believe the surgery trend is symptomatic of the greater issue of competition.

The high level of competition is speculated to factor into social phenomenon such as Korea’s high suicide rate, the highest among OECD countries. The country ranks low on the OECD happiness index due to long working hours and a wealth divide.

“The demand for plastic surgery should not be demonized,” said Park, the physician. “But the problem with Korea is that the competition ㅡ which seems to be driving the demand for cosmetic surgery ㅡ seems to have prevented people from developing their own, subjective happiness index.

“Cosmetic surgery could be a symptom of a society that is experiencing trouble embracing a more diverse set of values.”

Krys Lee, a Korean-born author who touches on identity issues, said any push toward a uniform ideal of beauty stifles room for diversity.

“It says something more about society in general and what their expectations of women are,” she said. “The danger is that it is harder to grow fully as a human being when you cave into the pressures of society around you and become what others want of you rather than what you want of yourself.”

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