One day, Garance and I were talking about some of the crazy and surprising things we’ve been noticing recently in the beauty industry. Something that’s been pretty striking is the increasing popularity of plastic surgery in Asia, and even the Asian community here in the US.
It’s something I’m a little familiar with, having family from the Philippines — tattooed makeup, minor plastic surgery or lip fillers are a little more commonplace there than they are here! And our amazing intern Nicole (who we all love!) has a Korean background, and told us a little about the acceptance of plastic surgery there.
But it’s not something you hear everyone talking about, so we decided to investigate. Our research led us to Dr. David Song, the President of the America Society of Plastic Surgeons who has a special interest in this topic as a Korea-born American. Speaking to him brought so much to light that I hadn’t known before, a really fascinating and insightful look into a rarely exposed corner of the beauty world…
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What is your background in plastic surgery and how did you come to focus much of your attention on Asian-centric plastic surgery procedures?
So, I’m Korean-American. I was born in Korea and came here when I was three years old, and grew up in Los Angeles. I never thought I would go into plastic surgery. I went to UCLA Medical School and, during the first few operations, I saw someone reattaching a finger and, to me, that was the coolest thing ever. So that was what led me into plastic surgery, from the get go, which is microsurgery. Most of what I do currently is reconstructive micro-surgery, breast reconstruction is really my main focus.
I’ve done a lot of speaking on Asian aesthetic surgery from the academic side, and what this means socially. I’m the president of the American Society of Plastic Surgeons so that has taken a greater focus quite frankly just because Asian influence and Asian culture and popular culture has really become global. It’s sort of a convergence of forces; as the Korean pop culture and Asian culture has become more and more globalized, so has the importance of aesthetics, and then, of course, aesthetic surgery.
South Korea has really been at the center of Aesthetic surgery in Asia for quite some time now and, as you probably know, cosmetic surgery in South Korea is extremely common and prevalent. So that’s how I got interested in all this.
Asian culture has become more and more globalized, so has the importance of aesthetics, and then, of course, aesthetic surgery.
And what exactly falls under the banner of Asian plastic surgery, can you explain what are the most popular procedures?
A lot of Asian-centric plastic surgery revolves mostly around facial aesthetic surgery. There’s an increase in breast aesthetics and body contouring, but still the most popular procedures are in the face: eyelid surgery, nasal surgery, facial bone surgery. Those are very common and prevalent across Asia.
What exactly does an operation like the eyelid surgery involve?
Specifically in Korea, approximately 25 to 40 percent have a crease in their upper eyelid but most don’t. So many are looking to create a crease in the upper eyelid, creating a crease in the upper eyelid to give the appearance of a softer look. In the past it’s been confused with Asians trying to look Occidental or Caucasian and, quite frankly, is not that at all. Many Asians do not want to look Caucasian; they want to look more like their Asian counterparts. The standard of beauty has become softer features with a crease in the upper eyelid. I think that has been the biggest misconception and I hope you can emphasize that. It’s not Asians trying to look Caucasian; it’s Asians trying to look more like what’s celebrated in Asia.
I think that has been the biggest misconception and I hope you can emphasize that. It’s not Asians trying to look Caucasian; it’s Asians trying to look more like what’s celebrated in Asia.
What would you say is at the most extreme end of the scale in terms of number of surgeries and lengths that someone would go to?
It’s not necessarily the number of surgeries; it’s the surgeries that are more invasive. Like narrowing the facial width by cutting into the facial bones. That’s a pretty dramatic surgery, and that can change completely someone’s identity. So you combine that with rhinoplasty, which is a nasal surgery, and upper eyelid crease creation, then you literally change someone’s identity. They aren’t recognizable from their previous self. And there have been some issues where Chinese people who have been too creative with surgery have to come back with some sort of affidavit stating they are who they are because they look so different from their past pictures. That’s a pretty dramatic change in appearance.
…there have been some issues where Chinese people who have been too creative with surgery have to come back with some sort of affidavit stating they are who they are because they look so different from their past pictures.
How do you think it impacts their identity culturally?
It’s so difficult to comment on that because everyone has their own personal reasons for doing surgery it. I think many people do it to gain more acceptance and then, sometimes, they find that they look so different that their friends and family don’t recognize who they are. And other times it’s celebrated because it’s a way of transforming into your true beautiful self. Some would actually say that your external appearance matches your inner beauty. That’s talked about a lot in Korea.
So would you say that having plastic surgery is, overall, viewed as a positive thing within certain Asian communities?
It’s definitely not a negative stigma anymore. Is it a positive thing? It’s hard to say because it is so personal. I was struck by, just a week ago, walking around an area called Apgujeong-dong where many of the plastic surgery clinics are concentrated in the Gangnam of Seoul. I probably saw half a dozen patients walking around with bandages around their foreheads and splints on their nose shopping. It’s really not something that’s secretive or hidden.
It’s really not something that’s secretive or hidden.
Outside of Korea where are seeing the growing popularity of being open about plastic surgery most commonly?
China, for sure. And to be clear there are many, many Chinese coming to Korea for their surgeries. I think that there are new statistics out by our society saying that China by 2020 maybe will be the third most prevalent cosmetic surgery nation in the world. That’s just within our news today: plastic surgery in China is predicted to hit 125 billion by 2019 for the third largest market.
What is the age range of people having these surgeries? What stage of their life are people having these surgeries?
Once again it’s an entire spectrum of older patients wanting to look rejuvenated, younger patients wanting to change and enhance their facial and body features. I’ve seen people that are in their late teens, 17 or 18. Then of course someone who is in their 80s. I would say it’s more concentrated with the 20s and 30s and probably more prevalent amongst women.
Do you think social media has had any impact on increasing the popularity and acceptance of plastic surgery in Asia?
For sure. It’s also a commonplace thing to see on TV – in most dramas and movies, as well as everyday news. Ten to fifteen years ago it wasn’t necessarily that prevalent in the media but now it’s everywhere. You see advertisements in the subway, you see advertisements in magazines. You see columns written about it, blogs written about it, and obviously on network TV as well in Korea.
It’s also a commonplace thing to see on TV – in most dramas and movies, as well as everyday news.
And these people who are selling plastic surgery procedures, the models and the actors and the spokespeople, are they usually people who have had operations themselves?
Many yes, and many will actually talk about it. Some will not talk about it. Not to be purposefully vague, it’s just a personal decision. It spans an entire spectrum of people that are well known to have had plastic surgery and people who don’t want to talk about it but clearly have had plastic surgery to maybe some that have not have plastic surgery.
Would you say it’s less taboo to talk about work that you might have had done in Asian countries than in Western countries?
I think so. I think particularly in Korea and in China because the incidents and the prevalence of cosmetic surgery is high, relatively speaking to the States, it’s less taboo and less taboo and stigmatized to talk about.
When did you really started to see more people in the Asian community here in the US embracing it in the same way that you have seen in Asia?
It has been a steady rise. I would say that 7 or 8 years ago is when we started to see an increase in Asian patients and now annually it’s been a steady rise in Asian patients looking for aesthetic enhancements and aesthetic surgery.
What are the risks involved in having procedures like this? The narrowing of the jaw and the eyelid procedure and other procedures that falls under this Asian-centric plastic surgery banner…
For any aesthetic surgery, people have to know that it’s real surgery. I think there’s a misconception. The flip side of the coin is that when the stigma is taken away and the taboo is taken away, the dangers and complications are glossed over and it’s glamorized. So it is real surgery. It’s real anesthesia. There are real potential complications related to it including bleeding, effects on vision. Particularly when it comes to jaw surgery, your teeth not lining up properly. Complications such as infection. It’s been reported that people have anesthesia reactions that aren’t talked about. Those are the extreme rare situations but these patients have to know that this is real surgery.
The flip side of the coin is that when the stigma is taken away and the taboo is taken away, the dangers and complications are glossed over and it’s glamorized.
What is the recovery time like for operations like the narrowing of the jaw?
The narrowing of the jaw the facial bones are actually cut and plated. There are plates and screws that are used to put them back together. This can mean 6 weeks before they see semblance to return to normalcy. For things like eyelid surgery it’s less, probably 2-3 weeks. For nasal surgery some say it take several months to get a stable long-term result because of the swelling, so it does vary.
What do you, personally, feel are the benefits of having a procedure like this?
Well, the benefits are extremely personal. For patients it varies from self-esteem, to confidence, to feeling much better about themselves – and that’s the real reason to do this type of surgery or any other type of cosmetic enhancement. Generally the patients we see that have long term results that they are very happy with are patients that do it for themselves.
What do these procedures cost?
It varies. Eyelid surgery can be in the low $1,000 – $2,000 range. Facial bone surgery can be upwards of $25,000 dollars. Rhinoplasty is somewhere in between.
Why do you think this is becoming a more prevalent practice now more than ever?
I think that just media attention and the ability to have consultations and travel. I think you are seeing a rising middle class and a rising wealthy class in China, for example. You are seeing the rise in the digital age and importance of image more so than maybe 20 years ago. And just greater awareness across media, both Internet and more traditional media outlets you are seeing greater exposure to aesthetic surgery. So, I think a combination of all those factors is what’s driving the rise of cosmetic surgeries in Asia.
You are seeing the rise in the digital age and importance of image more so than maybe 20 years ago.
Finally, do you have any advice; physical, mental or otherwise, for someone who is considering one of these procedures?
I think the advice that I would give is to seek someone that’s a member of the American society of plastic surgeons. Do your homework. Make sure to build a rapport with your surgeon and ensure that your surgeon knows what your motivations are, what your expectations are, and what the potential risks and complications can be. I think that’s the most important thing. People spend more time researching their hair salon than their plastic surgeon unfortunately and that has to change. This is real surgery with real potential complications, it’s a serious endeavor and they should do their homework.
People spend more time researching their hair salon than their plastic surgeon unfortunately and that has to change.
Photo: Erik Melvin