Thinking About Getting Cosmetic Surgery in Korea? Make Sure You Read This First

Korea Cosmetic Surgery(Sources: left, dongA; right, The Kyunghyang Shinmun)

The more operations, the more possibilities for complications, mistakes, and patient deaths. So, with the highest per capita number of cosmetic surgery operations in the world, you’re always going to hear a lot of harrowing, even terrifying experiences of going under the knife in Korea. Korean cosmetic surgeons, who are no more unethical or incompetent than those from any other country, shouldn’t be singled out for horror stories that can happen anywhere.

But it’s more than just numbers. With so many clinics lacking even basic first-aid equipment; doctors clamoring to break into the lucrative cosmetic surgery market whatever their training and specialization; patients receiving little to no warnings of side-effects; little regulation by the Ministry of Health and Welfare; insufficient support staff because they’re too expensive; and patients doped-up to disguise the fact that the hot-shot surgeons they’ve hired have been replaced with cheaper ones, then the whole industry is well overdue for a makeover. In hindsight, it’s amazing that such an important growth market, and symbol of Korean skill and technological prowess, is really such a cowboy industry.

I learnt how bad things were from translating and following-up on the following article, but frankly it’s not the best source in itself. Feel free to skip through to the links at the end instead, which I hope provide a valuable resource for readers:

성괴 대신 내면미인 뜨는 세상 꿈꾼다 / I Dream of a World of Inside Beauty, Instead of Cosmetic Surgery Monsters

The Kyunghyang Shinmun, 22.05.13, by 이보람 / Lee Bo-ram (boram@k-health.com)

‘성형대한민국’에서 벗어나려면… / How to change this cosmetic surgery republic…

2013년 대한민국의 성형은 과열양상을 넘어 광(狂)적인 면까지 보이고 있다. 이를 잘 나타내는 말이 ‘성괴(성형괴물의 줄임말)’다. 최근 젊은 층에서 유행하는 말인데 똑같은 얼굴의 여성들이 강남거리를 활보하고 있다는 한 웹툰 작가의 만화에서 비롯됐다. 이러한 현상을 없애고 올바른 성형문화가 자리 잡기 위해 선행돼야 할 것은 무엇일까. 전문가들은 무엇보다 ‘내면의 아름다움이 평가받는 나라’가 돼야 한다고 입을 모은다. 특히 우리 사회에 만연된 외모지상주의가 먼저 타파돼야 한다는 지적이다.

In 2013, cosmetic surgery has just gotten crazy in Korea. This is shown in the arrival of a new term, ‘cosmetic surgery monster.’ Popular among young people, it originated from a webtoon about women on the streets of Gangnam all strutting about with the same face. What things have to be done in order to resolve this situation, and cultivate a proper cosmetic surgery culture? Experts say we have to be a country where inner beauty is also evaluated. In particular, we have to do away with the lookism that is deeply entrenched in Korean society.

SNL Korea Plastic Face 1(Source: Roshiel. See also: “SNL 코리아 Satirizes Korea’s Cosmetic Surgery Craze)

외모 편견·차별 사라져야 사회정의 구현 / Social Justice Requires the End of Judging and Discrimination based on Appearance

미국 스탠퍼드대 데버러 로우드 법대교수는 저서 ‘아름다움이란 이름의 편견’에서 외모지상주의의 문제점을 꼬집었다. 그는 전반적으로 외모가 떨어지는 사람은 고용이나 승진가능성이 외모가 뛰어난 사람보다 낮았으며 매력적인 외모를 가진 정치인은 그렇지 않은 정치인보다 두 배 이상 많은 표를 얻었다고 말한다. 또 외모를 법적·정치적인 평등의 문제로 바라볼 때 비로소 외모로 인한 편견과 차별을 없애고 진정한 사회적 정의를 구현할 수 있다고 강조한다.

Stanford University Law professor Deborah Rhode pointed out the problems of lookism in her article “Prejudiced Toward Pretty” (2010). She said that, overall, chances of employment and promotion decrease with one’s appearance. Attractive politicians also receive twice as many votes as uglier opponents. Also, she emphasized that in order to realize social justice and end discrimination, it is necessary to think of differences of appearance as a legal and political issue.

건강과 대안 이상윤 책임연구원은 “요즘 우리 사회를 보면 외모에 의해 성과나 능력이 평가되는 것이 도를 넘어섰다”며 “중장기적으로 외모지상주의에 대한 국민적 인식전환이 필요하고 개인의 능력과 성과로 평가받을 수 있는 사회가 돼야겠지만 지금 상황에서는 성형에 대한 피해와 규제부분 등을 보다 정확하게 알리고 천편일률적이고 획일화된 아름다움의 기준이 변할 수 있도록 모두가 노력해야한다”고 지적했다. 전문가들은 이와 함께 성형수술에서 나타날 수 있는 의료분쟁은 물론 의료사고에 대한 인식수준을 높이는 것이 필요하다고 강조했다. 즉 수술을 원하는 이들이 수술에 대한 위험성과 후유증 등을 정확히 알 수 있게 하는 통로가 필요하다는 것이다.

Lee Sang-yoon, chief researcher at the Center for Health and Social Change, said that “When we look at our society these days, it’s ridiculous how much ability and achievements are based on appearance,” and pointed out that “In the mid to long-term, we need to change our attitudes to lookism. We have to become a society in which people are evaluated based on their own individual abilities and achievements. But for now, it is more important to make people aware of the dangers of cosmetic surgery, to regulate it more, and to promote the idea that there is more than just one, monotonous beauty standard to aspire to.”

Experts emphasize that people considering cosmetic surgery should educate themselves more about side-effects and their legal options should problems arise. Both should be made easier for prospective patients.

실제 의료분쟁조정 신청이 매년 증가하는 가운데 성형외과와 관련된 의료분쟁도 큰 축을 차지하고 있다. 한국소비자원 소비자분쟁조정위원회 의료분쟁조정 신청조사 결과 올해 1분기에 신청된 의료분쟁조정사건은 233건으로 전년 동기(73건) 대비 약 3배 이상 증가했다. 진료과목별로는 내과, 정형외과·성형외과, 치과, 신경외과 순이었다.

한국소비자원 관계자는 “치료방법의 장단점을 숙지하고 고령이나 수술병력이 있는 환자의 경우 치료방법에 따른 효과나 부작용, 비용 등을 충분히 고려한 후 수술은 최후에 신중하게 결정해야한다”고 말했다.

Medical malpractice suits are increasing every year, a large proportion of which are cosmetic surgery-related. According to a survey by the Korea Consumer Agency, in the first quarter of 2013 there were 233 suits, over three times those in the same period the year before (73). In order of ranking, most were internal medicine related, followed equally by orthopedic surgery and cosmetic surgery, then dental, and finally neurology.

A spokesperson [A guess—literally, the term is "person connected to"] from the Korea Consumer Agency said “People have to weigh the good points against the costs and possible side-effects of cosmetic surgery very carefully. Older patients and those with preexisting conditions and medical histories should really consider if it is necessary at all.”

성형수술피해자 ‘인권·구제’ 사각지대서 방황 / Cosmetic Surgery Victims Are at a Loss

또 성형에 대한 ‘정확하고 올바른 정보 제공’이 필요하다는 지적도 이어졌다. 사실 지금으로선 성형외과수술에 대한 정보는 일부 병원이나 업체에서 운영 중인 포털사이트 카페나 관련 블로그 글들이 대부분이다.

Accurate and unbiased information about cosmetic surgery is also required. At the moment, information is mostly available from portal sites and blogs run by hospitals and the medical industry.

한국환자단체연합회 안기종 대표는 “사실 성형수술피해자들은 인권이나 구제 부분에서 사각지대에 놓여있는 상태”라며 “아무래도 본인이 원한 수술이었기 때문에 수술 후 의사에게서도, 가족에게서도, 나아가 사회에서도 외면 받는 상태”라고 말했다. 안 대표는 “본인이 예뻐지고 외모적인 만족을 얻기 위해 수술을 했지만 수술 후 부작용이 생겼거나 의료사고가 발생했다면 당연히 그에 합당한 법적 보호를 받아야한다”며 “정부가 정확한 성형피해자 실태조사에 나서 적극적으로 보호받을 수 있는 통로가 마련돼야한다”고 주장했다.

An Gi-jong, a spokesperson for the Korea Alliance of Patients Organization, said “In fact, cosmetic surgery victims are in a bit of a blindspot in terms of their support and legal rights,” as “because the surgeries are voluntary, when things go wrong they receive little sympathy from society, their doctors, and even their families.” He insisted that “even if the victim underwent surgery to improve their appearance, if malpractice occurs they should still receive legal protection,” and “the government should look into the current status of cosmetic surgery malpractice cases and implement a more proactive way of safeguarding their rights.”

현장에선 성형진료 허용 놓고 ‘갑론을박’만…. / The Pros and Cons of Limiting Cosmetic Surgery Licenses

이처럼 성형수술이 과열양상이 보이면서 일각에서는 성형진료를 성형외과 전문의에게만 받을 수 있도록 한다든지 전문의와 비전문의를 보다 확실하게 구분할 수 있도록 하는 대안이 필요하다는 목소리도 나오고 있다.

As explained, cosmetic surgery is getting out of control. So, one school of thought holds that only specialists should be permitted to perform operations.

대한성형외과의사회 이상목 회장은 “성형외과가 난립하고 각종 성형과 관련된 의료사고가 빈번하게 발생하는 이유는 전문의가 아닌 이들이 성형관련 진료와 수술을 하기 때문”이라며 “정부는 보다 확실하게 성형 전문의와 비전문의를 차별화해 국민들이 제대로 선택할 수 있게 하는 방안을 강구해야한다”고 말했다.

Lee Sang-mok, chairperson of the Korean Society of Plastic and Reconstructive Surgeons, said “One reason there are so many clinics popping-up and the number of malpractice suits is increasing is because so many non-specialists are performing surgeries.” Consequently “The government should make a division between specialists and non-specialists and help patients to choose doctors appropriately.”

하지만 전문의와 비전문의를 차별화하고 전문의에 대한 정보만 제공할 경우 오히려 일부 전문의에게만 시장독점권이 부여돼 비용이 높아지는 문제가 생길 수 있다는 반론도 만만치 않다.

However, if such a division is made, and patients are directed only towards specialists, there is a danger of monopolization and increased costs for consumers.

보건복지부 보건의료정책과 관계자는 “현재 의료법상에서 의사면허를 취득한 이들은 성형이나 피부 등의 의료행위를 할 수 있다”며 “전문의와 비전문의를 나누는 등의 규제는 오히려 한쪽에 독점적인 권한을 주게 돼 가격심화현상이 빚어지게 될 것”이라고 말했다.

A spokesperson [Again, technically a person connected to] from the Ministry of Health and Welfare’s medical welfare department said “According to current laws, anybody with a medical license can perform cosmetic surgery or dermatological operations,” and agreed that “a division between specialists and non-specialists would result in monopolization and higher costs.”

여기에 과도한 병원광고나 마케팅 등을 규제하고 제지할 필요가 있다는 의견도 꾸준하게 제기되고 있다. 이에 정부는 과열된 미용성형수술 오·남용 사안을 점검하고 예방대책을 강구하기 위한 ‘보건의료안전관리대책협의회’를 꾸린 상태다. 정부는 협의회를 통해 무분별한 미용성형광고를 제지하고 이용을 부추기는 부분에 대한 규제를 검토 중인 것으로 알려졌다.

In addition, there are an increasing number of voices raised against excessive hospital advertising and marketing, and are calling for their regulation. In response, the government established the Health Safety and Prevention Association in order to investigate how to cool down the cosmetic surgery fever, its marketing, and to and prevent abuse and excesses within the industry (end).

Korean Cosmetic Surgery CartoonHere are some links for further reading, in chronological order. Naturally, most cover much of the same material as each other, so for busy readers I’ve highlighted some of the most important points from them here (source, right: 헬스경향):

A very old article of course, but its description of the industry could easily pass for 2014.

Cut throat competition among the growing number of plastic surgeons has driven some to promote more radical procedures that others might not offer…

…A doctor with the Korean Society of Plastic and Reconstructive Surgeons said the procedure took off around four years ago when a Seoul dental clinic ran a major ad campaign promoting the cosmetic benefits.

As it became popular, plastic surgeons began offering the surgery, causing the price to fall and making it more affordable to more people.

“If we are seeing more complications, that’s largely because the sheer number of people getting the surgery has increased rapidly in such a short period of time,” said the doctor, who declined to be identified.

As the number of plastic surgeries has risen in Korea, so too has the risk for accidents. According to the International Society of Aesthetic Plastic Surgery, 650,000 plastic surgeries were performed in Korea in 2011. But experts also point to lax regulations and inadequate facilities as cause for concern.

About 839 out of 1,091 cosmetic surgery clinics nationwide lack proper emergency medical equipment, according to an assessment by the Health Insurance Review and Assessment Service. And many clinics go without hiring anesthesiologists or trained professionals to cut costs.

By law, any doctor with a medical license can perform a cosmetic surgery, even if he or she does not specialize in the field. The clinic in North Chungcheong, where one patient died in March, did not have a specialist.

Experts point out that clinics should be equipped with appropriate medical equipment to deal with emergencies that can occur during a surgery.

However, most do not have this or any other measures in place.

In data provided to Rep. Choi Dong-ik of the main opposition Democratic Party (DP), 77 percent out of 1,100 clinics performing cosmetic surgery were not equipped with defibrillators or ventilators, which are mandatory devices for first aid. Only 1.2 percent of such clinics in Gangnam have emergency equipment…

…Laws governing medical advertizing state that such billboards must have warnings included details of the potential side effects of surgery, but most have these in such small lettering that it is barely legible. An abundance of plastic surgery ads appeared after the government allowed medical institutions to set up promotions outside their premises in 2012.

…the Ministry of Health and Welfare has been taking a hands-off approach to plastic surgery because it is not covered by national health insurance.

“The Ministry of Health and Welfare does not guarantee the appropriateness of medical activity or the safety of new medical technology,” said Kim Jun-hyun, a member of the policy board for the Health Right Network. “The Ministry should at least assess the safety of operations offered by plastic surgery clinics through an official investigation.”

The number of complaints involving botched procedures almost tripled from 1,698 in 2008 to 4,806 last year, according to the Korea Consumer Agency. Among the 71 people who got help from the KCA in settling disputes over botched plastic surgery in the first half of 2013, only 15 percent said their surgeons warned them of the risks and potential side effects in advance.

Lee Sang-mok, the president of the association who also led the probe, said that his team had discovered instances of ghost surgery among doctors, which is the practice of substituting one surgeon for another without the patient’s knowledge.

The association also acknowledged that some doctors would administer to patients large doses of sleeping pills in order to conceal the fact that a different surgeon was performing the operation.

The president attributed such cases to excessive competition in the industry and low moral standards among surgeons.

Related Posts:

(Hat tip to Hong Kong Law Blog for some of the links)

Operation Beautiful: An Interview with Korean Body Image Activist Min-ji Kim

Minji Kim Busan HapsRemember this immensely popular guest post from last year? Click on the image for my interview of its hardworking and inspiring author, body-image activist Min-ji Kim. Frankly, it’s well overdue!

Quick Hit: Consent is STILL Sexy

Consent(Source: Heal Yourself, Skeletor)

I’m just sick of Bora’s boobs.

Okay…no, not really. They’re just a constant reminder of the curse of blogging about sexuality and popular culture. Thanks to them, “Consent is Sexy: SISTAR, slut-shaming, and sexual objectification in the Korean idol system” is literally my most viewed post—but also, per view, probably one of the least actually read.

You’d never think it took a month to research and write, and that I consider it one of my proudest blogging achievements.

Ironically for the frustration that causes now though, it too was born out of the frustration of two weeks of watching interviews of SISTAR members, naively hoping that they would reveal something about the extent to which they consented to—indeed, hopefully played an active role in choosing—the sexualized costumes, choreography, and so on provided by their management company. Instead, I was left with nothing more substantial than learning their favorite flavors of ice-creams, and a firm resolve never to watch any more of the crap that counts as most K-pop entertainment.

But finally, nearly a year later, I’ve just learned of two interviews where girl-group members were able to talk about their jobs like actual human beings.

The first, on the new show The Spokespeople (대변인들), where Rainbow’s Jisook, Stellar’s Gayoung, and Dal Shabet’s Subin, from roughly 8:00 to 26:00 (it’s—grr—unavailable in Korea; click here to overcome that) discussed their recent ‘sexy concepts.’ It’s a still a little frustrating in places, the MCs being “spokespeople” for the “weaker people who can’t speak out” apparently meaning that guests should shut up while the MCs speak for them instead, with poor Subin barely getting a chance to speak at all. But when they did, all three sounded quite genuine:

Next, as Asian Junkie put it:

Ex-TAHITI member Sarah Wolfgang (Hanhee) did an AMA on Reddit recently, where she answered questions on everything from a group member smelling like shit to eating disorders.

And you can read a breakdown of the interview there, including those eating disorders, her complete lack of input into her image, and the debts members are sometimes left with.

Finally, it’s not a recent interview, but The Learned Fangirl just did a review of Nine Muses of Star Empire (2012), which I also covered in last year’s post. While that documovie may sound dated by K-pop standards, it easily remains the most revealing look inside the industry, and I completely agree with the authors’ conclusion:

Interestingly, Billboard‘s Jeff Benjamin had a very different take than us on the documentary, calling it a film that would cause “k-pop haters [to] completely shift their paradigm.” We doubt that — instead it will make a manufactured music form seem manufactured. It’s a warts-and-all look behind the curtain of music industry, and is an unsentimental look at what it takes to create pop star fantasy.

Thoughts?

Related Posts:

When K-pop Gets Under Your Skin…

city of girls' generation gangnam(Source)

My latest piece for Busan Haps, on the contributions that K-pop has made to cosmetic surgery medical tourism.

I chose the topic because I’d always assumed that K-pop was easily Korea’s #1 cultural export. And, building on from that, that surely most medical tourists to Korea would be coming for cosmetic surgery. After all, what would this blog be without all the posts on dieting and body-image narratives in K-pop songs? On stars’ cosmetic, beauty, and dieting-related endorsements? Or, of course, on the ideals set by their bodies themselves?

I couldn’t have been more wrong.

First, because K-pop only accounted for just five per cent of the revenues from cultural content exports in 2013, as demonstrated in this Arirang news report from January. That worked out to $255 million, out of a total of $5.1 billion.

Korean Content Industry Exports for 2013(Source)

Next, because cosmetic surgery tourists only comprised seven point six percent of medical tourists in 2012. Yes, really.

When I wrote the article, I mistook that for the 2013 percentage, which isn’t available yet. But, assuming it remained the same (although the trend is for rapid growth), that would have resulted in a paltry $7.6 million in revenues in the January to November 2013 period, based on these figures that incorporate revenues lost from Korea’s surprisingly high numbers of outgoing medical tourists (unlike the grossly inflated KTO figures).

No wonder “a renowned business professor” recently dismissed the economic benefits of K-pop.

Frankly, another reason I chose this topic was because I expected I’d quickly prove him wrong. Instead, I soon found myself chagrined, forced to concede that perhaps he had a point.

But the long-term benefits? He’s dead wrong about those. To find out why, please see the article!

Corée du Sud La quête du galbe

Corée du Sud La quête du galbe Eva John(Source)

For French speakers, a Libération article about body image and cosmetic surgery in Korea that I was interviewed for recently. Many thanks to Nouvelles d’Asie ‏for and A G on Twitter for passing it on, and for the above photo.

Unfortunately, it’s one Euro for a month’s access. But you can’t ask for much cheaper than that!

Update: The article is freely available now.

Media and Body Image Workshop, Bar Carmen, Seoul, Sunday 30th, 5-8pm

(Sources: left, center, right)

Yes, it’s back on, and I promise that none of my relatives will be in hospital this time!

Once again, please see Disruptive Voices’ Facebook Event page for more details and RSVPs, or if you’re not on Facebook then please feel free to ask any questions in the comments here, and/or to just turn up to Bar Carmen in Itaewon on the day. (Note that it’s not on the main drag though, but on the other side of the hill: see here or here for maps.)

Those Damned Double Eyelids…

How can a society still have Caucasian beauty ideals if its members explicitly don’t want to look White?
Park Bom 2NE1 Can't Nobody Screenshot(Source)

Ubiquitous skin-whitening ads. Cosmetic surgery clinics with only Caucasians on their websites. Until a few years ago, almost never seeing a Korean lingerie model.

With parents, hakwon-owners, and recruiters demanding only Caucasian English teachers too, you can hardly be blamed for assuming that the corollary of White privilege is Caucasian beauty ideals. Add the large numbers of Korean women who get surgery for double-eyelids or more prominent nose-bridges, features widely perceived as much more common among Caucasians than Koreans, then who hasn’t once thought that Korean women go under the knife because they want to look White?

Of course, actually talk to Korean cosmetic surgery patients, and most take great offense to that notion. And they would surely know their own motivations—much better than any outsiders or newbies to Korea, who may not realize what intellectual baggage and racial stereotypes they’re bringing with them. Also, light skins have been associated with non-farming elites for millennia; Caucasians may be used on cosmetic surgery websites more in an Occidentalist sense to signify class and lifestyle than specific body features; and Caucasians were really only used in lingerie modelling because moonlighting pornography actors tainted it for Korean models. Even double-eyelids may not be as Caucasian as thought, as it is commonly claimed that possibly as many as 50% of Koreans have them (although in my experience, little to no evidence is ever provided for any figure—even by academics).

Korean Cosmetic Surgery Clinic Website(Source)

That said, I think commentators can sometimes come across as a little smug and superior as they point out the mistakes of “expats-turned-anthropologists“; after all, expats are just strangers in a strange land, trying to make sense of the place. What’s more, they don’t form their opinions in a vacuum, they’re not all simply racist, and I hardly countered all their observations with that last paragraph. So it would be incredibly myopic and defensive to just dismiss their opinions, and/or to pretend that current Korean beauty ideals haven’t been at all influenced by the “the very real presence of white people” in Korea in the last 60 years.

In short, Korean beauty ideals are complicated. And sure: perhaps by all those “expats,” I’m really just talking about myself not so long ago (that’s complicated too). Either way, over the years I’ve been reading about body image in Korea, I’ve often been taken aback by the number of academics who didn’t acknowledge how convoluted the subject is. Some just seemed to take Caucasian body ideals as a given. Why? Were they just being lazy? Were they simply parroting the narratives about Korean cosmetic surgery that dominate the English-language media? Hadn’t they ever—damnit—actually talked to Koreans, who would have vehemently denied wanting to look White?

Reshaping the Female Body, Body Image(Sources: Left, right)

Apologies though, for not taking note of exactly who said what at the time, but then I’m not here to attack any convenient strawmen. Instead, I want to pass on an alternative explanation that I’ve just come across:

  • First, that because different body features, types, and weights have different positive or negative associations (e.g., fat people are lazy), however unfairly and irrationally (jumping ahead, flat noses and eyelids without a crease have negative connotations in the US).
  • Next, that because these associations are legitimated—indeed, perpetuated—by the seeming scientific rationality and objectivity of cosmetic surgeons
  • That consequently, Korean cosmetic surgery patients tend to choose from a limited number of (positively-associated) procedures that tend to make them look more Caucasian (or, more accurately, a heavily Caucasian-influenced, Westernized, increasingly global ideal) than Asian, rather than the other way round (with the proviso that “Caucasian” and “Asian” are largely social constructs).

In other words, they can still retain Caucasian beauty ideals despite not wanting to look Caucasian personally.

Caveats abound. One of the most obvious of which is that it sounds like I’m saying any empowerment patients feel—and most do feel empowered—is really a sense of false consciousness, their choice of positively-associated procedures really being heavily circumscribed by society, their surgeons, and themselves. I’m very wary of any notion of consumers as dupes though, so I was glad to stumble across the work of Kathy Davis for an opposing viewpoint, as described in Body Image: Understanding body dissatisfaction in men, women, and children by Sarah Grogan (2nd ed., 2007). Yet she too acknowledges empowerment still occurs within the context of culturally-limited options (page 70, my emphases):

The question of why women are willing to undergo unnecessary surgery to make their bodies conform more closely to accepted norms may help us to understand the nature of body dissatisfaction in women. Kathy Davis (1995) in Reshaping the Female Body: The Dilemma of Cosmetic Surgery looks at cosmetic surgery from a broadly feminist viewpoint. She argues that understanding why women engage in a practice which is painful and dangerous must take women’s explanations as a starting point. She attempts to explore cosmetic surgery as one of the most negative aspects of Western beauty culture without seeing the women who opt for the “surgical fix” as what she calls “cultural dopes”(i.e., by taking seriously their reasons for having cosmetic surgery).

Page 71:

Women she interviewed [in the Netherlands] reported that they experienced the decision to have cosmetic surgery as a way of taking control of their lives, and that cosmetic surgery was something that they had decided upon for themselves, rather than under pressure from partners or knife-happy surgeons. They were clear that they had made informed choices, based The Politics of Women's Bodieson weighing up the risks and possible benefits of surgery. Davis takes the position that cosmetic surgery may be an informed choice, but it is always made in the context of culturally limited options. She argues fiercely against the idea expressed by many authors, including Kathryn Morgan (1991), that women who opt for cosmetic surgery are victims of male lovers, husbands, or surgeons. She also disagrees that women who opt for cosmetic surgery are the dupes of ideologies that confuse and mystify with the rhetoric of individual choice.

Davis (1995) sees women as active and knowledgeable agents who make decisions based on a limited range of available options. She argues that women see through the conditions of oppression even as they comply with them. The women she interviewed reported that they had made free choices, although these “choices” were limited by cultural definitions of beauty and by the availability of particular surgical techniques. The “choices” need to be placed within a framework that sees women’s bodies as commodities.

But the journal article which inspired this post is “Medicalization of Racial Features: Asian-American Women and Cosmetic Surgery“, Medical Anthropology Quarterly 7(1), pp. 74-89, March 1993 by Eugenia Kaw, which I read on pages 167-183 of The Politics of Women’s Bodies: Sexuality, Appearance, and Behavior, ed.by Rose Weitz (1st edition, 1998; source, above-right). Originally, I intended to summarize it for you here, but since I’ve started writing I’ve found a PDF of the article, so frankly I see no need—interested readers can just download it and read it for themselves. Instead, let me provide some copy and pastes here to give the gist for any much-too-busy-but-still-quite-interested readers.

First, from page 79, on the negative associations of “Asian” features:

Eugenia Kaw 1From page 81 on the how the medical industry legitimizes and perpetuates those negative associations:

Eugenia Kaw 2Finally, from pages 85-86, on the clear patterns that emerge despite patients making “truly individual choices” (alas, Kaw too is guilty of casually throwing in that 50% figure!):

Eugenia Kaw 3Again, caveats abound. Not only is Kaw’s article quite dated, but there are dangers in extrapolating studies based on Bay Area surgeons and patients to Koreans (to be clear, Kaw herself never does so). As Ruth Holliday and Jo Elfving Hwang explain in “Gender, Globalization and Aesthetic Surgery in South Korea”, Body & Society, June 2012 18: 58-81 (page 7 at this downloadable link):

In researching cosmetic surgery in Korea, a further problem of ‘ethnic’ cosmetic surgery studies which focus on Asian-Americans is that their results have been generalized to apply to ‘countries of origin’; that is, Koreans in Korea. Accordingly, what are seen as ‘whitening’ practices in the West are also presented as ‘Westernizing’ practices in the East without much consideration of localized discourses that intersect with more globalized practices of cosmetic surgery. Explanation of Korean cosmetic surgery only in terms of Westernization seems unlikely given Korea’s strong sense of nationalism, as well as its national relationship with other regional powers, for example, Japan.

Indeed, their article is a real eye-opener in its own right (no pun intended!), and made me realize how Korean cosmetic surgery is even more complicated than I imagined, and how much more I have to learn. For example, from page 13 (source, below-right):

Blepharoplasty [eyelid surgery] in particular has often been explained in terms of ‘Westernization’. However, it is worth remembering that whilst many Koreans already have a double eyelid, many Westerners undergo blepharoplasties too. Wider eyes signal youth, energy and alertness. Korean women have used temporary eyelid tapes and glues for decades, most usually justified as easing the application of make-up. Eye surgery is seen as a more convenient permanent fix (the surgery takes ten to twenty minutes depending on technique) which saves time and allows greater participation in sports and swimming, for example. Blepharoplasties (like breast augmentations) Korean Eyeappear to have originated in Japan (the first performed by a surgeon named Mikamo in 1896) and were originally used to treat children born with one single and one double eyelid (Miller, 2006). East Asians tend to have more adipose fat in the eyelid than Caucasians and importantly men and women who have too much fat removed are seen negatively as artificially western. Wider eyes may be desirable, but they must be wider Korean eyes, not Western ones. The most important aim of cosmetic surgery is to create a natural look that ‘enhances’ the body without losing the ‘Koreanness’ of the subject who undergoes surgery.

Like most epiphanies then, this is really a starting point for me rather than the final word, and I realize it may already be familiar to the many readers who’ve done more research into cosmetic surgery than myself (thank you for indulging me!). Nevertheless, I do think that the Korean public and cosmetic surgeons and patients will share many of the same associations as their Bay Area counterparts. And, even if I’m mistaken about that, investigating public associations of and (especially) medical discourses surrounding certain body features promises to be a fruitful new line of investigation for understanding body image in Korea. I’d be very interested and grateful to hear your thoughts on that, and your own observations.

Update: It wasn’t really relevant to the making of this post, but Joanna Elfving-Hwang’s “Cosmetic Surgery and Embodying the Moral Self in South Korean Popular Makeover Culture” in The Asia-Pacific Journal, Vol. 11, Issue 24, No. 2, June 17, 2013, focusing on the Korean show Let Me In, would be an excellent starting point for more on those medical discourses.

Update 2: I’ve been blogging for so long, sometimes I forget what’s already been posted! Please see here for one of my most-heavily commented posts, in which a reader discusses how those negative associations of monolids came about.