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Asian Plastic Surgery—Social Issues by Shirley Leong

Plastic surgery reaches beyond the realm of economic and legal issues, and especially when targeted towards members of a certain ethnic group, can have weighty social and racial ramifications as well.  To put the effects of plastic surgery marketing in Asia into perspective, note that while the United States may be the biggest market for cosmetic surgery in the world, the Asia-Pacific region is a close second.  Even within the United States, Asian Americans are more likely than any other ethic group, white or non-white, to pursue cosmetic surgery.  Specifically, Asian Americans only make up only 3% of the US population, but more than 6% of all procedures performed in the US in 1990 were performed on Asian Americans.  The number of Asian Americans performing these types of surgeries is expected to be even higher than the recorded 6% since many choose to have their operations done in Asia where it is much cheaper. 

Popular Procedures Among Different Ethnicities

Beyond pure statistics of what percent of each ethnic population chooses to undergo surgery, an evaluation of the most popular plastic procedures by race also sheds light on just how ethnically-charged the plastic surgery issue is.  Caucasians who go under the knife usually seek to augment their breasts, smooth wrinkles, and remove fat through procedures such as breast implantations, facelifts, collagen injections, and liposuction.  African Americans usually opt for lip and nasal reductions.  Asian Americans, on the other hand, desire to undergo double-eyelid surgery, a procedure where parts of their upper eyelids are excised to create a fold above each eye, making the eye appear wider.  Other procedures in high demand by Asian Americans are nasal dorsum implants for a more prominent nose.  Breast implantation, leg-lengthening, and brow and jaw implantations are also highly desired surgeries.

Asians in the Asia-Pacific regions echo the desires of their Asian counterparts in America when it comes to plastic surgery.  Below is a table of popular plastic surgeries in the Asia-Pacific region along with estimated cost of each procedure. 

Table of Popular Plastic Surgery Procedures in the Asia-Pacific Region

From the above table, it is clear that the types of surgeries Asians opt for alter their ethnic features for a more Western look.  For example, approximately 75% of all Koreans and 50% of all other Asians are born without the double eyelid crease, making the prevalence of double-eyelid surgery a significant cry against the monolid feature that is so intrinsically Asian.  Nose enlargements for East-Asians (Koreans, Japanese, and Chinese) and nose reductions for Indonesians reflect the desire for tall, slim, and Western noses, while face slimming serves to diminish the round facial features and high cheeks characteristic of many Asians.  Calf slimming and leg lengthening are done because a Western stature is coveted by the naturally-shorter Asians.  Interesting, the only leading procedure not geared towards a more Western physical ideal is hymen reconstruction, showing the remnants of a more conservative time in Asia. 

Westernized Media Influences a Gradual Shift in the Asian Ideal of Beauty

Within the United States, Asians (who make up 3% of the population) account for less than 1% of all faces in magazine ads.  When Asians are portrayed in the American media, Asians are represented dichotomously (see picture below), either as the Eurasian-looking fashion models and celebrities with double-eyelids and pointy noses such as Nancy Kwan, who starred in The World of Suzie Wong, 1960 (who is half Chinese and half English/Scottish) or as dull, passive, nonsocial “model-minority” characters such as Charlie Chan.  Since the late 1990 Asian “invasion” of Hollywood, there has been a surge of Asian stars portrayed in the Asian media such as Lucy Liu and Jacky Chan, but even Jacky Chan has openly admitted to having undergone double-eyelid surgery. 

Dichotomous Depiction of Asians in Hollywood

Above:  Charlie Chan in a publicity still from                    Above:  Nancy Kwan, half Chinese and half

The Return of Dr. Fu Manchu (1930)                                   English/Scottish Hollywood star

Even in Asia, America magazines and films have met a strong demand, and since World War II, popular Asian magazines and electronic media depict models who are either Caucasian or Asian with stereotypically Western facial types.  Eugenia Kaw, in preparation of her article “Opening Faces: The Politics of Cosmetic Surgery and Asian American Women,” interviewed Jane, a twenty-two-year-old Korean American who underwent double-eyelid surgery at sixteen and nasal bridge surgery at eighteen.  During the interview, Jane thumbed through Korean fashion magazines, showing Kaw the models she thought looked Caucasian, Eurasian, or had double-eyelid and nasal bridge surgeries.  While Jane was born and raised in the United States, she visits her relatives in Korean often.  She notes that the media influences on Asians were similar in the United States and in Korea, stating “When you turn on the TV [in Korea] you see people like Madonna and you see MTV and American movies and magazines.  In any fashion magazine you don’t really see a Korean-type woman.  My mother was telling me that when she was a kid, the ideal beauty was someone with a totally round, flat face. Kind of small and five feet tall. I guess things began to change in the 50s when Koreans started to have a lot of contact with the West."  Indeed, in the Age of Mass Media Globalization, dominant countries such as the United States have a glaring influence on the media content of other countries in the world.  Especially for the upwardly-mobile Asian countries, the Western ideal of beauty has taken a strong foot-hold, leading to the rise in plastic surgery to create more Western features. 

The New “Korean Wave”

After decades of conforming to a “white beauty” standard, some surgeons find that there is an emerging backlash in Asian cultures in which women now turn to Asian media for inspiration for plastic surgery operations.  This new trend, aptly coined the “Korean Wave,” started in the late 1990s when the South Korean government targeted entertainment as their next big export industry.  The current popularity of Korean stars in Asia has established Korean ethnic features as a standard of beauty, and some sociologists see this as a rejection of the Caucasian beauty that dominates international media and an embrace of an Asian standard of beauty. 

However, what appeals to so many Asians about the Korean features proliferated by the “Korean Wave” are exactly the features that make them look more Western.  For example, after the Korean TV drama “Daejanggeum (The Jewel of the Palace)” gained popularity in many Asian countries and even Asian networks in Western countries (see table of televise status below), many Asian women have asked doctors to make them look like Lee Young-ae, the star of the soap opera.  These patients coveted Lee’s huge eyes, high nose, and small mouth, features that indeed make her more Western-looking than her other Asian counterparts.  Complicating the situation even further, some Korean actors and actresses have spoken openly about their own plastic surgery procedures, making this “return to Asian” or “return to Korean” standard of beauty quite misleading. 

Table of Televise Status for “Daejanggeum (The Jewel of the Palace)” by Country

Plastic Surgery Marketing in Asian Media

With rising incomes and a higher demand for plastic surgery in the Asia-Pacific region, plastic surgery marketing in the Asian media has become prevalent, spawning various plastic surgery shows modeled off American ones.   

Lovely Cinderella, a reality show in which 14 contestants who have undergone plastic surgery compete to win a 50,000 Yuan (or 8,000 USD), equivalent to more than 10 months of surgery, and a trip to Hawaii.  This program is modeled on ABC’s Extreme Makeover and Fox Network’s The Swan, and has brought in over 4 million viewers per episode since airing on Friday Nights in China’s Hunan province.  The last episode was broadcasted on Sina.com, enabling more than 100 million internet users to tune in.  Hunan TV is planning to air the second season on nation-wide networks. 

A contest sponsored by Beijing’s EverCare Cosmetic Surgery Hospital and Clinic called Evercare Jianxiang Dreamworks Project has created China’s “first plastic beauty,” Hao Lulu, who is still in the media limelight for undergoing a 200-day-long marathon of procedures in 2003.  Her surgeries total more than 36,000 USD. 

Left: Zhang Di, winner of Miss Ugly, in front of her “before” picture.     Miss Ugly, held at the end of 2003 a week before China was to host the Miss World competition (either ironically or as a clever marketing ploy), was a competition in which a line of “ugly ducklings” in Shanghai fought for the chance to receive 100,000 yuan (16,000 USD) of plastic surgery and other treatments.  Zhang Di, the winner of Miss Ugly, says that she has long been unhappy with her small eyes, flat nose, and her lower lip that pouted outwards when she smiled.

In Korea, similar contests to win plastic surgeries exist.  For example, SeouSeoul Petrol Stations started running a promotional campaigned called “Dreams Come True,” in which customers at their gas stations can win prizes, one of which is a chance to undergo plastic surgery.  Kwan Ki Yong, chairman of the petrol company, says the promotion has led to a 20% increase in customers. 

In some shows and contests, instead of winning plastic surgery, the winners are those who have undergone surgery.  Miss Plastic Surgery, held in China during December of 2004, was a beauty pageant for women who had undergone surgery.  The event was organized by an 18-year-old woman who was disqualified from a Chinese beauty pageant (in which contestants were required to be natural beauties).  The sponsors of the pageant include Chinese makers of cosmetic surgery products and plastic surgeons. 

These contests to win plastic surgery procedures are not restricted to women.  A twenty-four-year-old man named Zhang Yinghua was selected from over 30 candidates in a competition looking for Heilongjian Province’s first artificial handsome man.  Zhang will undergoing at least seven plastic surgery treatments estimated to be around 300,000 Yuan (36,300 USD) and lasting two to three months at the Shanghai Kinway Plastic & Cosmetic Surgery.  Zhang, who is already considered a very handsome man, wishes to undergo surgery to improve his chances in the entertainment industry. 

The Perceived Necessity of Asian Plastic Surgery

Up to this point in the essay, Asian plastic surgery has been depicted as the effect of a lack of Asians in the American media, the dominance of Western media and the Western ideal of beauty, and of the prevalence of plastic surgery shows sponsored by the big players in this lucrative industry.  However, it would not be a true ethical dilemma without Asian societies first internalizing the influences from foreign media and then imposing physical standards upon its citizens to conform to.  The book Enhancing Human Traits: Ethical and Social Implications calls this phenomenon society’s “free choice under pressure” because individuals feel the need to undergo procedures to conform to society’s standards of what is “desirable” or even “normal” rather than “Other.”  (In the case of Asian plastic surgery, “desirable” and “normal” describes Western and Eurasian features wile “Other” describes classic yet frowned-up Asian features.) 

With its internalization of Western beauty standards, the Asian media is misleading Asia’s youth into believing that changing their looks is a ticket to a better life, and in some cases, even essential for a better life.  In China, women seek extreme makeovers in hopes of landing the perfect career and spouse.  Dr. Yang, a plastic surgeon in China who interviewed with sociologist Eugenia Kaw, estimates that 20% of her clients come to buy a new face with larger eyes, a taller nose, and the likes in hopes of improving their job aspects, commenting that, “In China, your face is your fortune.”  Even men more than ever before are convinced that surgery will improve their career prospects as well.  Dr. Choi Oh Kyu of Korea believes that about 15-20% of his patients are men hoping to advance their careers with surgery. 

Perhaps the best example of “free choice under pressure” is the numerous height quotas placed on university admittance and job applications.  To get a job with the foreign ministry, for example, male applicants need to be at least 5 ft 7 in, while women must be at least 5 ft 3 in so that Chinese diplomats can match the height of their foreign counterparts.  For more looks-driven industries, the quotas are more stringent: air stewardesses must be over 5 ft 5 in.  Even in industries where height seems to have no effect, height requirements are utilized: to get into law school, women must be over 5 ft 1 in and men over 5 ft 5 in, while even some computer companies list height requirements to weed out the number of submitted resumes.  Even in everyday life, in some places people under 5 ft 3 in are not eligible to take a driving test and height requirements are also frequently mentioned in personal ads of newspapers and magazines.  In a society where the average height of women is 5 ft 1 in and the average height of men is 5 ft 6 in, these height requirements make leg-lengthening surgery a subject of free choice under pressure, especially if one aspires to a position with such quotas. 

Conclusion—Social Issues in Asian Plastic Surgery 

 In the United States, the relative lack of a correct and accurate portrayal of Asians, the utilization of “Western-looking” Eurasians and Asians, as well as the dominance of all-white, all-American images in the media has led to an internalization of Western ideals in the Asian American community, making Asian Americans the ethnic group most likely to undergo plastic surgery in America.  The situation for Asians in the Asia-Pacific region parallels that of their Asian counterparts in America.  With the rapid globalization of mass media, the dominant West has strongly influenced the Asian ideal of beauty, as seen in Asia’s recent rise in plastic surgery contests and pageants.  With the internalization of Western ideals of beauty, plastic surgery is seen as the way to improve one’s future career and martial prospects.  The lucrative plastic surgery industry in Asia is clearly acting in an unethical manner when it comes to the social ramifications of their business.  By supporting plastic surgery shows and contests, they are not only giving Asians a rosy depiction of the effects of plastic surgery, but they are also making citizens aspire to the Western standard of beauty while despising features that are ethnically natural and were even considered beautiful just fifty years ago.

One
by Shirley Leong

Two, amorphous blobs drifting through space
One, fiery mix of orange, sunrise yellows, and reds
One, the dusk itself, bruised blue and purple
Contained, coexistence amid non-recognition

Two, blue dancers in the Degasian space
One, arms spread, passion in every bend, tilt, gesture
One, arms folded in, shy and wistful
Parted, studio broken by painted strokes

Two, number of illusive intimacy, rifted space
One, relish for ascendancy, for freedom in its purest
One, curse of the lonely and afflicted
Consummated, space wedded and agape eternal, One.