Seoul, South Korea, is the plastic surgery capital of the world, with more procedures per capita than any other nation.
The most common procedure in Korea is blepharoplasty, or double eyelid surgery. According to the International Society of Aesthetic Plastic Surgery, it's the most popular plastic surgery operation in the world, with 1.43 million people getting it done in 2014. It's so prevalent that a former Korean president had the operation while he was in office.
Blepharoplasty is also controversial.
Critics say that the operation makes patients look "less Asian," while proponents say that it's simply a matter of beauty — bigger eyes equals more attractiveness, essentially.
"Most Koreans don’t have a double eyelid line, so in that case, sometimes they look sleepy and tired," says Hang-Seok Choi, the director of JK Plastic Surgery, a Seoul-based clinic that sees 10,000 patients a year.
"Ladies want to have a beautiful look, defined look," Choi tells Tech Insider, and the 20% of his patients that are male "want some beauty too," so they also often opt for eyelid surgery.
Choi says it's one of the cheapest operations (between $1,000 and $3,000) and it's less invasive than other options, leading to a shorter recovery time.
But the operation has a racially charged past.
To critics, the surgery is a symbol of white America's history of cultural dominance over South Korea.
It goes back to American plastic surgery pioneer Dr. Ralph Millard, who was stationed in Seoul from 1950 to 1953 to do reconstructive surgery for the war wounded. Millard is known among plastic surgeons today for his innovations in facelifts and cleft palates.
Millard was reportedly the first person to develop and perform the operation in Korea.
But the surgeon who introduced double-eyelid surgery to Korea also projected the worst of Asian stereotypes onto people with "monolids."
In a 1964 edition of the American Journal of Ophthalmology, Millard wrote that "the absence of the puerperal fold produces a passive expression which seems to epitomize the stoical and unemotional manner of the oriental." He wrote that he had the first opportunity to try the operation when "a slant-eyed Korean interpreter, speaking excellent English, came in requesting to be made into a 'round-eye.'"
Many of his patients were reportedly Korean women working in the sex trade who wanted to get the operation to increase their appeal to American GIs. Other clients were so-called "war brides" — Korean women who married American soldiers and moved to the US — who wanted to fit in more in their adopted home.
Historians and cultural critics say there are a few factors that have contributed to the prevalence of double-eyelid surgery today.
In "Asian American: Historical Crossings of a Racial Frontier," Stanford comparative literature scholar David Palumbo-Liu argues that the double eyelid trend started after World War II, as Japanese and Korean women opted for it so that they could blend in better to the West, reflecting American — particularly white American — dominance.
This was apparently the case in the US as well.
In a 1993 study of eleven Asian American women in the San Francisco Bay Area who received plastic surgery, ethnographer Eugenia Kaw found that patients underwent plastic surgery in order to "escape persisting racial prejudice that correlates their stereotyped genetic physical features ('small, slanty' eyes and a 'flat' nose) with negative behavioral characteristics, such as passivity, dullness, and a lack of sociability."
Today in Korea, plastic surgery at least seems less racialized. Seoul-based plastic surgeon Minhwa Na — who's been doing double-eyelids for 15 years — tells the Korea Herald that her clients aren't trying to looks less Asian.
"I would get serious complaints if I performed the procedure and the Korean patient gets a crease like the one of a Caucasian person. What people want is a natural crease that is suited to Asian faces," she said. "The whole idea that undergoing this surgery is an attempt to look white is absurd."
But as history shows, it's probably more complicated than that.
Cultural critic Moonwon Lee tells the Korea Herald that while people don't personally believe they're trying to look white by getting their eyelids done or other plastic surgeries, they're still moving away from Korean-ness. The big eyes, small faces, and perky noses that are hallmarks of beauty in Korea aren't natural to most Koreans, he says.
These homogenized beauty standards stand out in Korean beauty pageants. The below GIF of contestants for the Miss Daegu 2013 beauty pageant made the rounds on Reddit and Gawker. The contestants have strikingly similar looks, especially in the eyes.
One former Korean beauty pageant contestant says that the majority of her pageant peers received plastic surgery, ranging from double eyelid surgery to nose jobs (rhinoplasty). Plastic surgery is, she says, seen by judges as a sign that a contestant is serious about their career.
Since everybody wants to look the same way, Lee says that Koreans assume it's normal, "regardless of history or meaning."
Eyelid surgery is also strongly linked to the global phenomenon of K-Pop (think "Gangnam Style" and Girls Generation), according to Atlantic writer Zara Stone.
"K-pop has created a completely new beauty aesthetic that nods to Caucasian features but doesn't replicate them," like the big eyes that are so dominant in pop culture, she says,
It's hard to wrap your mind around jsut how huge K-Pop is in South Korea. According to the Paris Review, 2.08 million Koreans — an unbelievable 4% of the entire population — tried out for "Superstar K," the country's biggest singing competition in 2012. As a result of this idolization of K-Pop stars, plastic surgery is seen as aspirational, even normalized.
Regardless of the history, the double eyelid surgery seems to be a matter of pragmatism for clients.
As Dr. Choi, the director of JK Plastic Surgery explained to us, going to the plastic surgery center carries as much weight as getting a haircut — it's an everyday thing.
Also, he says, Korea is a remarkably competitive society.
"Nations have different need for beauty," Choi says. "In Korea, the land is small and crowded, that everybody can see, can look at each other in the face."
Not only do people live closely together, but you submit your photo with your resúmé, with the assumption that if you look like you can take care of yourself, then you can take care of your job . Attractiveness is a competitive advantage in the job market, which is why, Choi says, applicants go as far as photoshopping their resume images.
"Usually," he says, "people believe that people with better appearance have more opportunity. "
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