Where is most cosmetic surgery performed?

If you answered the USA, you are correct. When it comes to sheer numbers, more cosmetic surgery procedures are carried out in America than anywhere else, with over 3 million performed in 2011.

However, according to new figures, when population is accounted for, Korea leads the world, followed by Greece and Italy.

The figures, from the International Society of Aesthetic Plastic Surgery, show that Korea has the highest proportion of its population undergoing cosmetic surgery, with one in every 77 Koreans turning to the knife or the needle.

Interestingly, some scholars such as professor Ruth Holliday, of the University of Leeds in England, and professor Joanne Elfving-Hwang, of the University of Frankfurt, suggest that the number of Koreans who undergo cosmetic surgery is likely considerably higher. The reason being, they say, is that surgical procedures often take place at private clinics and therefore only a fraction of surgeries are recorded, not to mention the industry is said to be globally poorly regulated, Korea being no exception.

Indeed, other reports estimate significantly higher rates of Koreans undergoing cosmetic surgery. For instance, NationMaster, a statistical website, puts the percentage of Koreans getting cosmetic surgery in at around 20 percent. Similarly, a 2009 survey by market research firm Trend Monitor, showed that one in five women in Seoul between the ages of 19 and 49 had cosmetic surgery. Some reports even suggest that as much as 50 percent of young adult Korean women under the age of 30 have undergone cosmetic surgery.

And, cosmetic surgery is certainly not limited to the female gender. Korean men are also visiting cosmetic surgery clinics in increasingly large numbers. For instance, the Korean Association for Plastic Surgeons estimated that the number of Korean men who had cosmetic surgery in 2010 stood at around 15 percent.

An earlier study conducted by a Korean employment website found that 44 percent of male college students were contemplating some form of cosmetic surgery.

This, of course, still begs the question, why are Koreans having cosmetic surgery in increasing numbers?

One explanation is that an attractive appearance is associated with positive social benefits. And therefore, undergoing surgery is regarded as a worthwhile investment. Research certainly reveals cultural prejudices toward attractive faces and physiques. For instance, matchmaking agencies in Korea often rate facial attractiveness as the most important factor ahead of other qualities such as educational or family background for those who are seeking a favorable marriage match.

Moreover, numerous studies have found that at the workplace and in their careers, overweight and unattractive people frequently meet prejudices in hiring, advancement and salary. For instance, in a recent survey of over 200 job recruiters in Korea, almost 70 percent admitted that the appearance of applicants affects their decision. Appearance even influences court decisions, at least according to a British study which found that judges often assign lower bail for defendants who are physically attractive.

Celebrity influence is believed to be another factor behind the cosmetic surgery boom in Korea. Many well-known Korean male and female celebrities have drastically altered their appearance by having surgery, including Miss Korea 2012 Kim Yu-mi and Kim Hyun-joong, formerly a member of the boy band SS501. Their successful transformations provide motivation to those contemplating surgery.

This is reflected in reports that many patients visit clinics with photos of celebrities, asking surgeons to duplicate their appearance. In addition, some TV dramas and films glorify cosmetic surgery. The hugely successful 2006 Korean film “200 Pound Beauty” is one example. The film is about an overweight girl who undergoes extreme plastic surgery to become a pop sensation.

Another explanation for the high rates of cosmetic surgery in Korea is the desire to achieve a more “Westernized” look. This is reflected in the popularity of certain procedures.

One of the most popular being “ssankapul” surgery, commonly known as double eyelid surgery, which reduces excess skin in the upper eyelid to make the eyes look bigger. Another common procedure is jaw reconfiguration, which was originally developed to correct orthodontic problems like underbite and crossbite but has now become an increasingly popular means to achieve both a smaller and more sharply-defined face.

Of course, altering one’s appearance to achieve a particular look is not a new phenomenon. People have been engaging in appearance modification practices for centuries and across cultures. For instance, in pre-industrial China, women bound their feet. The Mayans practiced body piercing. In Egypt, tattooing was prevalent.

However, whilst humans have engaged in body-altering practices for centuries and across certain cultures, Korea is not one of them. This does not mean that appearance has not long been valued in Korea. Historically, a neat and well-kept appearance was a marker of social class and a sign of an orderly life. Until recently, though, deliberately altering the body’s appearance was not a common practice in Korea.

This owes much to Confucianism, which formerly played a major role in the life of Korean society. Confucianism strongly urges against altering the body as it is considered a gift from one’s mother and father. Is Confucianism still valued in Korea? Yes. This is evidenced by, among other things, a deference for the elderly. But, attitudes to Confucianism, at least in terms of the body, are certainly “undergoing surgery,” pun intended. 

By Andrew Dunne

The writer has been teaching at Chosun University in Gwangju for several years. Prior to coming to Korea, he carried out studies on body modification practices and published papers on the subject in peer-reviewed journals. He can be reached at atdunne@gmail.com. ― Ed.