Has South Korea Become the World Capital for Plastic Surgery?

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People are garthering at Buddhist Cheer Rally for celebration of Lotus Lantern Festival on may 11 2013, Dongguk University Stadium, Seoul, Korea. qingqing/Shutterstock.com

South Korea knows a thing or two about cosmetic surgery.

That’s because it is home to an estimated 5.1 percent of the world’s registered plastic surgeons, with just over 2000 practitioners working in the field. This places it sixth on the list, behind the United States., Brazil, China, Japan and India.

It is also well-acquainted with medical tourism.  The Ministry of Health and Welfare (MOHW) estimates that between 2009 and 2013, over 630,000 international patients had visited South Korea for medical procedures, generating $950 million in revenue.

According to the most recent statistics from the International Society of Aesthetic Plastic Surgery (ISAPS), more than 23 million cosmetic surgical and nonsurgical procedures were performed globally in 2013. The U.S. performed the highest number of procedures, followed by Brazil and Mexico respectively.

However, The Economist found that when accounting for population, South Korea was actually performing the highest number of cosmetic surgeries per capita, followed by Greece and Italy.

Dr. John DiMoia, an assistant professor at the National University of Singapore, specializes in the history of scientific and medical institutions in South Korea.

He says South Korea’s prowess in performing cosmetic surgery can be traced back to the aftermath of the Korean War, when it was necessary to treat burn victims and people with disfiguring injuries.

“If you look at it historically, the oldest people claiming to do plastic surgery in South Korea tend to be post-Korean War reconstructive surgeons,” DiMoia says. “They’ve had a good 40-to-50 year period to work on and develop that expertise, so the guys you’re seeing now who are very good are probably second or third generation surgeons.”

DiMoia estimates it wasn’t until the early 2000s that cosmetic surgery started to take off in South Korea, facilitating the reputation of its citizens for going under the knife.

JK Plastic Surgery is a luxury cosmetic surgery clinic located in the Gangnam district of Seoul. It also bears the distinction of being the first hospital in South Korea to officially serve foreign patients, and since 2009 has consistently received the best hospital award for foreign patients every year by the South Korean government. It is is one of many private clinics offering all-inclusive packages for patients, catering for different languages as well as providing luxury transportation, accommodation and a city tour.

Private clinics are extremely common in South Korea, and DiMoia says that doctors have “every incentive” to move away from the public system and start their own practices—a move that is proving to be lucrative.

“Along with things like plastic surgery, this also affects Caesarean sections and other diagnostic procedures, where it has been argued that South Korean doctors may over-prescribe procedures and diagnostics simply because these are additional forms of revenue,” DiMoia says.

It is widely known that the South Korean government has been investing heavily in medical tourism, which extends to other forms of medical treatment such as palliative care and heart surgery.

Dr. Joanna Elfving-Hwang is an associate professor of Korean Studies at the University of Western Australia, and an expert on the relationship between South Korean culture and cosmetic surgery. She says South Korea’s reputation for cosmetic surgery is being actively promoted by the government.

“It’s an intentional thing. They don’t make a secret out of it. South Koreans want to be known for being good at plastic surgery, because they are,” Elfving-Hwang says.

The move appears to be working. South Korea recently made headlines in The New York Times, amid reports that Chinese tourists were flocking to the nation for the combined vacation/surgery experience.

DiMoia says it is clear the South Korean government is putting a “substantial amount of money into the industry”, embracing the nation’s soft economic power.

“That money is attracting South Koreans, but I see these efforts as trying to attract a large number of people from the northeast, and increasingly Southeast Asia,” he says. “Koreans are well aware that they can mobilise their medical expertise, combined with a certain appeal as a sort of ‘sexy-image’ country, and combine that to push themselves further, economically.”

Elfving-Hwang concedes that in South Korea there are older religious and cultural principles that draw upon the concept of physiognomy—the assessment of a person’s character based on their physical appearance. This is similar to the ancient Greeks, she says, who considered exterior beauty as a sign of goodness.

Writing in the Asia-Pacific Journal: Japan Focus in 2013, Elfving-Hwang made the argument that in contemporary South Korea, notions of ‘correct’ or ‘appropriate’ appearance were heavily linked to a person’s performance in society.

The concept of conveying one’s social status through appearance is not new to South Korea. In the premodern Chosŏn-era (the last imperial dynasty, lasting from 1392 to 1910), it was expected that one would display their social status through class-appropriate clothing and decorum.

After more than 500 years of cultural tradition, Elfving-Hwang believes it is possible that some of these notions have endured in Korean society. For example, a politician would have very different cosmetic procedures done, compared to a young woman looking to become a performer.

“The aim is not necessarily to achieve beauty, but a look that is ‘right’ for a particular occupation or social position,” Elfving-Hwang says.

But she says the assumption that all South Koreans are undergoing a huge amount of cosmetic surgery is a misrepresentation by Western media, and that it’s “really more of an urban phenomenon,” than one specific to South Korea.  “If you go to the countryside, you will struggle to find people who’ve had any work done. So it’s really more of a middle class issue than anything else, very similar to China or America,” Elfving-Hwang says.

Certain neighborhoods of Seoul have an international reputation for being cosmetic surgery hubs. In these particular suburbs, it is not uncommon to find many plastic surgery clinics in a row, with heavy advertising visible on the street and in the subway.

Plastic surgery sign in the Seoul metro, South Korea is a well-known plastic surgery hot spot, with tourists from other parts of Asia.

Plastic surgery sign in the Seoul metro, South Korea is a well-known plastic surgery hot spot, with tourists from other parts of Asia. meunierd/Shutterstock.com

Another common misconception is that South Koreans are having cosmetic surgery to look ‘more Western’—an assumption that has been widely promoted by foreign media.

Instead, Elfving-Hwang argues there is an increasingly shared global beauty ideal that draws on physical attributes across various cultures.

“There is always this assumption that we in the West, broadly speaking, are somehow in a position to say what is appropriate and what is not; how people should relate to their bodies and what is the ‘correct’ relationship with cosmetic surgery and fashion,” Elfving-Hwang says. “It doesn’t tell me anything about Korea, but it tells me everything about how we see ourselves in the West compared to the rest of the world.”

Dr. Hang-Seok Choi, director of JK Plastic Surgery, says the clinic receives more than 5,000 international patients each year, and that the trend is growing noticeably. He notes that the ratio compared to domestic patients can be flexible depending on the season, ranging between 2:8 and 5:5. Foreign patients, he says, visit from all over the world, with the highest number travelling from China, followed by CIS (former Soviet Union) nations, Middle Eastern nations, Southeast Asia, America and European nations. Patients vary in age, although Choi says the clinic receives the highest number of patients in their 20s and 30s, mostly seeking facial surgery for their eyes and nose.

“Asian people, including domestic patients, are mostly interested in eyes, nose and facial bone contouring while body related surgeries such as breast augmentation or liposuction are most popular among Western patients,” Choi says.

But “anti-ageing procedures such as lifting, or upper or lower blepharoplasty [eyelid surgery] are popular across the world and Middle Eastern patients look for non- or minimally invasive treatment using lasers and hair graft.”

Without regard to culture or country of origin, it is predicted that the practice of plastic surgery will only grow increasingly more popular from here.