Bright lights startle your eyes, sending them into the submission of being closed. Slowly, they being to adjust to the reflective surroundings. The white walls, white bed, white floor. Everything is white. Around you, the world rests in a tranquil white stillness. The second thing to hit you is a profound pain in your nose. Your body tries to pull itself up but the world drags it back as you lay your head on the pillow. Everything hurts, you can only moan as you pull the blankets closer to your body. The tranquil peace that had encompassed the world merely becomes one of pain and fear. You think back to the events that brought you here. This white sterile room, the fiery hell dragging you to the beauty you so desperately crave.

In order to understand the popularity of plastic surgery in Korea today, it is important to understand its past. Within Korea’s history, the influence of foreign cultures dates back much further than can be originally thought. About a hundred years ago, early in the 1900s, Korea was still ruled by emperors. But then it quickly became a country at war. Japan annexed Korea in 1910. When Japan annexed Korea, it was trying to make one unified Asian culture, with Japan, Korea and China. There were a number of ways that Japan tried to take away Korean culture.

After Japan’s devastating defeat in World War II, the US became an increasingly influential force within Korea. Their defeat then disrupted the central system of leadership within Korea allowing outside influences, mainly the US and Soviet Russia, to pour into the country. After the war, the US continued to assist Korea. The US sought to help rebuild Korea after World War II, but also after the Korean War in the 1950s when Korea split into two countries — North Korea and South Korea. Soviet Russia took control of the North, and the US exerted its influence in the South. Before World War II, Japan controlled Korea, then influencing Korean culture. However, after WWII the US quickly became the most influential foreign culture in South Korea.

This influence was especially strong during the Korean War which required the involvement and support of countries such as the USA. One such figure of influence was Dr. Ralph Millard, an American doctor stationed in Seoul from 1950 to 1953, according to Business Insider. Although his original purpose was to perform reconstructive surgery on those wounded in the Korean War, Business Insider also explains that his work soon became an integral part in the development and popularization of blepharoplasty, or double eyelid surgery.

Double eye surgery is a procedure where an incision is made on the upper eyelid in order to create a fold to separate the eyelid into two parts. Rather stereotypically, Asians are known for having a monolid, or eyes with no visible crease in the upper eyelid. This often makes them appear small and attractive. The effect of it is a small crease which makes their eyes appear more Western and therefore more attractive to employers and those around them. Historically, Koreans found this desirable because made them look more Western, therefore desirable to soldiers. Presently, it has become more desirable because it makes one’s eyes bigger and brighter.

Notably, many of those coming to request this procedure were Korean sex workers hoping to appear more attractive to American soldiers. While the surgery may have helped impoverished Korean women find work or a life in America, it also helped to create a negative perception of Asian features. In fact, Dr. Millard’s past is shrouded in controversy because of his negative view on ‘Asian’ features. In a medical journal Dr. Millard discussed the idea that an eye without a double eyelid looks unemotional and gives Koreans the air of an indifferent manner. He wrote, “The absence of the puerperal fold produces a passive expression which seems to epitomize the stoical and unemotional manner of the oriental.” His negative view of a rather stereotypical ‘Asian’ feature leaves a sour taste in the mouth of those who feel it wrong to create a negative view of Korean culture in order to make money by physically altering facial features.

Regardless of its murky history, blepharoplasty is still known as the most popular surgery in the world. According to the International Society of Aesthetic Plastic Surgeons (ISAPS), about 1.43 million blepharoplasty procedures were performed throughout the world in 2014 alone. Its popularity is probably due to it being less invasive and cheaper (approximately $1,000-$3,000) than other types of plastic surgery. However, it is probably the most popular due to the look it gives the eye. Of the millions of blepharoplasty operations that take place every year, it is estimated that 650,000 procedures are performed every year in South Korea, according to Business Insider. Although this number may seem small in comparison to larger countries such as the USA or Brazil, South Korea has the largest rate of general plastic surgery per capita, according to ISAPS. This overwhelming popularity has brought international attention to South Korea’s medical industry.

The popularity of these procedures had led to a continuously growing, “medical tourism” sub-industry. Medical tourism attracts foreigners to a country to get medical procedures done. With numbers growing exponentially the sub-industry of medical tourism has become a large part of South Korea’s economy. In 2013 alone, about 400,000 foreigners came to South Korea for medical tourism and this number is expected to rise to 1,000,000 by 2020 according to a documentary by Al Jazeera. Not all of these were specifically those wanting to get plastic surgery, but all types of medical procedures. This suggests that South Korea’s government wants to attract people from all over the world to come to the country using a method that works, medical tourism. Through promoting medical tourism South Korea has been able to get ahead and it has become a big part of business in the country. According to an article in The New Yorker, “‘Surgery tourists’ from abroad make up about a third of the business in South Korea, and, of those, most come from China”. It has even reached the point where government-funded centers which cater to tourists have been opened. One such state-of-the-art center in Seoul contains TV screens in multiple different languages for those searching for clinics to get a certain procedure done. Some clinics will even offer identity certificates to patients in order for them to be able to return to their home country after having their face changed. With so many patients coming from abroad, this has led South Korea to become a center for plastic surgery. Ads for different clinics line the walls and cars of the subway in cities. The country has even developed its own “district” where one can walk down the street and pass by clinics on both sides. Plastic surgery has become such a normal part of the culture, and has become a huge industry to launch South Korea into prominence as a country. This has, however, caused an increasingly more distressing problem; botched surgeries and illegitimate clinics. Despite a growing number of laws to counteract this problem, the industry has grown so fast, they don’t have the ability to enforce the new laws and regulations.

A growing international business of plastic surgery within South Korea has left it open to those just looking for a cash grab. The field of plastic surgery is riddled with not only unlicensed doctors, but brokers. These brokers are people that bring people to clinics. Despite whether or not they are reliable, a number of these brokers have made careers by bringing people to various clinics. There are, of course, rewards for bringing a certain amount of patients to a certain business varying  from clinic to clinic. Most commonly, these brokers will either receive money or free plastic surgery. Bringing business to these clinics has a way of legitimizing them, giving them a name through the amount of ‘customers’ they’ve had. Another way customers can be brought to clinics is through the internet. People who either work for them, or are hired by them will write false positive reviews in order to attract potential patients. This practice shows the clinic in a positive light, but misleads people searching for a good clinic. These often illegitimate clinics sometimes do not have surgeons licensed to practice plastic surgery. According to Patricia Marx in her article “About Face” published in the New Yorker, “As many as eighty percent of doctors doing plastic surgery are not certified in the field; these are known as ‘ghost doctors.’” This has caused numerous amounts of harm for patients, largely increasing the number of malpractice cases. It has even caused death in some cases. One of the larger issues surrounding ‘ghost doctors’ is the poor anaesthesia techniques used on patients. Done incorrectly, it can lead to coma or death. In some Korean forum sites, there are multiple stories of witnesses to people dying from incorrect use of anaesthesia. Although only some of these reach the news, it’s still an eye-opening fact to think about. One of the biggest questions people have about this is, of course is why?

South Korea’s culture is not the sole force to be blamed on this plastic surgery “boom”. One must take into account the medical tourism aspect. This has brought in numerous customers and has only increased the country’s prominence in the plastic surgery field. For Koreans who get it, it makes them feel much better about themselves. Contrary to the ideology of “it’s what’s on the inside that counts,” South Korea seems to focus more on one’s appearance and directly links it to their success. For this reason, potential employees have to attach a photo of themselves to their resume. Combined with the belief that anybody can be improved upon, and this creates a culture where plastic surgery thrives. Jessica Choi, a Korean-American who traveled to Seoul to get surgery, said afterwards, “I love it. I feel softer. I feel more feminine. I have more confidence. I really believed that death would have been better during those first few days of recovery but it was well worth it.” Although it is happening in such large numbers, it has made many people more confident in themselves.

South Korea’s plastic surgery culture may be contained in a tiny country, but it still attracts people from around the world into the country. Due to the exponential growth of medical tourism and plastic surgery, the improper regulation has caused a lot more harm to be done than good. As a result, the number of malpractice cases have gone up and so has dissatisfaction from the procedures performed. Just as it has the power to build up someone’s confidence, it also has the power to destroy it. Improper procedures can, and already have ruined people’s lives. Forever changing their face, or leaving them dead due to improper anaesthesia. On a surface level, the price of beauty is the pain of recovery. In reality, however, it is the risk of finding the wrong doctor, one that will truly show how the price of beauty doesn’t always have a “happy ending.” Is it really worth it? That is for you to decide, wherever your eyes care to take you.