Seoul Under the Knife

Walk around Seoul’s Beauty Belt — a strip in the city’s flashy Gangnam District (the “Beverly Hills” of Seoul, if you will) immortalized by pop singer PSY — and you’ll find over 200 different plastic surgery clinics. With names ranging from Small Face to New Nose to Cinderella Clinic, the centers are upfront about their services; with taglines such as “Haven’t had surgery yet? That’s why you’re single!” to “New nose, new you, new job” to “This is why celebrities don’t need makeup — you can be next!” These types of advertisements are scattered throughout the city: on sides of buses, on walls of subway stations, and, with one in five Korean women having gone under the knife, on people’s faces.

Yet these personalized and semi-confrontational advertisements don’t seem to bother Koreans. While plastic surgery used to be an intensely personal decision, in Seoul, the narrative surrounding cosmetic surgery has shifted. All around the city, people — mostly women — walk around with bandages on their nose bridges or with masks covering their chins. Enter a coffee shop, and women chat loudly about their next potential surgery or their most recent clinic visit; plastic surgery, once something that was relatively hush-hush, has become almost a rite of passage for Seoulites. Promising teenagers a rhinoplasty or a blepharoplasty (a double-eyelid surgery to enhance the size of one’s eyes—by far the most popular surgery) as a college acceptance gift has become the norm.

The New Yorker’s Patricia Marx studied this phenomenon; in her piece, Korean college students explained that “when you’re nineteen, all the girls get plastic surgery, so if you don’t do it, after a few years, your friends will all look better, but you will look like your unimproved you.” Perhaps it is this hypercompetitive mindset that propelled South Korea’s plastic surgery culture to this new height: a 2015 study by the International Society of Aesthetic Plastic Surgeons (ISAPS ) deemed South Korea the plastic surgery capital of the world, with its residents undergoing the most cosmetic surgery per capita in the world. While ISAPS data shows that one in five Korean women have gotten some type of cosmetic work, others estimate that the figure is closer to one in three, particularly for those between the ages of 20 and 40.

The influence of plastic surgery is so significant that it plays a critical role on the country’s economy: according to Korea’s Fair Trade Commission, in 2014, Korea owned 24 percent of the $16 trillion world plastic surgery market share. In 2013, Seoul announced that it would be putting in place a 10 percent sales tax on popular cosmetic procedures such as lip augmentation, chin reduction, and body hair removal. At the time, media reports cited that the plan could bring in an additional 2.49 trillion Korean won ($2.17 billion) in tax revenue over the next five years. A few years later, in 2015, Seoul announced a pilot program to provide foreigners tax reimbursements for a range of cosmetic surgeries — a clear inducement to further boost medical tourism numbers.

South Korea’s surgeons are deemed the best in the world, and cosmetic procedures on the peninsula cost between a third and two-thirds of their American alternatives.

With world-class surgeons and cheap procedures, South Korea has cultivated a significant international clientele base, with most clinics offering interpretation services in English, Cantonese, Mandarin, Vietnamese, Russian, and Japanese, and some clinics offering direct transportation to and from Incheon airport. The more prominent private clinics offer travel packages for patients, combining city tours, plastic surgery operations, and luxury accommodations in one neat, all-inclusive experience.

The Ministry of Health and Welfare estimates that in 2013, over 210,000 patients from 191 countries received medical treatment in South Korea, a 32.5 percent increase from the year prior. From a report by the Korea Tourism Organization, the country’s medical tourism industry raked in a $453 million revenue in 2012 alone. In 2013, the medical expenses paid by international clients increased by 47 percent, amounting to 393.4 billion won ($343 million). Foreigners’ per-capita medical expenses overshadow that of Korean residents, at 1,860,000 versus 1,020,000 won.

South Korea’s largest international base is overwhelmingly from China, where, while plastic surgery is common, both medical and hygienic standards are perceived to be lower than in South Korea. A 2014 New York Times article followed the medical tour of three Chinese women. The three visited Seoul for plastic surgery; one to “have her jaw broken and restructured to get a V-shaped face” and the other two to get nose jobs. Stories like these are common, as “the Chinese, mainly women, are visiting in droves for body modification, from the minor, like double eyelid surgery, to the extreme, like facial restructuring.”

University of Western Australia Korean Studies professor Joanna Elfving-Hwang explains that South Korea’s “reputation for cosmetic surgery is being actively promoted by the government.” The Korean government has set aside up to $4 million annually to promote the industry and to account for the expected 1 million medical tourists by 2020. While the reason plastic surgery is so pervasive in South Korean culture is rooted in the country’s unique history, sociology, and philosophy, for a country that has struggled to attract international visitors in the past, it is no surprise that the government capitalizes on its status as the plastic surgery epicenter of the world.