The Influence of Western Culture on Plastic Surgery Consumption in South Korea

The recognition of the Korean cosmetic industry has skyrocketed in recent years. You may have come across a video about the benefits of a 10-step skincare routine while scrolling through social media, or spotted a rack of sheet masks on sale as you pass by a cosmetics store. These phenomena originated from South Korea, a nation that has undergone rapid post-war industrialization and as a result, is now hailed as one of the most technologically advanced countries in the world. However, although Korea’s advanced technology extends into the realm of the beauty industry, its longstanding conservatism is still embedded in Korean ideology and continues to influence gender expectations and cultural values. This manuscript reviews the most common surgical procedures performed in Korea and investigates the origin of modern Korean beauty standards. Plastic surgery consumption in South Korea will be analyzed by evaluating the influence of imported Western appearance ideals on surgical enhancements as well as examining the modern-day woman’s adherence to the traditional norms of femininity that are rooted in Korean history. This article also explores counterarguments of self-empowerment and globalization of beauty standards as motivation behind cosmetic procedures in today’s society.


The Rise in Plastic Surgery
After the Korean War that lasted from 1950 to 1953 and devastated the Korean economy, South Korea has succeeded in becoming the fastest nation to industrialize and urbanize its post-war economy, while still upholding its historical values and traditions. The rapid technological advancements in everything from smartphones to its seamless public transportation system have made Korea a highly sought-after tourist destination, but the most notable attraction in Korea has been the plethora of plastic surgery clinics sprawled across the capital city's wealthiest districts. The multinational television network, CNN, has even deemed the nation a plastic surgery mecca "where doctors are highly skilled [...] and the technology is top-notch" [1].
In the past few decades, the South Korean economy has faced a notable rise in permanent alterations of the body for aesthetic purposes; the cosmetic industry has been growing at a recent rate of 10 percent per year [2]. This boom in the industry is sustained by the steady surge of practitioners available to operate, as "100 new plastic surgeons [enter] the market every year" [3]. In 2008, statistics put the percentage of South Koreans reportedly going under the knife at around 20 percent; given that many cosmetic surgeries are not recorded and have become private practice, the actual percentage is most likely much higher [4]. While many foreigners evaluate Korean facial alterations as an attempt to conform to Western notions of beauty (e.g. a prominent nose bridge, a thin nose, and large eyes), plastic surgery emerged in the 2000s in order to adhere to traditional values that link physical appearance to success, and to comply with the patriarchal standards of femininity that Korean women were expected to uphold.
The thriving plastic surgery industry is aided by the escalation of advertisements that romanticize risky medical procedures by promising that attractiveness will lead to a better future. Compared to other countries, operations are notably much cheaper in Korea and are performed by experienced doctors as a result of the ubiquity of plastic surgery [5]. With plastic surgery clinics so easily accessible and affordable to the general public in places like shopping malls, surgery is extremely trivialized, and reconstructions of the body for aesthetic purposes has become widely accepted and positively received as a favorable investment to the extent that it is even considered a graduation gift for high school seniors [4]. The government has also acknowledged and invested in the aesthetic surgery industry as an important source  [6]. Thus, the vital role that the plastic surgery industry has in the success of the economy sheds light on the extreme practices of aesthetic enhancements in Korea.

Western Discrimination Against Asian Facial Characteristics
The United States had an enormous influence on the South Korean economy in more ways than one after the war ended in 1953. Although plastic surgery rates in Korea have significantly increased in the2000s, its beauty standards have been influenced by Western norms long before this era. Korean women actively embraced Western beauty standards in 1876 after opening its ports to international exchange [7]. Common surgical procedures appeal to Western beauty standards; the most common surgical procedures being blepharoplasties (i.e., double-eyelid surgeries) that give a wide-eyed appearance, and rhinoplasties (i.e., nose reshaping) that create a more prominent nose shape and dimensional facial structure. Thus, "the Western image of ideal beauty came to replace the existing Korean ideal of beauty, and [...] became dependent on [...] surgical operations that were originally created with Western women in mind" [3].
Recent data determine that "Forty-four percent of Korean [...] ads used Caucasian models. Local models did not often appear in global brands' ads in Korea," [7]. This reinforces the appearance ideals of the West in Korean local advertisements by featuring Caucasian models who possess these specific facial characteristics instead of Korean models, sending an underlying message that Western faces are desirable, despite the fact that this ideal is usually genetically unattainable. This underlying message is also evident in the global mass media that is heavily dominated by Western culture, which brands Asian features as undesirable with racial stereotypes associating monolids with dull and emotionless personality types and small nasal projections with weak character -"perpetuat[ing] the notion that Asian features are inadequate" [5]. The outcomes of these stereotypes are (but not limited to) the following absence of Asian winners in global beauty pageants such as Miss Universe and the underrepresentation of Asian leading actors in the American entertainment industry despite a large Asian population in the United States [3].

The Adoption of Western Ideals to Combat Colonial Influence
All the given evidence points to a proliferation of a Western ideal in Korean culture and seems to assume that an internalized obligation to pursue this ideal is the underlying motivation to undergo plastic surgery among Korean women. Although the most common surgeries in Korea produce Western-oriented features, the argument that a desire to match Western ideals of beauty propels Korean women to go under the knife fails to consider the influence of long-standing traditional beliefs on Korean beauty. The ultimate reason for facial alterations among Korean women is influenced by the historical events and superstitions embedded into Korean culture. One such historical event behind embracing a more Western appearance lies not in the admiration of Western facial features, but as a defiant act against Japanese colonization that lasted from 1910 to 1945: "The western body [...] was mobilized in defiance of Japanese standards of beauty -as anticolonial discourse" (p. 69).

Physiognomy as a Predictor of Success
In addition, although cosmetic procedures gained popularity in South Korea during the 2000s, beauty has been a significant aspect to Korean tradition for centuries. In particular, the cultural infatuation with the alteration of facial features emerges from physiognomy, a practice that dates back to the Goryeo and Chosun Dynasty. A prominent belief in Korean tradition, physiognomy proclaims that one's appearance determines one's fate, thus altering one's appearance changes one's destiny. Even today, physiognomy continues to be a significant determinant for plastic surgery, proven by how "Many who consider undergoing aesthetic surgery consult a physiognomist beforehand, and aesthetic surgeons and physiognomists work closely together making mutual recommendations to clients" [4]. Many Koreans still believe that facial characteristics determine one's future, and fortune-teller Lee Heon gives an example of this fortune-telling practice by referring to how "ears [tell] whether or not a person is spiteful or good-natured," and "the higher the bridge of one's nose is, the more money they are expected to earn" [8].
Therefore, the pursuit of facial features such as a high nose bridge is sought after among Koreans not as a yearning to appear Western, but for its superstitious link to prosperity. In addition, physiognomy has enormous influence in the job market, as recruitment executives highly consider candidates' appearances as an essential factor in employment and "physiognomy is often used to evaluate candidates where qualifications and experience are equal" [4]. Thus, current literature on Korean beauty standards portray physiognomy as a basis behind plastic surgery in South Korea because of a longing for success in the work field, which is independent of a specifically Western influence. Therefore, although plastic surgery boomed in South Korea in the 2000s, the desire to alter one's appearance is not a recent phenomenon, but in fact originated from the long-lasting Korean traditional belief of physiognomy that still plays a major role in decisions to have body alterations today.

Patriarchal Sexism in the Job Market
The historical influences on the rise of plastic surgery in present society are exemplified not only by physiognomy, but also by the deep-rooted patriarchy that defines the standards of femininity that women must maintain, and occupational success is often associated with feminine beauty. Contrary to Korean women in the past, women now are more active in achieving economic independence from men by seeking employment. However, regardless of women's advancements in independence, the obsessive maintenance of beauty in South Korea today emerges from the prevailing patriarchal structure of Korean society that places limitations on professional opportunities women can receive. For instance, "teachers preparing their students for the job market [...] focus first and foremost on grooming their students' appearances rather than concentrating on academic directions, grades, or abilities" because "In order to achieve higher and more profitable positions in the labor market, women have no choice but to adjust their bodies to the standard concept of femininity" [3]. This standard concept of femininity refers to how women are still subjected to conform to patriarchal instructions on femininity to maximize access to job opportunities.
The idea that "Beauty, more than character and intelligence, often signifies social and economic success" has become systemic to the extent that it is no longer a surprise that attractive candidates will receive better treatment in the job market, especially nowadays when portraits are mandatory in resumes [5]. This assumption is evident in recent findings that women with plastic surgery receive an increase in annual income from $300 to $700 [9]. As one of the world's most educated societies, South Korea's academically competitive graduates must exceed other candidates to stand out in a job market where everybody has impressive credentials for employment [10]. By enhancing their appearances, Koreans can put their best foot forward. But in doing so, Koreans, particularly women, subject themselves to superficial judgements on appearances solely to maintain the societal expectations that determine occupational success in a cutthroat competition for jobs.
Overall, beauty has become a necessity that women must attend to in South Korea because women still face gender oppression to look a certain way that embodies femininity to surpass other women in gaining employment, as revealed by the statistical data that beauty is often correlated with higher incomes. Thus, Korean women use cosmetic treatments such as plastic surgery to alter their appearances to adjust to the sexist nature of the competitive labor market in a male-dominated society that evaluates appearance more than skill and experience.

A Tool for Self-Empowerment
A counterargument to the idea that the patriarchal labor market compels women to partake in cosmetic treatments is that these alterations show that women are self-governing and not forced into undergoing treatments, but rather choose to voluntarily in order to take care of themselves and open up more opportunities for themselves which should be seen as empowering, not oppressing; "Women's pursuit of good looks is based on pleasure rather than force, and women throw themselves willfully and enthusiastically into the beauty market" [3]. However, this perspective of women gaining agency from plastic surgery neglects how women who undergo surgical procedures to alter their appearances are motivated to do so because they suffer from an inferiority complex and low self-esteem engendered as a result of the male-constructed expectations of femininity. Holliday and Elfving-Hwang [4] share this view, saying that in South Korea, "aesthetic surgery exists within a misogynistic (beauty) culture, and only really affects women" (p. 63). Thus, the need to be liberated from suffering over appearance through surgery shows the dissatisfaction that women have with their physical appearances because of the cultural emphasis on beauty as a determinant of success. The negativity of cosmetic treatments is shown through the feminist organizations in South Korea, and the feminist approach to plastic surgery in South Korea is that "the women's rights movements in Korea are very clear about its negative implications" [4]. This shows how South Korean women are also aware of the harmful societal pressures on beauty and that acquiring plastic surgery with expectations for more success in the job market is a sign of the oppressive patriarchy, not a sign of female empowerment. Hence, plastic surgery is not a means for women to develop self-agency but is just the negative outcome of a longing for success and female submission to patriarchal ideals of femininity, and surgery is deemed a practical solution to an economy that limits female opportunities in the job market.

A Response to Globalization
Another opposing idea towards Koreans aspiring to obtain foreign facial features is that the beauty characteristics that South Koreans aspire to obtain through plastic surgery are from a globalized image embodying features influenced by not just the Western cultural hegemony but from other parts of the world as well. Holliday and Elfving-Hwang [4] support this notion, highlighting how the globalized image is not just unattainable to non-Westerners like South Koreans, but to Westerners as well: "Positioning blepharoplasty as Westernization ignores the fact that wide eyes have local significations such as youthfulness and active desire, and that Western women also routinely undertake similar surgeries" (p. 75). Therefore, saying there is a Westernization of Korean beauty norms denies the constructed nature of Western beauty itself. However, both stances -the Westernization or the globalization of beauty norms in South Korea as the underlying reason behind plastic surgery in South Korea -overlook the societal pressures of beauty placed on women in order to increase their professional opportunities. While women may have global or Western features following their plastic surgery, this does not indicate that they had surgery with the intention of looking foreign. The intention behind plastic surgery in South Korea is largely due to the desire for greater career opportunities in a workplace that emphasizes appearances heavily. In addition, given the strong nationalism in South Korea, it is unlikely that South Korean women would receive cosmetic treatments to aspire to look like Westerners and rather do so because they yearn to enhance their natural Korean features. Samuel S Kim [11] provides evidence for this in his book, Korea's Democratization , with a quote from Jin wung Kim who claims that 'Koreans [share] "new stirrings of nationalism arising from their country's rapid economic growth and political liberalization" and that this new nationalism had stirred anti-foreign sentiments aimed mainly at "Korea's 'big brother,' the United States' (p. 135). Kaw [5] describes this point of view by saying how many Asians who undergo plastic surgery "deny that they are conforming to any standardfeminine, Western, or otherwise -and others express the idea that they are, in fact, molding their own standards of beauty" (p. 77). To elaborate, many Koreans claim to be attracted to their native culture and take a critical stance toward the Western cultures and institutions as shown by how they value a more natural Asian look that does not conform to the Western standard. Therefore, South Korean women are inclined to receive plastic surgery not to obtain specific foreign features as shown by the patriotic attitude Koreans have about their Asian heritage, but because of how the competitive career industry heavily focuses on women's appearances for employment.

Conclusion
All in all, modern literature shows that the increase in South Korean plastic surgery practice and marketing emerged in the 2000s not because of a desire for the attainment of Western features, but because of the Korean traditional values. Even though Korea historically encountered an exportation of Western beauty culture during the era of Japanese colonialism, cultural ideologies such as physiognomy, linked appearances to success, and the long-standing patriarchal standards of femininity in South Korea has permeated into the job industry. The history behind the cosmetic industry in South Korea reveals the extensive fixation on appearance and how South Korean women are often forced to uphold outdated norms to achieve economic independence and attain higher ranks in an increasingly competitive job industry.