K-Beauty & The Government-Funded Face

A guest post from Elise Hu, author of "Flawless: Lessons in Looks and Culture from the K-Beauty Capital."

“Beauty is political!” we cry as the cosmetic surgeon scrapes our nasal bones and shapes our cartilage into something more socially acceptable — smaller, sloping, sanctioned by Hollywood executives and aesthetic eugenicists. “Beauty is political!” we repeat, insisting every purchase is an act of economic independence, every injection is an act of autonomy, every swipe of lipstick is an act of Suffragette solidarity, every beauty standard embodied is an all-important act of choice. “Beauty is political!!”

I don’t disagree entirely. Beauty is political. But the political power of beauty is rarely wielded by the people; it is more often wielded against the people.

This is what went through my mind while reading Flawless: Lessons in Looks and Culture from the K-Beauty Capital, a new book out today from NPR correspondent Elise Hu. In her deep and deeply-felt investigation into Korean beauty culture — from appearance expectations to skincare ingredients to product packaging, plastic surgery, and the effect it all has on women the world over — Hu uncovers how the country’s government funds a number of K-beauty ventures. (Not because the products and procedures contribute to citizens’ health and wellbeing, of course, but because the products and procedures fuel economic growth and further the country’s global influence.) It’s a fantastic example of how standardized beauty isn’t about beauty so much as capital and control, and I’m thrilled to have Hu unpack some of this in guest post for The Unpublishable today. Read her essay on medical tourism below, then grab a copy of Flawless.

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How Selling A Nation Means Selling Fixes To Your Body

by

Elise Hu

via Instagram

Even before you grab your bags from the carousels at Seoul’s Incheon International Airport, you can fit your face into a spectral imaging machine to get your skin qualitatively analyzed for its health relative to your age. The AI-powered analysis is a free service courtesy of the Korea Tourism Organization’s Medical Tourism Support Center. Staffers there to greet incoming travelers can usually speak at least some English, Chinese, Japanese and Russian. Kiosks and clerks can help you find a facility for acupuncture or joint therapy. But most travelers are looking for skin treatments or cosmetic procedures — and they will happily pair you with their preferred plastic surgery clinics. 

Korea boasts the most sophisticated medical aesthetic market in the world. It is the destination if you’re looking to get your asshole bleached, armpits colorized and/or your skull reshaped over the weekend in time for a return to work on Monday. Seoul boasts more cosmetic surgeons per capita than anywhere else on the planet — twice as many surgeons as the US, and 150 percent more surgeons than Brazil, the distant runner‑up. Because of its exceptionally high density of doctors, the Gangnam neighborhood has come to be known as “Plastic Surgery Street” or “The Improvement Quarter,” and the glutted market means the practitioners there are driven by competition to attempt treatments and techniques yet to be allowed in the States. 

As I found in my reporting for Flawless: Lessons in Looks and Culture from the K-Beauty Capital, the imperative of upgrading the physical body is not just woven into domestic society, but into the country’s export industries and global positioning. How did Seoul become the place where influencers flock to load up on laser treatments, injectables and other therapies before blasting out their experiences to the masses? It’s part of a sophisticated national strategy. 

Following a financial crisis in 1997, the regulatory climate in South Korea made it more lucrative for doctors if they specialized in surgical practices and diagnostic testing. Cosmetic surgery offers both the need to “diagnose” patients with a “problem” to fix, as well as the surgical solution to “fix” it. So, entrepreneurial medical professionals began to apply a scientific glaze to things like 3D imaging to help optimize the face or using big data to aggregate the ideal shapes and ratios for bodies. After all, if there is an ideal that can be “proven” by “science,” surgery or other treatments become easier to sell. 

The state even supported the logic of bodily change as good citizenship by providing temporary tax breaks that could go toward cosmetic surgery. (Today, treatment for male pattern baldness is covered by the country’s national health insurance.) The professional and personal pressures of their nation’s beauty culture came down particularly hard on South Korean women. Their prospective employers or loved ones would ask why they wouldn’t fix their eyelids, or get a blemish removed, when it was medically possible? Supply drove demand.

The evolution of jawline surgery in Korea is a notable example. As I detailed in my book:

Doctors began popularizing jawline surgery— a procedure that was previously only for reconstructive purposes— as a commercialized cosmetic procedure in the early aughts. Also called V‑line surgery, the procedure is aimed at reshaping the bottom half of the face and involves shaving and occasionally cutting, disassembling, and rearranging both lower and upper jaws (maxilla and mandible bones) to achieve a delicate- looking jaw. When you change the size and shape of the jaw, you transform the entire face. Jawline surgery stands out from eyelid surgery or rhinoplasty because it was normalized and popularized in Korea and by Korean doctors. There’s some local pride in that: in 2014, a clinic exhibited more than two thousand jaw fragments in two giant glass vessels, each bone labeled with the name of the patient from whom it was carved. Despite its popularity in Korea for more than a decade, it is still considered “foreign” by U.S. and European doctors.

The medical tourism industry is predicated on problematizing the way we look. The V-line jaw is a made-up standard where supply first created demand. “It came about just about fifteen years ago and now it’s accepted as the thing to be,” Korean feminism writer James Turnbull told me, illustrating how profit- driven industries can make standards stick. 

But in 2007, South Korea found itself in a jam: Too many doctors, not enough patients. The country is small enough to fit into the space between LA and San Francisco, and the domestic market was saturated with spas, dermatology clinics and plastic surgery centers. Enter the Korea Tourism Organization and other export-minded agencies, which established medical tourism as one of its focus areas for growth — one of the country’s “strategic products.” 

Offering tax breaks, tourist packages (transportation, hotels and meals included) for medical tourists, and touting Korea’s advancements and competitive pricing (treatments are a fraction of what they cost in the US), the effort transformed Gangnam’s Improvement Quarter into a thriving attraction for aesthetic upgrades. In 2009, about 60,000 foreigners visited Korea for medical procedures. By 2019, the number of medical tourists reached nearly half a million— an eightfold increase in a decade, after climbing steadily each year, according to numbers from the Korea Health Industry Development Institute. 

Government agencies — national and municipal — offered some “tourist info hub” type services to help find registered clinics for those interested in getting work done. But the system of support for medical tourism is a network of private brokers, like Eunogo, which partner with the hospitals and doctors to help foreigners choose services from a suite of options and guide patients through the entire process. “Korean surgeons have great skill and quality, all we needed is a good system,” Eunogo’s Joy Kang told me. “It was interesting to build something to connect foreign demand with quality doctors.”

They don’t just help foreign patients match with clinics, the broker agencies offer concierge services like translation (different clinics specialize in different dominant languages), or even staffing a caretaker to be with you throughout the entire medical process, including being the first person you see when you come out from anesthesia. This is usually all paid for by the hospitals, which rely on a constant influx of patients. As the saying goes, if you’re not paying for the product, you are the product.

“If you’re not paying for the product, you are the product.”

For many of today’s hottest procedures, the ones you probably have seen on TikTok, no recovery time is needed. And hold onto your receipt! A cosmetic surgery tax refund comes with all cosmetic services performed on non-Korean passport holders, making the transaction an even better bargain. 

If surgery renders a tourist’s face unrecognizable from their passport photo — there’s a service for that, too. The Korea Tourism Organization issues a “plastic surgery certificate” immigration officials accept as proof of identity, along with the original passport, in order to leave the country. For many people, international travel comes with the hope of a transformative experience. But few countries can rival Korea’s ability to guarantee that you will be a changed person by the time you leave — if only on a purely superficial level.