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Discounts, loopholes lure surgery patients

For many graduating senior girls who completed their College Scholastic Ability exam two weeks ago, transforming into a beautiful swan for the first day of university orientation now takes precedence over math or English grammar. The first step toward a new look for many girls is having blepharoplasty, a surgical procedure better known as double-eyelid surgery, which adds a crease to the eyelids to make the eyes appear larger. Elizabeth Lee, a former Fulbright scholar who made a documentary titled “Good for Her” on cosmetic surgery while in Korea from 2002 to 2003, described this period in a young woman’s life as “a rite of passage.”
Korean businesses have been quick to take advantage of this new market ― the student who has shifted her attention from the pages of a book to her reflection in the mirror. The SAT exam identification can be used by students to receive discounts at restaurants, clothing stores, hair salons and, more recently, cosmetic surgeons. Dr. Cho Seong-don, a plastic surgeon at Yedam Clinic in Sinsa-dong, said that some doctors performing such procedures offer discounts to exam takers, despite the practice being banned by the Korean Medical Association. A spokesman for the association said such solicitation runs counter to medical law, which bans doctors from “attracting patients in the interest of business.” Dr. Cho, a member of the Korean Society of Plastic and Reconstructive Surgeons, is one of eight watchdogs who comb the Internet for doctors advertising plastic surgery price cuts, such as the SAT exam identification discount.
Dr. Kim Kwang-seop, a specialist in plastic surgery in Apgujeong, says it is common practice for discount coupons to also be distributed at crowded subways, entrances to women’s universities, hair salons and public baths, or via pop up windows on clinic Web sites.
Two graduating seniors planning to have surgery in the next few weeks, who asked to remain anonymous, said they will receive discounts they discovered through word of mouth and the Internet. Because of the clandestine nature of these offers, monitoring this illegal activity has proven difficult.
In the mid-1980s, economic advancement led to an increased desire for plastic surgery, and the parents of students now taking the SAT grew up in the era when it became popular. While filming her documentary, Ms. Lee surveyed or interviewed girls and boys in middle school and high school, along with college students and young adults. Asked to define beauty in Korean society, many of the respondents favored Westernized facial features such as big eyes, a high and narrow nose and a small face. That bias was noted by only 30 percent of middle school students, but 70 percent of college student respondents said they believed Caucasian facial features were superior to Korean.
In a phone interview from Los Angeles, Ms. Lee said, “At a younger age, Korean children hold concepts about beauty that dramatically shift over time. As they get older and need to compete more, they start to understand what will help them to survive and even thrive.” One professor that Ms. Lee interviewed for her documentary thought the greatest difference between cosmetic surgery in the United States and Korea is that Americans have operations to look more attractive, but Koreans feel they are a necessity.
Ms. Park, an undergraduate student at one of Korea’s top universities, decided to have double-eyelid surgery in 2002 when she graduated from high school. Her parents agreed to her wishes. She said many girls in her school had decided to have the surgery, and she heard that one doctor many of her classmates were using had provided good results. She was not happy with her own surgery, however, and said, “I heard that my friends had become pretty, so I wanted to [have the surgery]. It took one day to decide. Now, I regret it.”
It wasn’t until she later saw a documentary about cosmetic surgery and checked the doctor’s credentials on his clinic Web site that she realized he wasn’t a specialist in cosmetic surgery.
According to the Korean Medical Association, there are less than 1,400 specialists in plastic surgery among the 80,000 doctors who belong to the association. In Dr. Kim’s estimation, more than half of those offer cosmetic surgery, with double-eyelid surgery and nose augmentation the most popular procedures.
Doctors who practice cosmetic surgery with no formal training exploit a loophole in the form of the term jinryo gwamok, best translated as “diagnostic subject.” The term arose in the 1960s when all Korean doctors were general practitioners and were obliged to use the term when offering specialized services. Nowadays, doctors with no specialized training in cosmetic surgery can use the term in order to perform such procedures. They are legally bound to display the term on their outdoor signs, but often print it in the smallest possible letters, so the signs are nearly identical to those of qualified plastic surgeons.
Although Ms. Park isn’t pleased with the results of her surgery, she continues to lead a normal life. Ms. Lee said many of the women she had spoken to didn’t want to go out in public because of their botched surgery jobs. She said, “Right now, there is shame if you don’t get surgery, but great shame if you do and something goes wrong.”
Dr. Cho and Dr. Kim both caution that although most Koreans think double-eyelid surgery is simple and harmless, many things can go wrong. After a badly-done operation, a patient may not be able to open or close her eyes completely. Most of the time, a skilled plastic surgeon can fix this, but sometimes the damage is irreversible.
Dr. Kim said, “Korean people need to be educated. I think the most important thing people need to know is this term on a sign is a trick.”
He added, “A poor person or a wealthy person may not know if her doctor is a real plastic surgeon,” because the doctor doesn’t tell the patient and the patient doesn’t ask. Moreover, although general practitioners practicing plastic surgery are required to include jinryo gwamok on their outdoor signs, it is not required on other advertising.
Going to medical school for six years and passing an exam for the Korean national medical license is all that is necessary for a doctor to practice any kind of medicine in Korea. The medical association said, “The fact that a physician is not a specialist in a certain area doesn’t necessarily mean that he or she can’t perform certain medical practices.”
Plastic surgery seems to be the most common crossover specialty because of the extra revenue it generates for general practitioners or doctors who trained in less lucrative areas. Dr. Cho says there is a “problem with the system” because doctors’ specialties are undervalued in the Korean medical system.
To learn to perform the procedures, Dr. Cho and Dr. Kim said doctors form study groups where they watch surgical videos and share tips on techniques. A trained dermatologist, who wished to remain anonymous, said many unqualified doctors offering plastic surgery or complicated dermatologic treatments first practice on their wives, mothers and friends before they start offering services to the public.
Ms. Lee’s documentary includes interviews with mature young women who made educated decisions to have cosmetic surgery. She said that not only does she think Korean society should be concerned about the amount of women opting for such surgery, but she thinks it is dangerous for girls just graduating from high school to change their faces surgically when they are so young.
Ms. Lim, a chemical engineering student also at one of Korea’s top universities, said she has been told many times by her aunt that she is not pretty or thin enough, so must study hard and find a good job because she will not marry a rich man.
Many of her friends had eyelid surgery before they started university, but she says, “I think I’m pretty enough, but sometimes I’m a little afraid that my professors or people I meet in society may think like my aunt. So, maybe I can’t be successful, especially in the Korean system.”

by Mi-soon Burzlaff