RM: This is 99% Invisible. I’m Roman Mars.
RM: There’s a daytime talk show that airs on CBS called “The Talk”. It’s kind of like “The View” if you’ve ever seen that: five female hosts sitting around a table discussing current events. And when it returned for its 4th season premiere in 2013, they came up with this stunt, called “Secrets Week.” Over the course of the week, each of the 5 co-hosts took turns revealing one of their deepest, darkest, juiciest secrets.
VL: Because who doesn’t love a good secret?
RM: That’s our newest producer, Vivian Le.
VL: For example, we learned that week that Sharon Osbourne had a fling with Jay Leno…
RM: Nghh. That should have stayed secret.
VL: But more interesting was a secret from one of the other co-hosts, Julie Chen.
THE TALK CLIP: My secret dates back to when I was 25 years old, and I was working as a local news reporter in Dayton, Ohio
VL: The way Chen tells it, she’d been paying her dues as a reporter, but what she really dreamed about was becoming an anchor.
THE TALK CLIP: You know it’s cold out in the field, I wanted to try and get a seat at the anchor desk.
VL: But when she approached her news director about the possibility, he gave her some “feedback”
THE TALK CLIP: And he said, “Because of your heritage, because of your Asian eyes, sometimes I’ve noticed when you’re on camera and you’re interviewing someone, you look disinterested, you look bored, because your eyes are so heavy, they’re so small.
RM: Oof. I hate people.
VL: Yeah. But Chen, who’s Chinese American, found herself wondering if maybe he had a point, and reached out to a prominent talent agent for some career advice. And he actually took it a step further.
THE TALK CLIP: And he said, “I cannot represent you, unless you get plastic surgery to make your look eyes bigger.”
VL: And then Chen admits to the audience that she did it. She got the surgery; a procedure called Blepharoplasty.
RM: For people who are not of East or Southeast Asian descent, Blepharoplasty is usually done to lift loose or sagging skin around the upper eyelids caused by aging. Just Google Kenny Rogers before and after 2003.
VL: But for a lot of people of Asian descent, this surgery is more commonly referred to as “double eyelid” surgery. About half of Asians, myself included, are born with what’s called a “monolid” or “single eyelid, which means that there’s no visible crease on the eyelid skin above the lash line. This is what Julie Chen had before.
RM: The double eyelid surgery adds a crease. So instead of the upper lid running smoothly from the bottom of the eyebrow, straight down to the eyelashes, there is now a small indented fold in the skin, just a few millimeters wide, that runs in a horizontal crescent above the lash line. This crease subtly changes the eye shape in a way that makes the eye itself appear slightly larger. The simplest method doesn’t even involve any cuts, just a few stitches along the eyelid to create the crease.
VL: Chen got the surgery in the mid 90’s but she kept it hidden from the public up until 2013. And that day, when she tells the audience about it, it was surprising to me to hear her sounding so…excited.
THE TALK CLIP: JC: Now I want to show you, really demonstrate what my news headshot looked like before I had this plastic surgery done. I mean if you look at the after, the eyes are bigger, I look more alert.
Sharon Osbourne: Fabulous!
Sheryl Underwood: More expressive.
VL: Listening to that response, Sharon Osbourne saying, “fabulous!” is sort of disturbing to me. Double eyelid surgery is one of the most popular procedures for Asian Americans, and hearing such a positive reaction, it really is no wonder why. The hopes of looking ‘fabulous’ or ‘more expressive’ are the same reasons why people in my own family have had the procedure done themselves.
RM: And this ethnically specific surgery may have its roots in Asia, but it wasn’t Asian doctors who popularized it.
VL: It was popularized by… a white guy from the U.S., who thought he was doing Asian people a favor by helping them look, less Asian. But before we get to him, the origin of double eyelid surgery itself dates back much further, to 19th Century Japan.
RM: Beauty standards will always vary from culture to culture, and even within the same culture over time. Double eyelids are seen as a beauty preference for a lot of Asians and Asian Americans today, but that wasn’t always the case. There’s actually little to no record of double eyelids as an aesthetic preference until something called the Meiji Restoration.
VL: Before the 1860’s, Japan practiced a policy of isolationism and limited their contact with other nations, but during the Meiji Restoration, which took place from the 1860’s through the early 1900’s, Japan opened up. It began incorporating a European-style banking system, new kinds of scientific technology, and Western-style clothing. It was also around this time that the first double eyelid surgery was performed by a Japanese surgeon.
DIMOIA: It’s easy to find like, wood-cut images or pictures of say 1880’s, 1890’s is of a limited number of Japanese female patients having eye changes.
VL: This is John DiMoia, a professor of medical history at Seoul National University. He says that as Japan’s contact with Western nations increased, so did an appreciation for double eyelids over monolids. And this seems to be the case with a lot of Asian countries.
DIMOIA: Particularly places in Asia where there was a heavy contact either with the British Empire or with the broader loose, you know, to use the word “American” empire. These tend to be places where Blepharoplasty has tended to pop up.
VL: It’s these moments where Asian countries begin developing relationships with Western empires that double eyelid surgery becomes more visible.
DIMOIA: Meiji Japan, definitely South Vietnam, there was lots of plastic surgery going on prior to and during the Vietnam War, and post Korean War.
RM: But while Blepharoplasty may have already existed in Asia here and there, it didn’t really take off in popularity until the Korean War.
(Radio voice): In Korea, United Nations troops push on in the cautious advance against the communists. An advance whose purpose…
RM: The Korean War, is technically, still ongoing. But the actual fighting between Northern and Southern forces lasted from 1950-1953.
VL: By the time the armistice was signed dividing the peninsula into North and South Korea, the impact of the war had left South Korea pretty reliant on help from Western nations.
DIMOIA: What happened obviously created a certain path dependency in the sense that much of the aid was coming from Western countries.
RM: This came in the form of food, construction, and importantly, medical aid. Which is how an American doctor, named David Ralph Millard, ended up in South Korea.
DIMOIA: He’s a military doctor. He doesn’t arrive into Korea until the war is winding down or just after.
VL: Millard had graduated from both Harvard and Yale, then served in the navy before settling on reconstructive surgery as his specialization. He studied under Harold Gillies, the father of modern plastic surgery, who was known for repairing the bodies and faces of WWI and WWII soldiers maimed in battle.
DIMOIA: I don’t know if the word, I don’t want to say “normalcy,” but he wants to restore some sense of a face that actually resembles a human face.
RM: Millard was stationed in Seoul in 1954, where he served as chief plastic surgeon for the United States Marine Corp. It was his job to provide reconstructive medical assistance to those suffering from disfigurement caused by war, burns, or simply by a lack of medical access.
VL: Millard was a fan of old West films. He’d grown up riding horses, and learning to tie knots, and spinning ropes, and idealizing manly western stars like Ken Maynard and Buck Jones. He ended up bringing this kind of cowboy, “good guy” saviour mentality to his work in some strange, and very literal ways.
RM: He first became well-known for doing cleft palate surgeries on children. In his autobiography, which he titled Saving Faces, he tells a story about his first cleft palate patient in South Korea. Millard had been looking for someone to test a new method on, but he was having a hard time finding a willing subject. When he couldn’t find a volunteer, he decided to rustle up one himself.
DIMOIA: This is before institutional review boards. He’s largely self authorized…
VL: Millard bragged that he spotted a 10 year old South Korean boy with a cleft lip, and ran back to grab a lasso that he kept in his footlocker. Yes, you heard that correctly, Millard brought a lasso over 6,000 miles to South Korea.
RM: I do not like where this is heading.
VL: He lassoed the 10 year old and performed surgery on him, and in case you were wondering, no, he did not have parental permission to do this.
DIMOA: But backing away historically probably today could not do many of the things that he did, were someone else looking in and actually reviewing his work from a professional standpoint.
RM: As crude and horrifying as Millard’s methods could be, his work in cleft palate repair did get him respect in the field of reconstructive surgery.
VL: But he would soon become famous, or maybe infamous for another procedure entirely. Blepharoplasty, or the double eyelid surgery. Millard was the first documented surgeon to perform this procedure in South Korea, on a translator. He covered this in an essay that he wrote about his time overseas called “Oriental Peregrinations,” meaning “Oriental journeys”.
DIMOIA: He depicts a Korean male translator who is coming to him because he wants to look different than he looks.
VL: Millard recounts, quote, “A slant-eyed Korean interpreter, speaking excellent English came in requesting to be made into a ‘round-eye.’” Unquote. The interpreter then tells Millard that his translation work relies on his relationships with Americans. So Millard writes, quote, “He felt that because of the squint in his slant eyes, Americans could not tell what he was thinking, and consequently did not trust him. As this was partly true, I consented.” Unquote.
RM: Which sounds…familiar.
VL: It’s basically the same feedback Julie Chen got 40 years later; that people couldn’t read her expressions, and audiences wouldn’t relate to her. The stereotype of the inscrutable Asian has a long history in Western countries. It paints people from Asian nations as perpetual foreigners who are just too different to assimilate.
RM: In Millard’s article, he shows dramatic before and after pictures of the translator, and it’s clear that he thought the work he was doing was more than just cosmetic.
DIMOIA: The caption, I can’t remember the exact words, says something like, “Now he is frequently mistaken for Italian or Spanish.”
VL: Millard goes on to say that the translator, his face totally transformed and now European-looking, plans to go the United States to study for the ministry.
DIMOIA: So I mean, this is where people get angry at Millard. Not only you know, for whatever his ethics are in terms of the medical stuff, but the cultural assumptions where he thinks he can completely transform this man’s life and his body through the act of surgery.
VL: Over the course of his year in South Korea, Millard continued performing Blepharoplasty on others, specifically South Korean sex trade workers who were trying to appeal to American GI’s. He described a woman’s desire for eyelid surgery to be for “economic” reasons.
RM: To Millard, Blepharoplasty offered a solution to a cultural disconnect between East and West, but it was only those with Asian features who were expected to change their bodies.
VL: With the population of East Asians growing the United States, Millard speculated that double eyelid surgery might be useful at home in the U.S. too. GI’s were bringing home Japanese and Korean brides, and Millard thought that plastic surgeons could help them integrate into American society.
DIMOIA: He definitely saw himself and liked to see himself as an advocate of the surgery, and I don’t think he could possibly have anticipated how it would get picked up in different ways.
VL: According to the American Society of Plastic Surgery, more than 12,000 Asian Americans had double eyelid surgery in 2017. The procedure has become completely normal for both women, and men. And given the racist history behind the procedure, it makes sense that some people in the U.S. are vocally critical about it.
Dr. Phil: “Look, eyelid surgery is fake, it’s anti-Asian, you’re erasing ethnic markers.”
Guest: “So it’s not so much necessarily about the droopy eye, it’s also about wanting to look more Caucasian”
Newscaster: “Chen’s story has prompted a backlash. Some critics accused her of selling out, others claimed she had other surgery too.”
RM: But not everybody buys this narrative of selling out.
EH: The Western media pretty much consistently has a pitying or condescending attitude about how Asians view plastic surgery.
VL: This is Euny Hong, journalist and author of The Birth of Korean Cool. She says that the reaction to Julie Chen’s double eyelid surgery was a perfect example of this condescending attitude.
EH: People were accusing her of being ashamed of her race, of being ashamed of having Asian eyes. I was kind of gobsmacked by this because, you know, again a person’s body should be their business.
RM: Hong can speak from personal experience, because she’s had the surgery done herself. She says it was no big deal.
EH: The procedure doesn’t take very long at all, it might even be something like 20 minutes.
VL: Hong says the stigma around the double eyelid surgery is distinctly American. The American media tends to assume that Asians are getting plastic surgery to look Caucasian. And in a multicultural society like the U.S., where racism is a daily reality, it can be hard for us not to interpret people’s motivations through that lens.
RM: But Hong says the attitudes about plastic surgery are different in South Korea where Blepharoplasty was first popularized. While the procedure might have originated with the desire to look more western, that isn’t necessarily why South Korean people get it anymore.
EH: The history of double eyelid surgery might have been motivated in kind of a racial hegemony or something like that, wanting to impose Western beauty standards on Asians. But as with a lot of things, including cuisine and art, it can have a certain origin, but it always gets adapted and localized. And Koreans have completely taken the ball and run with it.
VL: The surgery has taken on a new meaning.
SY LEEM: You know, now we are really focused on, we really focus on making beauty instead of making Western faces.
VL: This is So Yeon Leem, a scholar of South Korean plastic surgery at Seoul National University.
RM: She says South Koreans aren’t looking to have their eyes changed for the same reasons that they did back in the 1950s when Millard was around. Today, they’re aspiring to their own uniquely South Korean standard of beauty, which has been shaped by complex cultural factors.
VL: In the late 1990’s, South Korea suffered through a financial crisis. The International Monetary Fund, or IMF, stepped in and completely restructured and modernized the economy. The country has since recovered and is now the 11th largest economy in the world, but the job market has become so competitive that getting a job can still be incredibly hard. People do whatever they can to compete.
SY LEEM: So your appearance is one of your resources. So you have to kind of develop your appearance to have a better job, and better future, or better partner.
RM: And the South Korean government has also fully embraced and encouraged the plastic surgery industry.
SY LEEM: There is all kind of the governmental effort to promote Korean plastic surgery industry. So plastic surgery, as well as Korean culture, has been kind of a national income source for the Korean government .
RM: The South Korean government has lifted a ban on medical advertising, and revised immigration rules to make it easier for foreign patients to get long-term medical visas. And now medical tourism makes up a huge portion of the plastic surgery industry. People come from all over the world to have work done in South Korea.
VL: And, of course, many South Koreans get plastic surgery too. Eyelid surgery is still the most popular procedure. It’s so common that a lot of young people in South Korea will get the surgery as soon as they’re old enough to.
JI YEO: It’s like a gift when you graduate high school, before you go to college. It’s kind of, it comes with the laptop gift set.
VL: This is Ji Yeo, a photographer who’s spent time documenting the healing process of South Korean plastic surgery patients. She’s witnessed many of the recent trends in Korean beauty culture affecting both women and men.
JI YEO: So, basically you have to have achieve somewhat baby looking face, which is lighter skin, and very big eyes, narrow and high nose…
RM: And Yeo says many people also want a sharp, narrow chin. The overall effect they go for isn’t necessarily Caucasian, it’s almost pixie-ish.
JI YEO: You definitely have to have a very sharp V Line Chin with no jawline, with like very straight narrow jawlines, so they tend to cut out those bones.
VL: To achieve this complete look requires a LOT more than the double eyelid surgery, which is fairly easy and low risk. Jaw reduction surgery is much more invasive and dangerous.
RM: Of course, any surgery has its risks, but this one involves slicing out a significant amount of jaw bone, and could lead to complications like nerve damage, or chronic jaw pain.
VL: 1 in 5 South Korean women have gotten some form of plastic surgery done, and if you look at women ages 19-29, that number shoots up to 1 in 3.
RM: Yeo says women face such immense cultural pressure to conform physically, that it can be hard to resist.
JI YEO: You should fight for your own beauty, you shouldn’t follow the idealized beauty. You shouldn’t be scrutinized by the culture. But it is so hard to fight, and it is so much easier and peaceful to be part of the culture.
RM: But as critical as Yeo feels about some aspects of the plastic surgery culture in South Korea, she does wish that the rest of the world would stop being so, judgy.
VL: Because whether you’re a Korean woman trying to meet your culture’s exacting beauty standards, or an Asian American woman like Julie Chen, weighing the choice between changing your appearance or hobbling your career prospects… You’re basically damned if you do, and damned if you don’t.