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Korea is shaping fashion and demand for aesthetic interventions across Southeast Asia

13.08.2018
Medicine, South Korea

South Korea in the world beauty industry is called the "paradise of plastic surgery."
Annually about 500 thousand aesthetic interventions are carried out here, and according to this indicator the country lags behind only the historical plastics leaders - the USA and Brazil. The unprecedented scope for a small Asian country has its backside - an extensive "gray" zone where uncertified and often less competent surgeons practice, and patients who are not accredited by the brokerage are piloted by patient flow. Vademecum traced the history of the Korean phenomenon and tried to figure out why the regulators and the public have not yet managed to clear the "plastic paradise" of frank sinners.

RACE OF INVASIONS

In April of this year, the public organizations "Asian Institute" and "Korean Movement for Peace" held a mass meeting in the Seoul region of Gangnam, where more than 500 aesthetic clinics are concentrated. Tradition guardians called for curbing the "dragon" of plastic surgery, calling it a form of "cultural violence against Korean women."

"Korean society has been literally obsessed with the race for plastic surgery, and I'm very sad that women are now perceived simply as sexual objects that need a scalpel to become perfect. Such commercialization is completely foreign to Korean culture. Our values ​​are based on invisible things such as righteous behavior, caring for children about their parents, but all this has been replaced by an obsession with changing its appearance, "quoted the head of the Asian Institute, Emanuel Pastreich, the British The Telegraph.

The obsession of Koreans with aesthetic interventions is by no means a figure of speech. If you focus on the data of the International Society for Aesthetic Plastic Surgery (ISAPS) and the publication of the national press, South Korea ranks third in the world ranking of the leading countries in terms of the number of interventions, about 500,000 operations are carried out annually here. Leading Korea to TOP3 Brazil (1.4 million interventions) and the United States (1.5 million), having a multiple of four and six times the population.

In 2016 (the most recent data) in the country there were more than 4 thousand profile clinics, where 2,3 thousand certified plastic surgeons practiced. Plus a few thousand more doctors who do not have relevant documents, but operate. The volume of the national market of plastic surgery is estimated by observers at several billion dollars. "Aesthetic procedures have become so common in South Korea that parents often give adolescents a graduation surgery to change the eye section or a cosmetic injection," says Yong King Chon, a specialist in the pharmaceutical business of LG Group (develops Yvoire).

In addition to participating in the TOP3 of the basic ISAPS rating, South Korea leads the list of medical tourists served by specialized specialists. According to the latest available data of the national Ministry of Health, in 2015 the country was visited by about 300 thousand medical tourists, 11% more than a year earlier, and a fifth of these patients came just for aesthetic interventions.

In 2014, the Ministry of Health recorded annual income from plastic surgeries to foreigners at $ 107 million. The entry flow was mainly formed by patients from Russia (28%), China (24%) and the United States (23%). "South Korea is a trendsetter in the beauty industry, including plastic surgery, throughout the Asian region. China, for example, is the largest market for medical aesthetic technologies and products developed in South Korea, "says Yong King Chong. How did South Korean plasticity grow to such proportions?

Different Yankees

The founding fathers of Korean plastic surgery are American doctors David Ralph Millard and Howard Rusk. Both surgeons worked here in the first years after the end of the Korean War (1950-1953) and dealt mainly with reconstructive interventions. Millard, for example, gained fame due to operations on injured lips and blepharoplasty, which he conducted for refugees, orphans and victims of war.

It was Millard in his memoirs that called South Korea "a paradise for a plastic surgeon." He also became a pioneer in conducting "double-eyelid" operations, which made it possible to transform the Mongoloid section of the eyes into a Europeanoid one, - Millard recalls, many Koreans wanted to resemble the US military.

Howard Rask, in addition to conducting extensive reconstructive practice, in 1953, established, together with the US-Korean Foundation, the mission of "Rask to Korea": ​​the participants in this project investigated the state of national health and sent local doctors to the training of new medical technologies in the United States. Residents returning from overseas brought to the Korean surgery American reconstructive and aesthetic techniques, than set the fashion for the European type of person in South Korea for many years to come.

According to the state-owned Response Plastic Surgery in Gangam clinic, TOP3 most popular aesthetic procedures in the country include blepharoplasty (or "double-eyelid surgery"), rhinoplasty and injections of glutathione-lightening skin. Demand, if I may say so, racial retouch.

However, other interpretations sound: the popular South Korean videobloger Alfred Lang recently posted a video in which he tried to debunk the "myth that Koreans imitate the Europeans." "The misconception that Koreans just want to look like white is a consequence of Western arrogance and Eurocentrism, which has no real basis. pale skin has always been a standard of beauty, not only in the East, but also in Asia in general. It was always thought that the pale the skin, the less time a person spends on the sun, and therefore belongs to a richer class, "the blogger quoted Business Insider. But as Korean plastic surgeons testify, Asians from the US and other countries turn to them for European looks.

Another common explanation for the super-popularity of plastic surgery in South Korea is the country's commitment to Confucianism, in which experts interviewed by Koreaexpose.com see hypertrophied conformism and the desire of Koreans to be similar to each other. And the trends here set the celebrity, the faces from the covers and screens.

"As soon as a new TV series is published, where a popular actress plays a plastic surgery or aesthetic injection, the rush demand for this procedure begins," confirms Jon King Jeong of LG. Stimulation of demand for aesthetic services is not only through the stellar "product placement", but also directly. One of the most high-profile TV shows in South Korea is the Let Me In show, or the "Beautiful Woman", which shows the stories of magical transformations: unsightly looks, suffering from their inferiority, people fall into the hands of a plastic surgeon, after which their life becomes an escalator to success.

THE PHANTOM SHOOKED AWAY

Stably high, and sometimes even rush demand for aesthetic interventions coupled with weak regulatory attention have become a fertile environment for the growth of the informal sector. Up to the middle of the 2000s, according to the national legislation, any surgeon had the right to perform plastic surgery in South Korea, although there were narrow-profile educational programs and a certification system in the country. Thus, in the industry in parallel (and sometimes in the commonwealth, but more on that a little later), there were two segments. The first is a legitimate one, consisting of specialists accredited in the Korean Society of Plastic and Reconstructive Surgeons (KSPRS) or the Korean Association of Plastic Surgeons (KAPS), licensed and verifiable, and the second is a group of plastic surgeons who remain invisible to regulators.

The situation was aggravated by the fact that a subsidiary segment was formed in the permanently growing market of aesthetic medical services, represented by intermediary brokers between surgeons and patients who organize operations for both Koreans and tourists. By the mid-2000s, hundreds of concierge companies were operating in the country that were not regulated and accountable to no one. At the same pace in Korea, plastic surgery clinics, often not licensed and employing low-skilled personnel, began to grow.

For the last 10 years, the industry has been shaken by scandals associated just with the merging of "light" and "shadow" and the dominance of "ghost surgeons". In the local press, every now and then there were news of how the next opionion leader was embarrassed - he promised the patient to perform the operation with his own hand, and when he was already anesthetized, he gave the intervention to his less experienced colleagues. Many star surgeons were burned by greed, provoked by a growing patient flow, - they could not personally physically handle all the suffering people, but they did not want to miss the profit, then a ghost surge team was called to the rescue, ready, as they say, for a small stake in the operating table.

One of the most high-profile was the story of a 26-year-old student of the Park. In 2012, he paid a clinic of the famous in Seoul Dr. Sang $ 10.6 thousand for an aesthetic operation to correct the shape of the jaw, resulting in partial paralysis of the facial nerves. "I went to see Dr. Sang, because he was very famous. it was strange that he prescribed an operation for me quickly, literally within a week, but he assured me that he himself would conduct the procedure, "- told The San Diego Union-Tribune Park. Suspecting the wrong, Efe, before getting anesthesia, quietly turned on the video camera: "It turns out that when I slept, another surgeon came to the operation, not Dr. Sang. And his assistants touched my body, and even laughed at how thin I was. "

After intervention, Park stopped feeling part of the chin, got a face swelling and a modified nose shape. "To go to this operation was the worst decision in my life - I was already beautiful, even despite some shortcomings," Park complained to journalists. The student initiated a lawsuit against Dr. Sang's clinic, but the outcome of the lawsuit, which lasted more than four years, is not found in open sources - either it ended in an amicable agreement, or the press lost interest in the incident.

According to the South Korean Alliance of Patient Organizations, several years in a row the number of complaints about plastic surgeons has steadily increased: if in 2012 the alliance received 3.7 thousand such applications, in 2013 - already 4.8 thousand, then in 2014 it exceeded 5 thousand. The number of lawsuits against clinics and individual surgeons has multiplied. According to the Archives of Plastic Surgery published by KSPRS, between 2000 and 2015, more than 200 trials between patients and plastic surgeons were recorded in South Korea, with no more than 20 processes completed by an "effective settlement".

Incompleteness of judicial practice was largely due to gaps in the law, clearly not keeping up with the rapid growth of the aesthetic niche: in the regulatory framework, no direct prohibition was imposed on surgeons who did not have specialized training and accreditation to engage in plastic interventions. In addition, as noted by representatives of the Alliance of Patient Organizations, most of the plaintiffs did not have convincing evidence that the operation was not carried out by the surgeon who was declared, but the clinics, building a line of defense, usually resorted to attack tactics - filed a counterclaim against the patient about misinformation. The pro-associations of plastic surgeons and social workers repeatedly appealed to state bodies with a proposal to amend the legislation, but their appeals were ignored - until the situation in plastic surgery began to threaten South Korea with an international scandal.

ZONE OF NEGATIVE

In 2015, a 50-year-old patient from China died in one of the clinics in the Gangnam district of Seoul. As follows from the materials of KAPS, during the operation, the woman had a cardiac arrest, which neither the brigade performing the aesthetic intervention had time to start or the resuscitators of the nearest Samsung Seoul Hospital, where the patient was urgently taken. She had a brain death. For sure, all the circumstances of the incident are unknown until now, but the Korean authorities announced then that the clinic that conducted the procedure with violations was closed.

Representatives of KAPS suggested that the hospital worked without an appropriate license. "Such hospitals are managed by businessmen, not doctors, and they are created in order to earn money. They will always strive for profit, even sacrificing the safety and health of patients, "then Joe Su said in an interview with the China Daily.

The tragedy awakened the regulators and called for action. Already a week after the incident, the Ministry of Health of South Korea issued a number of regulatory innovations aimed at tightening control over the activities of plastic surgeons, clinics and concierge companies. The regulations that came into force prescribed all health facilities and brokers working with tourists in the field of plastic surgery to undergo a strict procedure of special registration in the Ministry, and violators could be imprisoned for up to three years and fined.

In addition, the Ministry of Health announced cash rewards to those who helped identify and bring to justice shadow brokers. At the same time, it was decided to create and place the medical korea.or.kr site of the medicalkorea.or.kr site dedicated to plastic surgery clinics and, moreover, to create an agency to provide foreigners with information about legal Korean medical centers.

Also, norms have been developed, according to which the risk of side effects during operations and the joint responsibility of the parties for possible undesirable consequences should be discussed by the clinic and the patient prior to the intervention. And finally, a normative act has appeared that gives the right to practice plastic surgery only to certified and licensed specialists.

Nevertheless, two years after the tightening of profile regulations in the industry, a new scandal erupted. In autumn of 2017, the leadership of Incheon International Airport in Seoul announced plans to open on its territory a plastic surgery center with an area of ​​2.5 thousand square meters. m - the idea was to enable transit passengers to receive aesthetic medical services without leaving the transport hub.

The cheeky business plan of aviators has caused a flurry of criticism and protests from profile industry associations - KSPRS and KAPS. Plastic surgeons called the undertaking blasphemous and illiterate, indicating the risks that can cause a plastic surgery or a cosmetology procedure conducted just before the flight. Doctors, in particular, mentioned the inevitable during the flight of jumps of blood pressure, capable not only to negatively affect the healing process, but also to provoke the appearance of thrombi. The associations sent protest letters to top managers of the air harbor and government officials, which did not stop Incheon Airport from announcing a tender inviting plastic surgeons of South Korea to open offices in the port medical center. However, no applications were submitted for the competition, and the project was stalled by itself.

However, adherents of order in the national beauty industry are not in a hurry to celebrate the victory: if new reports of emergencies with medical tourists have not yet appeared, then on the domestic market, tragic incidents happen regularly. In 2016, KAPS discovered another brigade of "ghost doctors" at the G Plastic Surgical Clinic: the reason for the investigation was the death of a schoolboy, whose general anesthesia before the operation caused cerebral hypoxia. KAPS and KSPRS continue to attack regulators with petitions demanding criminal liability for practitioners without a doctors license, but the authorities do not yet find an adequate response. "We hear from time to time that such surgeons are still performing operations," a representative of the aesthetic clinic of TL Plastic Surgery in Seoul told Vademecum.

Further reforms in the industry are trying to provoke the public. For example, Seoul metropolitan last year announced the renunciation of new contracts related to advertising on its plastic surgery sites, and the complete removal of all thematic banners until 2022. The decision was made after the organization received 1,180 complaints Seoul residents and guests of the capital, declaring that advertising plastic surgery clinics "creates an unhealthy and distorted view of the image of the female body."

It is possible that the reorientation of consumer demand will help to smooth out sectoral contradictions - in South Korea, as in the rest of the world, patients often prefer minimally invasive procedures to radical interventions. The most recent trend is the infatuation of Koreans with injections of fillers based on hyaluronic acid. "In the new series, actresses began to appear with extensive contour plasty, in the volume of approximately 7 ml of filler for the whole face [the standard dosage of such a procedure in Russia is 1-2 ml. - Vademecum]. Therefore, we expect the popularity of such a procedure to increase - so it seems to women that they look richer and younger, "says Jon King Jeong of the pharmaceutical division of the LG Group.