Changing Faces

At 18, Saeko Kimura was a shy, sleepy-eyed university student. Until she discovered a secret weapon: if she applied a strip of glue to her eyelids, her eyes became wider, rounder, prettier. "Men noticed me," she says. "I became outgoing. Suddenly, I had a life." Her new looks also landed her part-time work as a hostess in an upmarket bar, where she gets top dollar on a pay scale determined by beauty.

But Kimura lived in fear of discovery, rushing off to the bathroom several times a day to reapply the glue and never daring to visit the beach. And so, at 21, she finds herself in a doctor's office in a Tokyo high-rise, lying on an operating table with her fists nervously clenched. Plastic surgeon Katsuya Takasu breezes in wielding a cartoonishly enormous needle. "This will hurt a little," he says cheerfully. Once the anesthetic is administered, Takasu brandishes another, hooked needle and threads it through Kimura's upper eyelids, creating a permanent crease. He then injects a filler fluid called hyaluronic acid into her nose and chin and pinches them into shape. Takasu inspects his handiwork. "The swelling will go down in a few days," he says. "But even if you went out tonight in Roppongi, you'd be a hit." A nurse hands Kimura a mirror. Though red and puffy, she now has the face she's always dreamed of: big, round eyes, a tall nose, a defined chin. The entire procedure took less than 10 minutes. But Kimura collapses with an ice pack on her face and moans, "Oh, the pain."

What we won't do for beauty. Around Asia, women—and increasingly, men—are nipping and tucking, sucking and suturing, injecting and implanting, all in the quest for better looks. In the past, Asia had lagged behind the West in catching the plastic surgery wave, held back by cultural hang-ups, arrested medical skills and a poorer consumer base. But cosmetic surgery is now booming throughout Asia like never before. In Taiwan, a million procedures were performed last year, double the number from five years ago. In Korea, surgeons estimate that at least one in 10 adults have received some form of surgical upgrade and even tots have their eyelids done. The government of Thailand has taken to hawking plastic surgery tours. In Japan, noninvasive procedures dubbed "petite surgery" have set off such a rage that top clinics are raking in $100 million a year.

Elsewhere in Asia, this explosion of personal re-engineering is harder to document, because for every skilled and legitimate surgeon there seethes a swarm of shady pretenders. Indonesia, for instance, boasts only 43 licensed plastic surgeons for a population of about 230 million; yet an estimated 400 illicit procedures are performed each week in the capital alone. In Shenzhen, the Chinese boomtown, thousands of unlicensed "beauty-science centers" lure hordes of upwardly mobile patients, looking to buy a new pair of eyes or a new nose as the perfect accessory to their new cars and new clothes.

The results are often disastrous. In China alone, over 200,000 lawsuits were filed in the past decade against cosmetic surgery practitioners, according to the China Quality Daily, an official consumer protection newspaper. The dangers are greatest in places like Shenzhen that specialize in cut-price procedures. "Any Tom, Dick or Harry with a piece of paper—genuine or not—can practice over there," says Dr. Philip Hsieh, a Hong Kong-based plastic surgeon. "They use things that have not been approved, just for a quick buck. And people in China don't know that they're subjecting themselves to this kind of risk."

Of course, Asians have always suffered for beauty. Consider the ancient practice of foot binding in China, or the stacked, brass coils used to distend the necks of Karen women. In fact, some of the earliest records of reconstructive plastic surgery come from sixth century India: the Hindu medical chronicle Susruta Samhita describes how noses were recreated after being chopped off as punishment for adultery.

The culturally loaded issue today is the number of Asians looking to remake themselves to look more Caucasian. It's a charge many deny, although few would argue that under the relentless bombardment of Hollywood, satellite TV, and Madison Avenue, Asia's aesthetic ideal has changed drastically. "Beauty, after all, is evolutionary," says Harvard psychology professor Nancy Etcoff, who is the author of Survival of the Prettiest: The Science of Beauty—not coincidentally a best seller in Japan, Korea, Hong Kong and China. Asians are increasingly asking their surgeons for wider eyes, longer noses and fuller breasts—features not typical of the race. To accommodate such demands, surgeons in the region have had to invent unique techniques. The No. 1 procedure by far in Asia is a form of blepharoplasty, in which a crease is created above the eye by scalpel or by needle and thread; in the U.S., blepharoplasty also ranks near the top, but involves removing bags and fat around the eyes. Likewise, Westerners use botox, or botulinum toxin, to diminish wrinkles—while in Korea, Japan and Taiwan, botox is injected into wide cheeks so the muscle will atrophy and the cheeks will shrink.