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Popular plastic surgery calls ethnicity, image and identity into question
By Karen Zraick

Erin Peck, a 34-year-old Korean-American woman who grew up on Long Island, always wanted bigger eyes and a thinner nose.

“I had very fat eyelids and it looked like I was squinting a lot,” Peck said.  

So two years ago, Peck decided to have something done about it: Asian eyelid surgery.

Also known as Asian blepharoplasty, it’s the most popular and fastest-growing cosmetic surgery in northeast Asia — and among Asian-Americans. The surgery adds a crease and makes the eyes look bigger by slicing the eyelid open and fusing the muscle with the skin.

“There are more and more patients of Asian descent interested in surgery,” said Wendy Lewis, a plastic surgery consultant who calls herself "The Knife Coach” and author of “Plastic Makes Perfect: The Complete Cosmetic Beauty Guide.”


Photo: Karen Zraick/NYC24

An eyelid surgery in progress.

But the procedure has sparked debate among Americans, right at the fault line of image and identity politics. Some claim that the women who undergo the surgery are conforming to a Western image of beauty, or trying to “erase” their ethnic identity.

Doctors and patients say they’re simply improving physical appearances, and that many Americans don’t understand a surgery that is commonplace among young women in South Korea and growing in China and Japan. If done well, meaning that the eye looks proportional to the patient’s face, the surgery is no more extreme than nose jobs or breast implants, some said.


Erin Peck discusses her surgery.

Almost half of all northeast Asians are born with an eyelid fold, which has long been considered more beautiful in Asia, according to Dr. Edward Kwak. Many feel like those who get the surgery aren’t trying to look white; they’re just trying to look like the many other Asians who have the fold.

On Asians, the eyelid fold is typically lower than on other ethnic groups: it often falls just above the eyelash. Dr. Kwak and other plastic surgeons say they try to add subtle folds for patients of Asian descent.


Before & after photos of Asian eyelid surgery.

According to estimates by the American Academy of Facial Plastic and Reconstructive Surgery, doctors performed about 50,000 Asian eyelid surgeries in 2007. A precise number is difficult to ascertain because the organization keeps exact numbers only for all eyelid surgeries, a category which includes eyelid lifts, performed on patients of all ethnicities.

Dr. Edmund Kwan has been performing the surgery in New York City for more than 15 years and also did Peck’s surgery. Kwan stressed that the Asian beauty standard has long favored bigger eyes with defined folds. In South Korea, the surgery is very common among young women and girls.

"They don't want to look white," Dr. Kwan said. "They just want to look better."

People with bigger eyes are perceived to be more beautiful and intelligent in Asia, Dr. Kwan said. Many women feel the surgery will help them succeed in the job market and land a husband. 


Photo: Karen Zraick/NYC24

Asian beauty standards have long
considered bigger eyes more attractive.

Peck said she was so happy with her eyes that she went back for another surgery last month: rhinoplasty to thin her nose. It’s often done in combination with eyelid surgery.

“I feel fantastic and pretty,” she said. “I was pretty before but this has made a huge difference in my confidence levels.  I feel like I can truly be myself and I see men just doing a double-take in the streets.”

Peck said that she never wanted to lose her ethnic identity, and that she went for subtle, natural-looking features. The most important change, she said, might not even have been physical.

“When you try and go for surgery, you think, ‘Oh my god, it’s going to make such a big deal in my life.” Peck said. “And it doesn’t. It’s the change within you. It makes you more confident to be who you are.”

Dr. Kwan said the style of surgically altered eyelids has changed over time. The first doctors to do the surgeries in the United States, starting in the 1960s, added huge, Caucasian-style folds high up on the eyelid, which are difficult to reverse. He said he encourages patients to go for a very subtle change, which is what most are looking for to begin with. 


Dr. Peck performs eyelid surgery. Warning: graphic content. (Video: 2:45)

Dr. Kwak said doctors may have added inappropriate eyelid folds due to lack of training. Even today, most U.S. doctors do not perform Asian blepharoplasty. Surgeons in Seoul, South Korea, one of the plastic surgery capitals of the world, have largely honed the technique.

Martin Wong, publisher of Giant Robot, a magazine about Asian-American pop culture based in San Francisco, said he is disappointed that so many Asian-Americans get it done. 

“I think that there are plenty of men and women who look really hot who got the eye job done,” Wong said. “But the message that they’re sending is the look they had before is not as good, not as desirable as the one that they paid for. I think that they should realize that the message that it sends is that they’re unhappy with a more Asian look.”

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A PATIENT'S IMAGE
OF ETHNIC BEAUTY
(Audio 1:45)
 
INSIDE THE OPERATING ROOM WARNING: GRAPHIC (Video: 2:45)
 
BEFORE & AFTER THE SURGERY (Audio slideshow 1:00)
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