In the Eye of the Beholder?: Eyelid Surgery and Young Asian-American Women

Eye Lid Surgery
Not long after his new baby arrived home from the hospital, Chung Jin Park* peered down to examine her scrunchy pink face. Though it was still too early to determine the shape of his daughter’s eyelids, Park turned to his family and jokingly announced, "Well, there goes the money for her surgery."

Traditionally a procedure sought only by patients with excess eyelid skin or those hoping to lessen signs of aging, eyelid surgery or Blepharoplasty has become popular among young Asian American women and accepted as just another cosmetic choice in an array of many -- like tinting your eyelashes or straightening your teeth. Approximately half of Asians are born with eyelids that are naturally smooth and uninterrupted by a crease in the skin. Asian patients seek out blepharoplasties to create or exaggerate a crease in their eyelids commonly referred to as "double eyelids."

Some parents, like Park, assume that paying for eye surgery as just another part of raising a daughter. This acceptance of surgery within the Asian American community, while not surprising, is now being seen by more and more feminist Asian Americans as the product of an ethnocentric, racist culture. The fact that professionals use the terms "Occidentalize" or "Caucanize" to describe the effect of the process, without thinking twice, is in itself-very telling.

Blepharoplasty is a simple procedure and is usually performed on an outpatient basis. It begins with cutting the upper eyelid into two parts and removing a sliver of skin millimeters wide as well as some of the fat underneath. Then, the surgeon reattaches the lower eyelid flap slightly beneath the upper to create a crease. It lasts less than one hour, requires a week of recovery and an antibiotic regimen, and has permanent effects.

"The women I know, their mothers ask them casually when they plan to do it. It’s like how girls go to get their ears pierced here -- like a right of passage."
According to the American Society of Plastic Surgeons there were 142,000 blepharoplasties performed in 1999 -- a number that has more than doubled in the seven years since the ASPS began to keeping count.

And now, thanks to greater availability and a cultural (some argue ingrained) preference for larger eyes, eyelid surgery has become the most popular surgery in the Asia-Pacific region. Demand is highest among Korean, Chinese, and Japanese women, though anecdotal accounts point to rising numbers of Asian men requesting the surgery.

"Eyes that are done look better," insists Silvia Kim, who operates a Korean cosmetics counter in Flushing, Queens. "The crease brings out the eyelashes and makes the eyes look bigger," she says, emphasizing the size difference with her thumb and forefinger.

Critics of eyelid surgery believe it is a cosmetic cop-out for Asian Americans who want to downplay their race, since all Caucasians and most non-Asians are born with the crease. Still others argue personal confidence is the issue, since an estimated fifty percent of Asians are also born with the eyelid fold. But Asians have been characterized by their eyes more than any other feature by Westerners (think Fu Manchu-style caricatures and slant-eye miming in the schoolyard.) This deep-rooted, racist cultural imagery makes it somewhat impossible not to see the widespread effort to alter this trait as a reaction. as well as a statement about the effects of Westernization on Asian Americans.

Those who oppose the surgery fault the pervasive influence of American culture on women’s self-esteems worldwide, especially with the expanding reach of the Internet. Theoretically, globalization of the media over the past few decades should have fostered a diversity of images, the result of a two-way transmission of cultures -- and body types. But some believe the marketing power of Hollywood, coupled with a Western tradition of colonialism, has sown cultural insecurity among Asians and other groups.

"It’s terrible that global culture has made the Western standard of beauty so predominant that Asian women feel they have to go under the knife to achieve that standard," says Dina Gan, editor-in-chief of A magazine, the nation’s widest-circulation Asian American publication.

Gan also believes the transmission of media -- and beauty standards -- has been unilateral. "You never hear about Caucasian women having their eyes done to look Asian," she says. Others point to the scarcity of Asian Americans in the media on the domestic front, and statistics by the Screen Actors Guild back this up. Though they make up four percent of the U.S. population, only two percent of television and theatre performers are Asian American. Moreover, the number of such actors on prime time television can easily be counted on one hand -- Lucy Liu of Ally McBeal, Ming-Na Wen of ER, Garrett Wang on Star Trek, Tia Carerra of Relic Hunter, and that annoying woman on DAG.

Eye Lid SurgeryJane [last name withheld], a high school junior, is conscious of the pressure to conform but is opposed to plastic surgery on any grounds. "Looking around at my friends and in the media, I see it. Asian women are different -- but we’re not supposed to look like white women even if the media says we should."

Blepharoplasty, though not as drastic or time-intensive as a nose or breast augmentation, is still plastic surgery. However, this perception of it being a gentler surgery could be partly responsible for its popularity among younger clients. Jane, who is Chinese-American, says she had an Asian friend in junior high who asked her parents for eyelid surgery while she was still in the eighth grade -- and got it.

"She thought it would make her eyes look a lot bigger" she says. Jane also believes parents were a source of pressure for her friend. She herself grew up in northern China, where she says she saw many of her mother’s friends having the surgery done.

Changwan Yenjitr, a student from Thailand, believes cosmetic surgery is strictly a matter of personal fulfillment. "If it makes you feel more confident, you should go for the surgery," she says, while admitting she would never go through with the surgery herself.

In addition to the enduring popularity of American movies abroad, some point out that Asian movie starlets and models usually have double eyelids. And the celebrities who don't have the double eyelids simulate them with some special glue or tape -- which need to be applied on a daily basis -- or simply opt for the surgery. While the crescent-shaped eyelid tape costs around two dollars for ten uses, professional eyelid surgery can set a person back anywhere from $1,500 to $3,000, not including expenses for facilities and the anesthesiologist.

Does all this spell backlash? A New York Times article earlier this year reported that Jewish American women are getting nose jobs in fewer numbers out of ethnic pride, some to the extent of undergoing reconstructive surgery to replace cartilage they removed from their bridges earlier. Angelo Ragaza, who plans to launch an Asian American style magazine called Element, draws a parallel to the trend, saying, "The women I know, their mothers ask them casually when they plan to do it. It’s like how girls go to get their ears pierced here -- like a right of passage. [But] we’re beginning to see a huge shift in attitude among Asian American women who are now questioning eyelid surgery."

Eye Lid SurgeryBut among Asian women, it is clear that eye surgery may only be part of the picture. According to surgeons, nose and breast augmentations are also increasingly popular among Asians and Asian Americans (presumably to fill the Western mold of beauty). In Thailand, cosmetic surgery is so common -- and affordable -- that there are surgery clinics conveniently based in malls, where shoppers can walk up to request anything from a chemical peel to a nose job. Operations that shave jawbones to slim the face are also in demand throughout Southeast Asia. And the Wall Street Journal recently reported that an increasing number of women in South Korea are slimming down their legs by having muscle surgically removed from their calves despite risks to their future mobility.

By the same token, plastic surgery is increasingly accepted in the United States. The ASPS reports over a million operations performed by board-certified doctors in 1999 alone. Blepharoplasty was the third most popular form of plastic surgery among women nationwide, with liposuction and breast augmentation as the leading two. While Asian Americans comprise four percent of total plastic surgeries, including cosmetic and reconstructive, most surgeons agree that they most commonly request eyelid surgery.

Dr. Paul Weiss, who has been practicing general plastic surgery in Manhattan for the past 25 years, believes that the increasing popularity of plastic surgery among Asians – and non-Asians – can be attributed to a greater acceptance of cosmetic surgery. "There’s a great deal of media attention to procedures people years ago didn’t think were available, and the exposure has been an impetus," he says. Dr. Weiss does emphasize there is a distinct procedure for surgeons working with Asian eyes, in which experience is a must. The procedure is called anchor blepharoplasty, a technique that a Hawaii-based surgeon has developed over the past three decades.

As with any surgery, the procedure incurs risks of infection, hemorrhaging and scarring. It is also possible that the surgeon may remove too much skin, or – in very rare cases – damage the optic nerve and cause blindness. But more often, the risks involve aesthetics gone awry. In unskilled hands, eyelid folds may be appear asymmetrical, or placed too high.

"It’s painful to look at when done badly," says Ragaza. "When the crease is cut too perfectly parallel to the edge of the eye, it’s almost a cartoon idealization of what white people look like."

Lia Kim, a high school junior whose eyelids are creaseless, doesn’t believe in taking chances with her eyes. She advises, "You’re born with it. If you’re not, deal with it."

*not his real name
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