THEY ARE everywhere. In subway stations, bus stations, on the roads, and even on television and radios. They stealthily exist among our unconsciousness, seep into our daily life and become a part of us. “They” are advertisements for plastic surgery hospitals. The countless advertisements around us display the omnipresence of plastic surgery hospitals in Korea, which in particular, manifests itself especially in areas like Gangnam and Apgujeong. The numerous plastic surgery hospitals not just in these regions, but in Korea as a whole, serve as evidence for an alarming fact published by The Economist: a vast percentage of people in Korea, which is 13.5 out of 1,000 people, have gone through plastic surgery. The most surprising fact, however, is that because of the excessively developed plastic surgery industry in Korea, such operations are being developed even for children. In a relatively short history of plastic surgeries, what kind of implications do pediatric plastic surgery hospitals have, and what are the causes for this social occurrence?

What is pediatric plastic surgery?

   According to the Oxford English Dictionary, plastic surgery is defined as “the process of reconstructing parts of the body by the transfer of tissue, either in the treatment of injury or for cosmetic reasons.” The important fact to note is that, by definition, there are two major reasons why people conduct plastic surgeries. The first reason is for the “treatment of injury,” while the other reason is “for cosmetic reasons.” Although the official definition largely includes these two reasons for conducting plastic surgery, the practice of pediatric plastic surgery in particular was traditionally developed mainly for the first reason – to treat injuries or scars on children. Because of this characteristic, most pediatric plastic surgeries are being practiced in regular hospitals instead of independent plastic surgery hospitals. Those include hospitals specialized in treating noses and ears treatment, or dentists performing dental pediatric plastic surgery, although hospital wings devoted to pediatric plastic surgery are also beginning to appear, such as the recently established Head-shape Clinic at Severance Hospital.

   Then what particular reasons do children have to receive plastic surgery operations to begin with? The majority of the cases are, as mentioned, for the “treatment of injuries,” since several health reasons encourage plastic surgery on children. One of the common abnormalities that encourage children to undergo plastic surgery is un-chung-ee, a condition where the inner lips of the patient are attached to the inside of his mouth. This physical disability disables the normal function of not only the mouth, but potentially other body parts connected to mouth as well, such as the patient’s teeth, chin, and nose. Another common reason people conduct pediatric plastic surgery is for sul-so-dae, best known as the “short tongue” syndrome. It is a condition when the muscle at the bottom of the patient’s tongue is fully attached to the bottom of the mouth, disabling the patient from moving the tongue freely. This syndrome hinders the individual from pronouncing words clearly, and also hinders infants from eating or sucking properly. Of course, physical abnormalities that encourage pediatric plastic surgery are not limited to the above, and can also include fixing parts of the body with inherent abnormalities such as fingers, ears, and chests, or erasing scars or wounds.

The blurry lines of pediatric plastic surgery

   Plastic surgery for the above stated reasons – inherent abnormalities in body functions or disabilities in basic body parts - is necessary, and it would be safe to say that such plastic surgeries are socially justified. This is applicable particularly in children, because natural and inherent abnormalities in body parts can cause a dysfunction in core performances of the body, such as normal metabolism, which make plastic surgeries necessary.

   The problem, however, is that it is unclear whether or not a certain bodily trait contributes to a dysfunction of the body. The reason for this confusion is because the necessary functions of body are often associated with a body’s appealing appearance. In other words, body parts that cannot perform normally tend to be unpleasing to the eye too, like in the case of short-tongue syndrome above. The short tongue syndrome is a characteristic case for such occurrences, since having a short tongue deforms the tongue into an abnormal shape when it is stretched. The abnormality not only disables the infant to suck properly, but it also causes the tongue to look less pleasing to the eye. Like in the example above, a lack of body function usually accompanies lack of beauty, and therefore blurs whether or not a child receiving plastic surgery is receiving it solely to improve normal bodily functions.

   In effect, this unclear boundary opens up the possibility for pediatric plastic surgeries to be used for other, unintended purposes. In other words, although the child may not have an abnormal body function, he or she might eventually undergo pediatric plastic surgery to fix unpleasant-looking body parts. As the morality of whether pediatric plastic surgery should be conducted on children is getting blurred, some parents are actually beginning to seek such surgeries solely for their child’s beauty. For instance, according to SBS news, some parents are beginning to look for ways to make their children’s head shape more pleasing to the eye. Other parents are forcing their children to have double eye-lid surgery, one of the most popular plastic surgery operations conducted for cosmetic reasons, among adults.

   One especially alarming fact is that the craving for beauty in children is already becoming widespread, and hence, it opens up possibilities for plastic surgery to be used for children’s beauty. The prospect of this phenomenon is especially worrisome in Korea, where the love for beauty itself is already a socially widespread pursuit. One of the fields where this thirst for beauty and appearances can be seen is in Korea’s employment fields. In job application forms for Korean firms, it is considered normal to attach a candidate’s personal photograph. In some European countries and the United States, however, attaching a personal photograph to a job application form is not always the norm. In fact, if the candidate believes that he or she has been disadvantaged through the photograph requirement, he can even sue the company. An article by Jodi Kantor (Reporter, New York Times) also displays the significance of appearances in Korean society. In her article A Look at Korean Culture from the Bathhouse, Kantor criticises Korean society for its persistence in lookism. Kantor claimed that Korea’s numerous cosmetics, advertisements for plastic surgery hospitals, and popular diet television programs are all parts of the lookism that persists in Korean society. Much to people’s unconsciousness, however, the persistence of lookism in the contemporary Korea also started to encourage an industry of plastic surgery. The plastic surgery fever in Korea has now gone so far as to inventing terms like “employment plastic surgery,” which is a term used to describe someone receiving plastic surgery to gain an advantage in the job market. Kwak Eun-young (Director, I Love Petit Plastic Surgery Hospital) claimed that “it has now become possible for patients to have their confidence level enhanced by plastic surgery, thereby enabling them to become more active participants in the job market, marriage and at schools.”

What now?

   True to Kwak’s words, Koreans are now living in an era of plastic surgeries as a result of widespread lookism and constant emphasis on the importance of appearances. What is alarming to note is that this lookism and the consequential popularity for plastic surgery is now even occurring among children. To begin with, the pursuit of beauty among children is, at most times, manifested as a replication of the form of beauty among adults. One of the biggest demonstrations of this phenomenon is the appearance of child pageants. The term pageant is defined by the Oxford English Dictionary as “a public entertainment consisting of a procession of people in elaborate, colourful costumes, or an outdoor performance of a historical scene.” Applying this idea to children, child pageant is generally understood as a term that stands for competitions among children that are elaborately decorated with adult dresses, cosmetics and jewellery. Although child pageants are not yet widespread in Korea, their worldwide appearance is becoming alarming enough to increase awareness about the direction of the pursuit of beauty among children, even in Korea. In the French Vogue magazine in 2010, for instance, the photograph of a ten-year-old girl named Thylane Loubry Blondeau was published, portraying her in colourful adult-like dresses and ornate decorations designed for adult women. One of her photos even displayed her half-nude. Although the case of Blondeau is an extreme case, it still shows that the attention for child beauty is increasing. The pursuit of beauty among children is shown as gradually imitating that of adults, and it is worrisome that the efforts to reach such kind of beauty may be through the means of plastic surgery.

         Especially in the United States or Europe, beauty contests for children like “Living Dolls” and “Toddlers and Tiaras,” dress and decorate children in an adult-like manner and are already gaining much popularity and fame. With children appearing in these shows as “mini-adults,” the dangers of them adopting the same beauty standards as adults cannot be neglected. It is especially alarming because some evidences carefully suggest that adult-like children are more prone to be exposed to crimes. One example that demonstrates such a case is that of JonBenet Ramsey in the United States, in 1996. Ramsey was a popular six-year-old child pageant. She mysteriously died, however, at the age of six, with the suspect yet unknown. Police investigations point that she had been sexually molested and was then strangled to death. The death and sexual abuse of one of the most famous child pageants raised awareness about applying the same state of beauty to children.

   It has been almost 20 years since the death of Ramsey, and over the last two decades, medical technology advancements has now made it possible to treat children with plastic surgeries. However, as aforementioned, the purpose of plastic surgeries is becoming more focused in beauty in a world where the standard of beauty for children is becoming uncannily deformed to imitate that of adults. Therefore, the development and possibilities of plastic surgery highlights the need to be cautious when judging whether plastic surgeries should be used on children as a means to reach beauty, and not just for reconstructive purposes.

The history of plastic surgery

   Unlike the increasing tendency to use plastic surgery for aesthetic reasons today, plastic surgery was not originally developed for such purposes.

1. The creation of plastic surgery traces as far back in history as BC800 in India. At the time, major criminals were punished by having their nose cut off, which meant their social life could never be the same. They had to live the rest of their lives with practically everyone knowing that the person in question has committed a major crime. These criminals were some of the first subjects of plastic surgery.

Soon after its birth, the essence of plastic surgery changed with history.

2: Plastic surgery was used in the 15th century to cure syphilis, a sexual disease that causes the nose to “melt”.

3: During the World War, plastic surgery was mostly used to treat scars and injuries of soldiers in the warfare.

Plastic surgery was introduced into Korea during the Korean War.

4: Plastic surgery was introduced in Korea when American soldiers started conducting the surgery for medical purposes. In post-war period, “charlatan surgeons” better known as “dol-pal-ee” began conducting aesthetic plastic surgeries to people, even though they do not have professional medical knowledge.

5: In June 1961, Doctor Yoo Jae-duck, who received a degree in plastic surgery in the United States, began lecturing plastic surgery courses at university level in Korea.

6: The Korean Ministry of Health and Social Affairs began conducting qualification examinations for plastic surgeons from 1975, and professionally trained surgeons were starting to get produced.

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 There is only a slight difference between “necessity” and “desire,” and it is often extremely difficult to differentiate between the two powerful longings. In this perspective, the case of pediatric plastic surgery is perhaps one that causes confusion between necessity and desire. Pediatric plastic surgery has most definitely been invented because of necessary reasons, yet there is a vital step that the society should take. Society must clarify the line of appropriateness of pediatric plastic surgery, and we, as part of the society, must be cautious to remember the danger of misusing pediatric plastic surgery to fulfil inappropriate purposes of adults and the society.