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He was worried, and I felt bad because he’s just a bus driver, not like he’s a high-powered CEO or something. But he said, ‘I want to look more awake so I don’t lose my job,’ and I said, ‘Okay, let’s do it.’ ” Lee’s Asian blepharoplasties cost in the neighborhood of $2,500. He has since seen that patient driving his bus in the neighborhood. He says he looked alert. But even if the idea of ethnic plastic surgery makes you queasy—even if plastic surgery, in general, makes you depressed—the more you talk to people who have actually undergone these procedures, the harder it becomes to view their choices as simple racial capitulations. (Still, I think I’ll skip that blepharoplasty Kwan recommended.) With Jamaican ancestry, a British upbringing, and a career that includes fashion journalism.. sign of ethnic self-loathing but proof that the loud-andproud club of American narcissists has admitted a new set of members—and with them new ideas of what qualifies as beautiful. The people I interviewed differed in their aesthetics, politics, and medical preferences. But they passionately agreed on one thing: No matter what white people say, this isn’t about them. Plastic surgery doesn’t have to be a sign of deference to some master race, they told me. In fact, it could be the opposite. So why won’t outsiders take them at their word? The most obvious answer is history. The first known Asian eyelid surgery was performed in 1896 in Japan, to create symmetry in a woman born with one creased eyelid and one monolid. Thirty years later, it had reached the States. “Changes Racial Features: Young Japanese Wins American Bride by Resort to Plastic Surgery,” the New York Times announced, in 1926, of a man named Shima Kito who fell in love with a white woman named Mildred. She agreed to marry him only after he “cut the eye corners so that the slant eye so characteristic of the Japanese race was gone. He lowered the skin and flesh of the nose so that the upturned trait disappeared, and he tightened the pendulous lower lip.” Then he changed his name to William White and got engaged to Mildred. The modern history of double-eyelid surgery is short enough that it can be told through the careers of two linked men—Edmund Kwan, the man who thinks my eyes need work, and his mentor, Dr. Robert Flowers, a white surgeon who began performing the operation in the 1960s. Growing up in Fairfield County, Dr. Kwan heard about family friends who had their eyelids and noses “done.” In medical school he gravitated first to surgery, then plastic surgery, thinking he’d one day serve Asian clientele. But in 1994, after training at Georgetown, Cornell, and Johns Hopkins’s renowned facial-trauma surgery unit, he still hadn’t performed a single Asian blepharoplasty. (Anti-aging eye lifts are also called blepharoplasties; the scars are similar but the procedures distinct.) Though the operation was known among Asians, and would grow more so in the decades ahead, it was less known in the general population, and thus in the corridors of medical schools and teaching hospitals. So Kwan moved to Hawaii to apprentice under Flowers. Flowers’s technique, which requires sedation and an incision between the lashline and brow, is still predominant. Flowers, who was raised in Tuscaloosa, Alabama, was a military surgeon when he first arrived in Hawaii in 1960. “I got over there just when we were stirring up a little mischief in Southeast Asia,” he said through a southern drawl in a recent phone interview. An amateur artist, he found himself “fascinated by the Asian face! I think there was only one Asian family in the State of Alabama back then. When I got to Hawaii, it was so interesting and alien. I would draw pictures of what I considered to be lovely Asian faces and eyes, sketching and so forth. Sometimes a boyfriend would come up and I would get into a bit of trouble, just looking at and sketching Asian eyes,” he said with a laugh. “Everybody was a Flower,” Kwan reminisces of those days. “Bob was truly an innovator. He didn’t go to Hawaii with the intent of operating on Asian patients. He opened his practice and, just by the population out there, a lot of his patients were Asian.” “The general idea then—and I keep hearing it even today—was that Asians who have facial and eyelid surgery want to ‘Westernize,’ ” says Flowers. “And that’s even what Asian plastic surgeons thought they were doing then as well. But that’s not what Asians want. They want to be beautiful Asians.” Flowers advocated subtler surgeries, pointing out that naturally creased Asian eyelids—which he estimates occur in perhaps half of Asians—are not the same as Caucasian lids. Compared with Asian eyes, the white eye is more deeply set and the crease tends to run more parallel to the lashline. Asian creases may be narrow or nonexistent at the inner eye—the goopy pink corner may be covered by downward-angled skin called an epicanthic fold—but flared up at the outer edge, creating an overall tilted eye shape. Not that everyone understood or appreciated the subtlety, particularly at the beginning. “I would say, ‘Wow, those are big eyelid folds,’ ” Kwan says of meeting patients who had undergone earlier, cruder blepharoplasties. He grabs his own eyebrows and yanks them halfway to his hairline so that he resembles a startled cartoon character. “The patients from further back had high eyelid folds, but I noticed the lids were getting smaller and smaller over the years.” Noticing how Asians’ shallower brows and noses deemphasized the “beautiful Asian lid folds,” Flowers began recommending brow-lifts and nose jobs to get the desired effect. Kwan uses the term “ethnic nose” to describe a category of low-lying noses common to Asians, African-Americans, and Hispanics. “Caucasians usually have a high bridge, so their nose jobs are called ‘reduction rhinoplasty and shaping.’ We remove some bone, narrowing it and smoothing it out and making the tip a nicer shape,” he explains. With “ethnic noses,” “the bridge is flat and we have to add something,” usually a hard silicone implant or cartilage grafted from the ear, rib, or septum. Similar implants can raise the profile of a sloping forehead or weak chin and cost
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