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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 several thousand dollars. Blepharoplasty and rhinoplasty are among the first procedures that come to mind when thinking about ethnic plastic surgery, and both have charged histories. But this is not the case for other predominantly Asian procedures Kwan performs today, several of which fall under the literally bone-crushing category of “facial contouring.” The first time Kwan broke and rearranged multiple bones in a patient’s face, back in New York, it was by accident. Korea, and also because the eye is particularly salient in medical and cultural discourse as a marker of Asian difference. This relatively simple surgery creates a crease above the eyelid. Caucasians are born with such a double eyelid, whilst plastic surgeons claim that about half of East Asians are born with it, and half are born with a single eyelid. A crucial ethical question surrounding this surgery is whether it aims to “Westernize” or “whiten” East Asians, as critics claim, or whether it is merely a beautification procedure (Kaw 1993). The development of this surgery must be understood in the context of modernization in Asia and geopolitical relationships between Korea and the West. In Japan in the 1930s the operation acquired a cosmetic rationale that evoked modernization. The rounder looking eye created by the surgery became associated with qualities such as “openness” and “individuality” during a period when it was thought desirable for Japan to “open” to the West (Shirakabe 1990, 219). In post-World War II South Korea the eyelid procedure continued to reflect not only modernization ideals, but also Cold War relationships with the West. US plastic surgeon David Ralph Millard (1955) learned about the technique while stationed with the Marines during the Korean War. He recounts how he performed it on a Korean translator who asked for “a round eye” to alleviate suspicion caused by his “slant eyes”. After the surgery, the patient was “mistaken for Mexican or Italian”. Millard noted that female patients also requested to be “Occidentalized in order to be more attractive to the American troops”. As with the North American Jewish nose job, the operation’s goal was passing as another race, but within the political climate of the Cold War. The surgery attempted to familiarize the political creations of war: the untrustworthy “gook” and the racially polluting “war bride” (Kim 2005). Opening the eye ostensibly made the “Oriental” less threatening in a geo-political context of suspicion.7 7 This logic of Westernization, however, began to fade in the early 2000s in Korea as the plastic surgery industry boomed and a new confidence arose in pop culture (Leem 2016a, 2016b, 2017; Holliday and Elfving-Hwang 2012). Until the 1990s, surgeries in Korea still often invoked a white reference point. At that time, large and round eyes with double eyelids were presented as features that distinguished a white face from a Korean one. By the 2000s, however, plastic surgery instead began depicting varieties of “pan-Asian beauty,” all with double eyelids, but without white faces as reference points. As demand for double eyelid surgery rapidly grew in the twenty-first century explicit emulation of white faces was deemed to be an exaggeration, even pathological, as in the caricature, “The Portrait of Gangnam Beauty” 8 . This image is a parody of a well-known, Korean painting, “The Portrait of Beauty,” painted by the Korean genre painter Yoon-Bok Shin in the late-eighteenth to mid-nineteenth centuries. While the original painting represents “traditional” feminine beauty, the modified version satirizes slavish emulation of Western beauty with its depiction of overly large eyes, a long, protruding nose, and an excessively small chin, references to surgical alteration. The term, Seong-hyung-goi-mul (Plastic surgery monster), is a criticism of unharmonious Westernized beauty (Leem 2017). The portrait reflects a shift in plastic surgery discourse towards promoting more naturallooking surgeries that ostensibly enhance beauty, not transform race. The double eyelid also became associated with qualities, such as alertness, sexual openness, and individuality, which were once associated with the West, but became Korean ideals, as beauty culture and consumer society expanded (Leem 2016a). These meanings of the Korean eye are highly gendered. Whereas beauty ideals for women in the past were linked to qualities such as fertility and tranquillity, newer ones reflected the ideal, and obligation, of active sexuality and female autonomy (Holliday and Elfving-Hwang 2012). Men also became more avid consumers of cosmetic surgery in Korea, including eyelid surgery, as more androgynous masculine ideals arose in popular culture. Men’s surgeries were not seen to emulate a Western look, but rather youthful K-pop stars, Korean “flower boys,” boy heroes from Manga, or other Asian models of masculinity (Holliday & ElfvingHwang, 2012; Miyose and Engstrom, 2015; Käng, 2014) However, while plastic surgery has shed some of its association with Westernization, Korean surgeons continue to utilize the race concept in facial surgeries. As in the US, surgeons in South Korea turned to anthropometry to better understand racial anatomy. New technologies, like photometric analysis, allowed surgeons to more precisely measure the Asian eye shape, spacing, and eyelid shape. This anthropometric gaze racialized phenotypic variation in new ways. For one, it revealed more variation in Asian eyes, such as eight sub-varieties of eyelid shape. Surgeons also specified in more detail essential anatomical differences between Asian and white eyes, such as differences in “lateral canthal tilt” (Rhee et al 2012)9 , or qualitative differences in the shape of the eyelid (that is, beyond the presence or absence of a double eyelid). The Asian crease is said to run parallel to the eyelid, while the
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