Based on reports in the popular media glorifying cosmetic surgery attitudes in East Asia, it has come to be assumed that the South Korean population has the highest rate of going under the knife in pursuit of beauty, a presumption that has" fed on itself" and generated everything from envy to criticism to undue cultural stereotyping.
So, is this correct? And if it is, how true and to what extent?
Our analysis (see chart below) of the latest raw data from the International Society of Aesthetic Plastic Surgery not only confirms that South Korea is indeed the country with the world's highest per capita rate of cosmetic plastic surgery, but it also provides an easy means for accurately determining and comparing such rates in most countries.
At the same time, it dispels as a myth an equally popular notion.
• Raw Data: Previous statistics compiled by the ISAPS in years past have been of limited value since the totals were badly skewed by the number of member plastic surgeons reporting data from each country. Countries where larger numbers of member surgeons chose to submit data appeared to have much higher rates of surgery than countries with smaller numbers of participating member surgeons.
This and related major procedural flaws are now addressed by improved methodology and extrapolation to include input from, essentially, all of a country's board-certified (or the national equivalent) plastic surgeons. Cosmetic surgery performed by non-plastic surgeons was not included.
The statistics for 2009, while not perfect, are thus the most comprehensive that have ever been compiled on international plastic surgery trends.
Interpretation of statistical data by the ISAPS, however, was minimal.
• Our Analysis: Due to the absence of detailed demographic profiles, our calculations to determine per capita rates were kept deliberately simple. We took the total number of reported invasive surgical procedures reported by the ISAPS (excludes non-invasive procedures like BOTOX and filler injections) and divided that by the most reliable total population estimates for each country posted on Wikipedia for year 2009.
In terms of total number of plastic surgical procedures performed, the United States headed the list of Top 25 Countries at just over 1.3 million operations. That number was then divided by the country's population of just over 309,000,000 to yield a value of 0.0042.
In other words, 42 out of every 10,000 people of all ages (children, teens, young adults, middle aged, elderly) in the entire United States underwent an invasive cosmetic surgical procedure in year 2009. Obviously, most cosmetic procedures are performed on young and middle aged adults rather than on children, teens, and the elderly, but this data was not provided.
To simplify terminology, we defined PP10K as an easier way of signifying "procedures per ten thousand people of all ages per year." The United States population thus had a PP10K value of 42.
PP10K values were determined for East Asian countries and several other countries with the highest volumes of plastic surgery. While China ranked third in the world for total number of surgical procedures performed at 1.22 million and the highest in Asia by far, that high total divided by its 2009 population of 1.322 billion people yielded a PP10K of 0.0009, or an approximate per capita rate of 9 (meaning only 9 people out of 10,000 per year).
Note that since some people underwent multiple major procedures during the year (for instance, eyelid surgery and rhinoplasty), some would be counted more than once and so PP10K provides only a close approximation of "per capita" data. Operations performed on medical tourists traveling from outside the country are also included. While detailed data on multiple procedures or percentage of medical tourists was not provided by the ISAPS, it would be expected to be fairly similar in most countries. Despite such limitations, the PP10K still provides a useful metric to allow for meaningful country-to-country comparisons.
• Results: Here are the PP10K rates of plastic surgery for the largest providers of cosmetic care in East and Southeast Asia as well as for a few other major players in the world:
Asian Plastic Surgery Guide's
Highest Plastic Surgery
Rates for 2009
PP10K = procedures per 10,000 people of all ages per year
• To compare rates between any two countries, simply divide their PP10K values.
For example, people in South Korea undergo invasive plastic surgery at a rate 1.7 times higher than people in Taiwan, 1.8 times higher than people in the United States, 2.3 times higher than people in Japan, and 8.2 times higher than people in China.
So, yes, South Koreans do indulge in more plastic surgery than people in other countries.
But, what about all those sensational stories stating that every other woman in South Korea has undergone serious cosmetic work?
The statistics here don't begin to substantiate such claims.
"More" doesn't equate with "all," even though the numerical values would certainly be much higher than 74 in 10,000 if one considered only young adults in the center of Seoul (as would also be the case for Los Angeles, Rio, Shanghai, and other cosmetic surgery "hotspots").
Note that while South Korea takes the prize for having the world's highest PP10K, it is easily surpassed by several much larger countries in total number of plastic surgery operations performed in 2009.