99% Invisible - 321- Double Standards

Episode Date: August 29, 2018

Blepharoplasty is often done to lift loose or sagging skin around the upper eyelids caused by aging. But for a lot of people of Asian descent, this surgery is not strictly about aging and more commonly referred to as “double eyelid” surgery. The double eyelid surgery adds a crease -- so instead of the skin of the upper lid running smoothly from the bottom of the eyebrow straight down to the eyelashes, there is now a small indented fold in the skin, just a few millimeters wide, that runs in a horizontal crescent above the lash line. In 2017 alone over 12,500 Asian Americans had double eyelid surgery, and given the racist history behind the procedure, it makes sense that some people in the U.S. are vocally critical about it...but it’s more complicated than that. Double Standards

This is 99% Invisible. I'm Roman Mars. There's a daytime talk show that airs on CBS called The Talk. It's kind of like the view, if you've ever seen that. Five female hosts sitting around a table discussing current events. And when it returned for its fourth season premiere in 2013, they came up with this stunt called Secrets Week. Over the course of the week, each of the five co-hosts took turns revealing one of their deepest, darkest, juiciest secrets.

Because who doesn't love a good secret? That's our newest producer, Vivian Lee. For example, we learned that week that Sharon Osborne had a fling with Jay Leno. Uhhh, that's a state secret. But more interesting was a secret from one of the other co-hosts, Julie Chen. My secret dates back to when I was 25 years old and I was working as a local news reporter in Dayton, Ohio. Now, I want to see.

The way Chen tells it, she'd been paying her dues as a reporter, but what she really dreamed about was becoming an anchor. It's cold out in the field. I wanted to try and get a seat on the anchor desk. But when she approached your news director about the possibility, he gave her some feedback. And he said, because of your heritage, because of your Asian eyes, sometimes I've noticed when you're on camera and you're interviewing someone You look disinterested you look bored because your eyes are Are so heavy. They're so small Uhhh, I hate people

Yeah But Chen who's Chinese American found herself wondering if Maybe he had a point and reached out to a prominent talent agent for some career advice. And he actually took it a step further. He said, I cannot represent you unless you get plastic surgery to make your eyes look bigger. And then Chen admits to the audience that she did it. She got the surgery, a procedure called blepharoplasty. For people who are not of east or southeast Asian descent, blepharoplasty is usually done to lift looser sagging skin around the upper eyelids caused by aging. Just Google Kenny Rogers

before and after 2003. But for a lot of people of Asian descent, this surgery is more commonly referred to as double eyelid surgery. About half of Asians, myself included, are born with what's called a monolid or a single eyelid, which means that there's no visible crease on the eyelid skin above the lash line. This is what Julie Chen had before. The double eyelid surgery adds a crease, so instead of the skin of the upper lid running smoothly from the bottom of the eyebrow, straight down to the eyelashes, there's now a small, indented fold in the skin, just a few millimeters wide that runs in a horizontal crescent above the lash line. This crease suddenly

changes the eye shape in a way that makes the eye itself appear slightly larger. The simplest method doesn't even involve any cuts, just a few stitches along the eyelid to create the crease. Chen got the surgery in the mid-90s, but she kept it hidden from the public up until 2013. In that day, when she tells the audience about it, it was surprising to me to hear her sounding so excited. I want to show you, I want to really demonstrate like what my news headshot looked like before I had this plastic surgery done. I mean, if you look at the after, that the eyes are bigger, I look more alert.

Fabulous. More expressive. More expressive. And listening to that response, Sharon Osborne saying, Fabulous. It's sort of disturbing to me. Double eyelid surgery is one of the most popular procedures for Asian Americans.

And hearing such a positive reaction, it really is no wonder why. The hopes of looking fabulous are more expressive for the same reasons why people in my own family have had the procedure done themselves. And this ethnically specific surgery may have its roots in Asia, but it wasn't Asian doctors who popularized it. It was popularized by a white guy from the US who thought he was doing Asian people a

favor by helping them look less Asian. But before we get to him, the origin of double eyelid surgery itself dates back much further to 19th century Japan. Beauty standards will always vary from culture to culture and even within the same culture over time. Double eyelids are seen as a beauty preference for a lot of Asians and Asian Americans today, but that wasn't always the case. There's actually little to no record of double eyelids as an aesthetic preference until something called the Meiji Restoration.

Before the 1860s, Japan practiced a policy of isolationism and limited their contact with other nations. But during the Meiji Restoration, which took place from the 1860s through the early 1900s, Japan opened up. It began incorporating a European-style banking system, new kinds of scientific technology and western-style clothing. It was also around this time that the first double eyelid surgery was performed by a Japanese surgeon.

It's easy to find like woodcut images or pictures of, say, 1880s, 1890s of a limited number of Japanese female patients having eye changes. This is John Demoya, a professor of medical history at Seoul National University. He says that as Japan's contact with Western nations increased, so did an appreciation for double eyelids over monolids. And this seems to be the case

with a lot of Asian countries. Particularly places in Asia, where there was a heavy contact either with the British Empire or with the broader, you know, Jews the word American Empire. These tend to be places where blood for a plastic has tended to pop up. It's these moments where Asian countries begin developing relationships with Western empires. That double eyelid surgery becomes more visible. Made you Japan, definitely South Vietnam.

There was lots of plastic surgery going on prior to enduring the Vietnam War and post-Creature War. But while Blufferoplasty may have already existed in Asia here and there, it didn't really take off in popularity until the Korean War. In Korea, United Nations troops push on and the clashes advance against the communists. The Korean War is technically still ongoing, but the actual fighting between northern and southern forces lasted from 1950 to 1953.

By the time the armistice was signed, dividing the peninsula into north and south Korea, the impact of the war had left South Korea pretty reliant on help from western nations. What happened, obviously, created a certain path dependency in the sense that much of the aid was coming from Western countries. This came in the form of food, construction, and importantly medical aid, which is how an American doctor named David Ralph Malard ended up in South Korea. He's a military doctor. He doesn't arrive until Korea until the war is winding down

or just after. Malar had graduated from both Harvard and Yale, then served in the Navy before settling on reconstructive surgery as a specialization. He studied under Harold Gilley's, the father of modern plastic surgery, who was known for repairing the bodies and faces of World War I and World War II soldiers named in battle. I don't know if the word I don't want to say normalcy, but he wants to restore some sense of a face that actually resembles a human face.

Malard was stationed in Seoul in 1954, where he served as chief plastic surgeon for the United States Marine Corps. It was his job to provide reconstructive medical assistance to those suffering from disfigurement caused by war, burns, or simply by lack of medical access. Malard was a fan of old West films. He'd grown up writing horses and learning to tie knots and spinning ropes, and idealizing manly western stars like Ken Maynard and Buck Jones.

He ended up bringing this kind of cowboy- good guy savior mentality to his work in some strange and very literal ways. He first became well known for doing cleft palate surgeries on children. In his autobiography, which he titled Saving Faces, he tells the story of his first cleft palate patient in South Korea. Malard had been looking for someone to test a new method on, but he was having a hard time finding a willing subject. When he couldn't find a volunteer, he decided to rustle up one himself.

This is before institutional review board exists. He's largely self-authorized. Milard bragged that he spotted a 10-year-old South Korean boy with a cleft lip, and ran back to grab a lasso that he kept in his footlocker. Yes, you heard that correctly. Malar brought a lasso over 6,000 miles to South Korea. I do not like where this is heading. He lassoed the 10-year-old and performed the surgery on him. And in case you were wondering, no, he did not have parental permission to do this. Backing away historically, probably today,

he could not do many of the things that he did, where someone else looking in and actually reviewing his work from professional standpoint. As crude and horrifying as Mlard's methods could be, his work in cleft palate repair did get him respect in the field of reconstructive surgery. But he would soon become famous, or maybe infamous, for another procedure entirely. Bluffer a Plasty. Or with the double eyelid surgery. Malard was the first documented surgeon to perform this procedure in South Korea. On a translator, he covered this in an essay that he wrote about his time overseas called

Oriental Paragrenations, meaning Oriental Journeys. He depicts a Korean male translator who is coming to him because he wants to look different than he looks." Malard recounts, quote, A slantide Korean interpreter, speaking excellent English, came in requesting to be made into a round eye. Unquote. The interpreter then tells Malard that his translation work relies on his relationships

with Americans. So Malard writes, quote, He felt that because of the squint in his slant eyes, Americans could not tell what he was thinking, and consequently, did not trust him. As this was partly true, I consented, unquote. Which sounds familiar. It's basically the same feedback that Julie Chan got 40 years later, that people couldn't read her expressions and audiences wouldn't relate to her.

The stereotype of the inscrutable Asian has a long history in Western countries. It paints people from Asian nations as perpetual foreigners who are just too different to assimilate. In Milar's article, he shows dramatic before and after pictures of the translator, and it's clear that he thought the work he was doing was more than just cosmetic. The caption, I can't remember the exact words, but he says something like, now he is frequently mistaken for Italian or Spanish. Milar goes on to say that the translator, his face totally transformed now in European

looking, plans to go to the United States to study for the ministry. So I mean, this is where people get angry at Malar, not only, you know, whatever his ethics are in terms of the medical stuff, but the cultural assumptions where he thinks he can completely transform this man's life and his body through the act of surgery. Over the course of his year in South Korea, Malar continued performing bluffer aplastion others, specifically South Korean sex trade workers who were trying to appeal to American GI's. He described a woman's desire for eyelid surgery to be for economic reasons.

To Milar's Blufferoplasty offered a solution to a cultural disconnect between East and West. But it was only those with Asian features who were expected to change their bodies. With the population of East Asians growing in the United States, Mlard speculated that double eyelid surgery might be useful at home in the US, too. GIs were bringing home Japanese and Korean brides, and Mlard thought that plastic surgeons could help them integrate into American society. He definitely saw himself and liked to see himself as an advocate of the surgery. I don't think he could possibly, though, have anticipated how it would get picked up in different ways.

According to the American Society of Plastic Surgery, more than 12,000 Asian Americans had double eyelid surgery in 2017. The procedure has become completely normal for both women and men. And given the racist history behind the procedure, it makes sense that some people in the US are vocally critical about it. Who says, look, eyelid surgery is fake, it's anti-Asian, you're erasing ethnic markers. So it's not so much about necessarily just a droopy eye, it's also about wanting to look more Caucasian.

Chen's story has prompted a backlash. Some critics accused her of selling out. Others claimed she had other stuff. But not everybody buys this narrative of selling out. The Western media pretty much consistently has a pitting or condescending attitude about how Asians view plastic surgery. This is Uni Hong, a journalist and author of the Birth of Korean Cool. She says the reaction to Julie Chen's double eyelid surgery was a perfect example of this condescending attitude. People were accusing her of being ashamed of her race,

of being ashamed of having Asian eyes, and I was kind of gobsmacked by this, because again, a person's body should be their business. Haul and can speak from personal experience because she's had the surgery done herself. She says it was no big deal. The procedure doesn't take very long at all and might even be something like 20 minutes. Haul says that the stigma around double eyelid surgery is distinctly American. The American media tends to assume that Asians are getting plastic surgery to look Caucasian,

and in a multicultural society like the US, where racism is a daily reality, it could be hard for us not to interpret people's motivations through that lens. But Hong says the attitudes about plastic surgery are different in South Korea where blepharopl plastic was first popularized. While the procedure might have originated with the desire to look more Western, that isn't necessarily why South Korean people get it anymore. The history of double eyelid surgery might have been motivated in kind of racial hegemony or something like that, wanted to impose Western beauty standards on Asians,

but as with a lot of things, including cuisine and art, it can have a certain origin, but it always gets adapt and then localized, and Koreans have completely taken the ball and run with it. The surgery has taken on a new meaning. Now we are really focused on making beauty, instead of making Western faces. This is so young Lee Im, a scholar of South Korean plastic surgery at Seoul National University.

She says South Koreans aren't looking to have their eyes change for the same reasons they did back in the 1950s when Malar was around. Today, they're aspiring to their own uniquely South Korean standard of beauty, which has been shaped by complex cultural factors. In the late 1990s, South Korea suffered through a financial crisis and the International Monetary Fund, or IMF, stepped

in and completely restructured and modernized the economy. The country has since recovered and is now the 11th largest economy in the world, but the job market has become so competitive that getting a job can still be incredibly hard. People do whatever they can to compete. So your appearance is one of your resource. So you have to kind of develop your appearance to have a better job and better future or better partner. And the South Korean government has also fully embraced and encouraged the plastic surgery industry. There is governmental effort to promote Korean plastic surgery industry. There is governmental effort to promote Korean plastic surgery industry.

So, plastic surgery, as well as Korean culture, has been kind of a national income source for the Korean government. The South Korean government has lifted a ban on medical advertising and revised immigration rules to make it easier for foreign patients to get long-term medical visas. And now medical tourism makes up a huge portion of the plastic surgery industry. People come from all over the world to have worked on in South Korea. And of course, many South Koreans get plastic surgery too.

Allied surgery is still the most popular procedure. It's so common that a lot of young people in South Korea will get the surgery as soon as they're old enough to. It's like a gift when you graduate high school. Before you go to the college, it's kind of a, it comes with a laptop, gift set. This is GEO, a photographer who spent time documenting the healing process of South Korean plastic surgery patients. She's witnessed many of the recent trends

in Korean beauty culture affecting both women and men. So basically, you have to have a chip somewhat baby-looking face, which is lighter skin, and very big eyes, narrow and high nose. And Yo says that many people also want a sharp narrow chin. The overall effect they go for isn't necessarily Caucasian. It's almost pixie-ish. You definitely have to have a very sharp V line chin

with no jaw line, with very straight narrow jaw lines. So they tend to cut out those bones. To achieve this complete look requires a lot more than double eyelid surgery, which is fairly easy and low risk. jaw reduction surgery is much more invasive and dangerous. Of course, any surgery has its risks, but this one involves slicing out a significant amount of jaw bone, and could lead to complications like nerve damage or chronic jaw pain. One in five South Korean women have gotten some form of plastic surgery done.

And if you look at women ages 19 to 29, that number shoots up to one in three. Yo says women face such immense cultural pressure to conform physically that it can be hard to resist. You should fight for your own beauty, you shouldn't follow the idealized beauty, you shouldn't be scrutinized by the culture, but it is so hard to fight and it is so much easier and peaceful to be part of the culture. But as critical as you feel about some aspects of the plastic surgery culture in South Korea, she does wish that the rest of the world would just stop being so judgey. Because whether you're a Korean woman trying to meet your culture's exacting beauty standards, or an Asian American woman like Julie Chen, weighing the choice between changing your appearance

or hobbling your career prospects. You're basically damned if you do, damned if you don't. The art of making metal facial prosthetics for soldiers injured during World War I. After this. So we talked a little bit about how war accelerated the development of medical fields, like reconstructive and cosmetic surgery. It also drove the growth of prosthetics, a field at the intersection of medicine and art and design, and 99PI producer Vivian Lee is back to talk a little bit more about that field. Like with reconstructed surgery, the development of prosthetics really advanced during World War I, but specifically a branch of medicine called an aplastology, which deals with customized prosthetic pieces for people with missing

or malformed parts of the body, especially for the face. World War I was a really rough time to be a soldier because technology like the machine gun and the tank had advanced to make killing people and injuring people so much more effective. Yeah, you hit the nail right on the head. And given the nature of trench warfare, soldiers would need to pop their heads out of these trenches

to fire off rounds or to advance, making their faces vulnerable. So this made facial injuries really common, but it was also this moment in history where medical treatment was starting to get a lot better, which is good, but you also had men suffering from terrible head wounds and then surviving. So you have a lot of soldiers

that are literally getting shot in the face, but they could now survive. It's really horrifying in and of itself, but it also made it hard for soldiers to come home and have a normal life with their new disfigurement. Exactly. And reconstructive surgery was still in the beginning stages, so you had things like skin grafts, but there really was nothing you could do in terms of plastic surgery for someone who had, you know, their jaw taken off or a gaping hole where their eye used to be. So anaplastology picked up in an aesthetic way where reconstructive surgery left off. And this is a really interesting intersection between art and medicine.

Right. So you need to be able to recreate a human face, which takes a lot of artistic talent, and that's where artists like Anna Coleman-Lad came in. She was an American sculptor who lived in Boston at the time. A lot of her pre-World War I artwork involved making like the bounding nymph and happy baby sculptures that you'd find in the mountains. And she founded something called the studio for portrait masks in France, which made facial masks for veterans with severe injuries to the face.

So how did an artist from Boston go on to found this studio in France with this really lofty mission? She moved to France with her husband because he was a doctor with the American Red Cross. And while she was there, she read about this other sculptor in London who was making these facial pieces for veterans. So she got funding from the Red Cross to do something similar in France. That's so cool. So what type of work goes into making a mask like this? Each mask would take about a month to make. Lad would base each look off of pictures of veterans before their injuries to try to match as closely as possible with they looked like originally. And the process involved taking a plaster cast of their faces

and then she'd shape the mask itself out of a thin sheet of galvanized copper. And these could weigh up to half a pound depending on how large the injury was. And they were held to the face, usually using string or wire. Sometimes they would use eyeglasses to keep them on if they wanted eye glasses.

And so these things are made of metal. Yeah, copper. That's amazing. It seems like it takes a lot of creative interpretation to make the right type of mask at a metal. Right, yeah, and that's what made these specifically so special because she would have to hand paint each of the masks directly on their faces to make sure that their skin tones match. And matching the skin tone is especially tricky because when you're outside, the hue of

your skin will change depending if you're in the sun or if you're in the shade. So she would basically need to split the difference between the two colors to make sure it wasn't extreme in either condition. And she'd also either use real human hair or slivered tinfoil to create the eyebrows or a mustache if they wanted it. And my favorite detail that she would do is, if the mask had to cover the mouth of the recipient, she would leave a gap in the lips just wide enough for a cigarette to be put in. I guess at that point, smoke up, just enjoy life. I'm not going to police your life at that point.

So did they do anything? The mass they really were just cosmetic. Yeah, they're only cosmetic. They didn't have any functional purpose. You couldn't chew food or see again. But for someone who had already suffered a massive facial injury, they could really meet a lot. I'm sure at that, It's such interesting work.

I mean, in the pictures, are really stunning. Yeah, and it's hard to describe these because when you think of a half-pound copper mask on someone's face, it probably doesn't sound like it's going to be very realistic, but there's this video of lad fitting these masks on veterans, and it's amazing how transformative they are once you see them in motion. And you can see for yourself on a video that we have up on the website it's at 99pi.org. Thanks, Viv. Thank you. 99% invisible was produced this week by Vivian Lee, mixed in tech production by Sheree Fusef,

music by Sean Rihal. Katie Mingle is our senior producer. Kurt Colestead is the digital director. The rest of the team is senior editor Delaney Hall, Avery Trollfman, Joe Rosenberg, Emmett Fitzgerald, Terran Mazza, and me Roman Mars. We are a project of 91.7 KLW in San Francisco and produced on Radio Row. In beautiful, downtown, Oakland, California. 99% invisible is a proud member of Radio Topia from PRX, a fiercely independent collective of the most innovative shows in all of podcasting. You can find them all at radiotopia.fm.

You can find the show and join discussions about the show on Facebook. You can tweet at me at Roman Mars in the show at 99PI org. We're on Instagram, Tumblr, and Reddit too. But you can get all the tools to decode the secrets of the built world. at 99pi.org you