The Japanese children undergoing plastic surgery

This article originally appeared on VICE Asia

Micchi, 9 years old, does not remember going under the knife. Instead, she only remembers the countless conversations with her mother about her husband’s wages.

In the months leading up to the big procedure earlier this year, they talked about what kind of double eyelids she wanted. Did she go for the less invasive and more subtle surgery? Or did she choose the more expensive option where a surgeon has to cut into the folds of her eyelids to update the skin’s laxity?

Her mother Rucchi encouraged her to choose the other. If her daughter was going to do that, she would have to go all out, Rucchi thought. At her request, we are not using their real names in this piece because she is afraid of negative reactions.

Rucchi posts these conversations between mother and daughter on her YouTube channel. She also uploaded a video of her daughter’s surgery, which shows the girl crying and having a panic attack.

The video, which has also been shared widely on TikTok, has since received quite a bit of criticism from people on the internet. Many wonder how such a young girl – who is clearly in pain – could get plastic surgery, even with her mother’s permission.

But Micchi is part of a generation of young people who, many years before they become adults, often undergo plastic surgery voluntarily.

In 2021, a Japanese clinic found that 9 out of 10 teenage respondents wanted plastic surgery to correct their insecurities, up from 7 out of 10 just two years ago. Many young people in other parts of the world have done the same. In the United States, more than 220,000 cosmetic procedures are performed annually on patients between the ages of 13 and 19.

Medical experts and governments are concerned about these numbers. Last year, British lawmakers made lip filler procedures, a popular minor surgery or “tweak” among young people, illegal for anyone under 18 to protect children. Opponents warn that younger generations, largely raised on social media, feel pressured to live up to physical ideals of beauty, resulting in psychological – and sometimes physical – harm to minors.

Toru Aso, a cosmetic surgeon in Tokyo, has seen for himself how the number of underage visitors to his clinic has increased in recent years.

In the more than twenty years he has been in practice, he has mainly operated on women in their 20s and 30s. “About ten years ago I had maybe one minor customer a month. Now I have one every day,” he told VICE World News.

For Aso’s patients, eyelid surgery is the most popular procedure, which is also seen nationwide. In 2020, 64 percent of all surgical operations in Japan involved eyelid surgery, also known as blepharoplasty. Although the procedure is relatively safe compared to more physically demanding surgeries like the Brazilian butt lift or liposuction, there are still risks involved, such as blindness or damage to surrounding eye muscles.

In Japan, anyone under the age of 18 can have plastic surgery as long as they have parental consent. But some guardians abuse this law and project their own ideals of beauty onto their children, Aso said. That is why he pays extra attention when minors visit his clinic. “I talk to them individually to see if the child really wants the procedure – sometimes parents drag their children in and try to force them to have plastic surgery,” he said.

Tomohiro Suzuki, professor of child psychology and body image at Tokyo Future University, acknowledges that plastic surgery can have positive effects on the human psyche, such as improved self-esteem.

But if these procedures are performed on minors who are still developing psychologically and physically, they may regret it later, he said. Often they don’t know what their ideal “look” is as they are still growing and some have already gone under the knife several times to achieve their perfect self image.

“Then you go into a cycle where you can’t stop getting plastic surgery,” Sukuzi told VICE World News.

Recent trends in plastic surgery are often associated with the rise of social media.

Research has shown that social networking apps like Instagram or Facebook make people much more aware of how they look to themselves – and to others. These sites also have filters that give people the “perfect” look, for example with higher cheekbones or fuller lips, which can be very different to what people see when they look in the mirror.

Some Japanese surgeons like Aso attribute the popularity of double eyelid surgery in their own country to the influence of Western, and mostly white, beauty ideals. People of mixed white and Japanese descent have traditionally been used in the Japanese fashion and media industries to portray an aspirational, ideal look. “It’s a face that looks just a little bit alien, with a few unusual features,” Aso said.

But Laura Miller, professor of Japanese studies and anthropology at the University of Missouri in St. Louis, says it is completely wrong to assume that Japanese choose double eyelid surgery to “look whiter”.

In his research on this topic, Miller has never met a Japanese youth who pursued a non-Japanese as an ideal. “Many women think that surgery will help them achieve one more kawaii look like popular Japanese models and entertainers,” she told VICE World News in an email.

While actors and singers originally set the ideals of beauty for a certain generation, social media has spawned a new breed of celebrity with just as much power: influencers.

This is how Nonoka Sakurai, Rie in reality, became known as an influential plastic surgeon. She had wanted plastic surgery since she was eight because she was bullied by her peers throughout her school career for having large nostrils that “made her look like a gorilla.” At 18, she had a rhinoplasty as her first procedure.

After 10 years and 25 million yen (17.0340 euros) in surgeries, Nonoka says she feels much more confident about her appearance. “I was insecure because I wasn’t popular with the guys at school,” she told VICE World News.

She realized she was unpopular because she was ugly, she said. The solution was to adjust her face. “Thanks to plastic surgery, I can walk around proudly and with my head held high.” Now a full-time plastic surgery influencer, she runs a women’s bar where customers hang out and chat with attractive waitresses.

But cashing in on her looks isn’t always as pretty as the self-love story the 33-year-old reads to her followers.

As plastic surgery becomes more widely accepted, there are also many more trends than simple double eyelid surgery to keep track of, she said. “People tell me my face is dated.”

Sometimes such comments come from anonymous profiles on the Internet. But sometimes they come from customers at her bar who tell her they like her face from five more surgeries ago, she said.

Keeping up with the constant rotation of trends can also be physically exhausting for Nonoka. Cartilage is added somewhere, only to be taken out a few months later. Silicones are injected everywhere. The anesthesia and anesthesia after surgery can be so painful, she says, that sometimes she wishes she were dead.

But she won’t stop until she finds someone who can tell her she’s the most beautiful person in the world, she said.

Rucchi, the mother who pushed her daughter to get plastic surgery, had never aspired to be the most beautiful of all.

But growing up with a younger sister and a mother who both had double eyelids, Rucchi always felt she was treated differently. She remembers her sister always getting compliments and sweets from the neighbors while she was empty-handed. “My sister was always loved by everyone, much more than me,” she said.

When Rucchi turned 18, she had surgery on her tonsil eyes. Now a mother of five – three boys and two girls – she says she’ll do her best to help her daughters grow up without insecurities, even if it means pushing them into plastic surgery.

“I’ve never seen a girl with almond eyes that I thought was beautiful,” she said. The same is not true for her sons, because according to her, society is more likely to accept ugly boys as long as they are successful and smart.

When Micchi turns 18, her mother wants her to have a nose job. Maybe also breast implants, she said.

“She’s still growing, so we don’t know how big they’ll be yet. But if she was worried they were too small, I’d make her do it,” she said.

As far as Rucchi is concerned, anything is possible.

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