Story highlights One in five Korean women from 19 to 49 have had plastic surgery, 2009 survey says

The older generation may push those younger to have work done

The majority of surgeries are considered "Westernizing" procedures

"Dr. Youn, my daughter is so ugly."

A Korean mother in her 50s sits before me in the exam room, her teenage daughter next to her.

"You need to fix her ugly nose, open up her eyes and give her a double fold of her eyelids," the woman says.

"Okay," I look at her daughter. "Jane, what do you think? Is this something you want?"

Jane stares at the floor, unmoving. Then she speaks, eyes still looking downward.

Dr. Anthony Youn

"I guess. Whatever my mom says."

Plastic surgery is hot in Asia. One in five South Korean women from 19 to 49 have undergone cosmetic surgery, according to a 2009 survey from market-research firm Trend Monitor . That's reportedly compared to about one in 20 in the United States.

Although the United States and Brazil are the top two countries in sheer number of plastic surgeries performed, China and Japan are numbers three and four, according to the International Society for Aesthetic Plastic Surgeons . South Korea, with a population of almost 49 million, is ranked seventh.

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Asian culture has embraced cosmetic surgery. Unlike in the United States, it's no longer considered taboo to admit to having been nipped and tucked, even among celebrities. Miss South Korea 2012 confessed to having gone under the knife, revealing, "I never said I was born beautiful."

Interestingly, I find that the older generation often pushes younger people to have work done. I've met several Korean parents in their 50s and older like Jane's mom who have no qualms about encouraging their children to undergo plastic surgery. They even poke and prod at their kids' faces to suggest how a surgeon should improve their looks.

The majority of facial cosmetic operations performed on Asians are considered "Westernizing" procedures. Two of the most popular, nose jobs (rhinoplasty) and eyelid lifts (blepharoplasty), are specially designed to make these features look more Caucasian.

Asians generally have wider and flatter noses. Asian rhinoplasty narrows the nose and makes it project more, similar to a European look. Asian blepharoplasty creates an extra fold in the upper eyelid. While present in nearly all Caucasians, this extra fold occurs naturally in only 15% of East Asians.

While Asian plastic surgeons claim that these procedures are meant to retain their patients' ethnicities and make them generally more attractive, I don't buy it. To put it bluntly: Facial plastic surgery on Asians is about making a person look as Caucasian as possible.

And that's a disturbing thought.

Full disclosure: As a young plastic surgeon, I trained in these types of procedures. I even performed a handful of them in my early practice. As a hungry young surgeon, I had no qualms about performing operations such as double eyelid surgery. The ethics of whether these procedures were right or wrong never really crossed my mind.

And then a string of events caused me to reconsider whether I should continue to perform these operations. Are these surgeries really the right thing for patients? For society?

First, I encountered Jane and her mother.

Then, I received a request from a mom to perform an Asian eyelid surgery on her son. "He really wants the surgery done," the mother said. "He wants to look handsome." Then I found out her son was only 8.

And I had a daughter. The most beautiful girl I've ever seen -- perfect in every way. She looks just like her mother, except for one feature that she's inherited from her daddy.

She has no fold of her upper eyelids.

And I hope she never feels the need to change that.